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U.S. Department of Health and Human Services

Archival Content: 1999-2005

A Comprehensive Approach:
Preventing Blood-Borne Infections Among Injection Drug Users

Chapter 2: Key Ideas

  • The problems associated with infection with blood-borne pathogens among IDUs require a comprehensive, multifaceted approach.

  • A comprehensive approach rests on cross-cutting principles that guide the ways that interventions are planned and carried out.

  • A comprehensive approach incorporates a range of strategies that take into account IDUs' differing life circumstances, cultures and languages, behaviors, and readiness to change.

  • Assessing current services and programs, in light of legal, social, and political environment and available resources, can help communities plan and carry out a comprehensive approach.

The AIDS epidemic and the public health importance of other blood-borne illnesses, primarily hepatitis B and hepatitis C, have introduced a new dimension to the issue of injection drug use and increased the urgency of finding effective and appropriate interventions for IDUs. Numerous studies have examined issues related to the nature of addiction, the reasons why individuals begin and continue to use addictive drugs, and the factors that help them change their behaviors so as to stop using drugs. Despite this growing body of scientific knowledge, many myths, negative stereotypes, and biases persist about drug users and their lives, the health and safety risks they take, and their ability to overcome addiction. These stereotypes and beliefs pro foundly influence the service, policy, and legal environment affecting IDUs and the scope and quality of health and social services provided to them (Friedman, 1998). They also constrain efforts to reduce the spread of blood-borne pathogens among IDUs and achieve the nation's ultimate goal, which is to substantially reduce or even eliminate drug use. To design and deliver effective interventions for IDUs, prevention providers, program staff, and policy makers must better understand the lives and issues faced by IDUs, address the biases they and society have toward this population, and work to ameliorate the stigma caused by such biases. They must also explore ways to surmount the profound differences in philosophy and approach that exist among various types of providers and that all too often hinder collaboration and limit effective solutions.

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