This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs.


Table of Contents


FRONT MATTER
EXECUTIVE SUMMARY
INTRODUCTION
PART 1 DIMENSIONS OF THE PROBLEM
1 THE EPIDEMIOLOGY OF HIV AND AIDS
2 THE EPIDEMIOLOGY OF INJECTION DRUG USE
3 NEEDLE EXCHANGE AND BLEACH DISTRIBUTION PROGRAMS IN THE UNITED
STATES
4 COMMUNITY VIEWS
5 THE LEGAL ENVIRONMENT
PART2 THE IMPACT OF NEEDLE EXCHANGE AND BLEACH DISTRIBUTION
PROGRAMS
6 THE EFFECTIVENESS OF BLEACH AS A DISINFECTANT OF INJECTION DRUG
EQUIPMENT
7 THE EFFECTS OF NEEDLE EXCHANGE PROGRAMS
8 DIRECTIONS FOR FUTURE RESEARCH
APPENDIXES
A DESCRIPTION AND REVIEW OF RESEARCH PROJECTS IN THREE CITIES
B PROFESSIONAL ASSOCIATION POSITIONS ON NEEDLE EXCHANGE AND
BLEACH...
C BIOGRAPHICAL SKETCHES
INDEX