High rates of HIV infection among injection drug users participating in needle exchange programs in Montreal : Results of a cohort study. Commentary.
Needle exchange programs (NEPs) are designed to prevent human immunodeficiency virus (HIV) transmission among injection drug users.
Although most studies report beneficial effects in terms of behavior modification, a direct assessment of the effectiveness of NEPs in preventing HIV infection has been lacking.
A cohort study was conducted to assess the association between risk behaviors and HIV seroprevalence and seroincidence among injection drug users in Montreal, Canada.
The association between NEP use and HIV infection was examined in three risk assessment scenarios using intensive covariate adjustment for empirical confounders : a cross-sectional analysis of NEP use at entry as a determinant of seroprevalence, a cohort analysis of NEP use at entry as a predictor of subsequent seroconversion, and a nested case-control analysis of NEP participation during follow-up as a predictor of seroconversion.
From September 1988 to January 1995,1,599 subjects were enrolled with a baseline seroprevalence of 10.7%. The mean follow-up period was 21.7 months.
The adjusted odds ratio for HIV seroprevalence in injection drug users reporting recent NEP use was 2.2 (95% confidence interval 1.5-3.2).
In the cohort study, there were 89 incident cases of HIV infection with a cumulative probability of HIV seroconversion of 33% for NEP users and 13% for nonusers (p<0.0001). (...)
Mots-clés Pascal : Programme sanitaire, Echange, Aiguille, Etude cohorte, Prévention, Virus immunodéficience humaine, Lentivirus, Retroviridae, Virus, Séropositivité, Infection, Canada, Amérique du Nord, Amérique, Toxicomanie, Voie intraveineuse, Etude comparative, Incidence, Epidémiologie, Prévalence, Homme, Education santé, Virose
Mots-clés Pascal anglais : Sanitary program, Exchange, Needle, Cohort study, Prevention, Human immunodeficiency virus, Lentivirus, Retroviridae, Virus, Seropositivity, Infection, Canada, North America, America, Drug addiction, Intravenous administration, Comparative study, Incidence, Epidemiology, Prevalence, Human, Health education, Viral disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0074179
Code Inist : 002B05C02D. Création : 14/05/1998.