HIV in a Post-Needle Exchange City

Background There have been no studies showing that participation in programmes which provide legal access to drug-injection equipment leads to individual-level protection against incident HIV infection. We have compared HIV incidence among injecting drug users participating in syringe-exchange programmes in New York City with that among non-participants.

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Findings HIV incidence among continuing exchange-users in the Syringe Exchange Evaluation was 1·58 per 100 person years at risk (95% CI 0·54, 4·65) and among continuing exchange-users in the Vaccine Preparedness Initiative it was 1·38 per 100 person-years at risk (0·23, 4·57). Incidence among non-users of the exchange in the Vaccine Preparedness Initiative was 5·26 per 100 person-years at risk (2·41, 11·49), and in the NADR cities, 6·23 per 100 person-years at risk (4·4, 8·6). In a pooled-data, multivariate proportional-hazards analysis, not using the exchanges was associated with a hazard ratio of 3·35 (95% CI 1·29, 8·65) for incident HIV infection compared with using the exchanges.

Cassie Rodenberg
Scientific American
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