Model projections on the required coverage of syringe distribution to prevent HIV epidemics among injecting drug users

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Peter VickermanCharlotte Watts

Abstract

Although syringe distribution is effective in preventing HIV transmission among injecting drug users (IDUs), there is little evidence on the required coverage to substantially reduce HIV transmission. A mathematical model is developed to explore the relationship between the endemic HIV prevalence among IDUs and the coverage of syringe distribution. Data from IDU populations in the United Kingdom and Belarus are used to explore the implications of increasing coverage and the effect of changes in other behaviors. Projections suggest that there is a coverage threshold, which, if reached, could lead to substantial decreases in HIV prevalence. The threshold largely depends on the frequency that IDUs inject and (safely) reuse their syringes, and corresponds to less than 4 syringe-sharing events per IDU per month. Other factors, such as the injecting cessation rate and efficacy of syringe cleaning, only have substantial impact near threshold coverage levels. Our results support a policy of increasing the coverage of syringe distribution but highlight the difficulty in producing a universal coverage target. Great public health benefit could be conferred by encouraging the safe reuse of an IDU's own syringes and small stable injecting g...Continue Reading

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Citations

Jan 16, 2007·International Journal of Epidemiology·P VickermanA Judd
Nov 10, 2010·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Bruce R Schackman
Dec 29, 2012·Sexually Transmitted Infections·Sevgi O Aral, Willard Cates
Oct 12, 2007·BMC Public Health·Martin FrisherMatthew Hickman
Jun 17, 2008·American Journal of Public Health·Souradet Y ShawJohn L Wylie
Feb 18, 2016·BMC Public Health·V Anna GyarmathyJózsef Rácz
Mar 4, 2008·The International Journal on Drug Policy·Anya SarangLucy Platt
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Oct 15, 2011·The International Journal on Drug Policy·Mohsen Malekinejad, Mohsen Vazirian
May 24, 2011·The International Journal on Drug Policy·Sophie ArnaudFrançoise Dubois-Arber
Oct 23, 2015·Mathematical Medicine and Biology : a Journal of the IMA·Marc ArtzrouniThierry A Mara
Apr 24, 2009·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Jisoo A KwonDavid P Wilson
Apr 21, 2011·Current Opinion in HIV and AIDS·David P Wilson, Lei Zhang

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