New York: Australia's early and widespread use of clean-needle programs seems to have kept HIV rates among injection-drug users in check over the long term, according to a study.
In 1986, several years after HIV and AIDS came to widespread attention, Australia set up publicly funded programs to provide injection-drug users with clean needles and syringes, an attempt to prevent needle sharing and head off an epidemic of HIV, the virus that causes AIDS, among drug users.
In many countries, needle exchange programs allow drug users to trade in used needles for new ones, but in Australia users are simply given new ones.
Libby Topp, at the National Center in HIV Epidemiology and Clinical Research in Darlinghurst, Australia, and other researchers found that between 1995 and 2009, the rate of HIV among participants in Australia's needle programs held steady at around 1 percent.
According to the study, reported in the journal AIDS, the pattern of infections also mirrored what is seen in the general Australian population -- that is, the majority were among gay and bisexual men.
"There has never been a significant, generalized outbreak of HIV among people who inject drugs in this country," Topp said.
"What our results show is that in a country where needle and syringe programs were introduced early and on a widespread basis, HIV transmission never became a problem among injectors."
Topp told Reuters Health in an email that, based on other research, the 1 percent HIV rate is true of all injection-drug users in Australia, and not only those who use the needle and syringe programs.
By contrast, an estimated 16 percent of injection-drug users in the United States are living with HIV, while in Russia that figure is 37 percent.
Clean-needle and needle-exchange programs have always been controversial, with opponents arguing that they sustain people's additions and sent the wrong message about drug use.
Advocates of the programs, including many public-health and HIV experts, point to studies showing that needle and syringe programs can cut HIV transmission -- such as a 2004 review by the World Health Organization (WHO) that concluded there is "compelling evidence" the programs reduce HIV infection.
In 2009, the United States repealed a ban on federal funding for needle programs, though some cities have long had their own programs.
"Every time an injector infected with HIV shares contaminated equipment with another person, there is a chance that they will pass on their infection," Topp said. "Clearly then, every injection undertaken with clean equipment completely prevents that transmission risk. So it is never too late to establish needle and syringe programs.
In the United States, people infected with HIV through injection-drug use accounted for 19 percent of the 1.1 million U.S. citizens living with HIV in 2006, according to the Centers for Disease Control and Prevention (CDC).
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