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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


Injection drug users (IDUs) play a key role in the continuing epidemics of HIV and other blood-borne infections, primarily viral hepatitis. Addressing the role that IDUs play in these epidemics is a challenge because it necessitates coordinated action on two of our most complex public health problems- AIDS and drug addiction.

In the past, prevention planners, public health agencies, community organizations, and providers tended to focus on one aspect or another of the problem: improving the quality of substance abuse treatment, encouraging HIV prevention education efforts, or helping IDUs who continue to inject to obtain sterile syringes.

Preventing Blood-borne Infections Among Injection Drug Users: A Comprehensive Approach takes a different tack, one that many in the prevention arena recognize and are acting on. No one provider or approach can do it all. To help IDUs reduce their sexual and drug-use risks of transmission, communities and organizations must embrace a broad approach that incorporates a variety of pragmatic strategies addressing IDUs' differing life circumstances, cultures and languages, behaviors, and readiness to change. This technical assistance document describes eight complementary strategies that, together, can make a real difference for HIV prevention for IDUs.

Services and interventions for IDUs don't take place in a vacuum, however. They are carried out within a complex, often contentious social, political, and legal environment. Potential partners in the effort to reduce infection among IDUs may not agree on every thing, but they do need to find ways to work together so that a critical mass of IDUs can obtain sufficient, high-quality services.

A Comprehensive Approach discusses this environment and lays out some principles that can help community groups, agencies, and providers begin- or continue- to collaborate.

The challenges are substantial, but so are the rewards, for reducing infections among IDUs will translate into a substantial public health benefit for the whole community. We hope this document will help move the field in that direction by providing new ways of thinking about this problem and about IDUs and by encouraging dialogue, collaboration, and constructive action.

Helene Gayle, MD, MPH
National Center for HIV,STD, and TB Prevention
Centers for Disease Control and Prevention
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