March 2, 2011
Effectiveness Of Expanding Harm Reduction And Antiretroviral Therapy In A Mixed HIV Epidemic
Effectiveness and cost effectiveness of expanding harm reduction and antiretroviral therapy in a mixed HIV epidemic: a modeling analysis for Ukraine
A new study from Stanford researchers published in PLoS Medicine makes the case that a combination of methadone substitution therapy and anti-retroviral treatment would have the greatest effect on reducing new infections and improving quality of life in a region where HIV is spreading rapidly among intravenous drug users.
"HIV is spreading in Eastern Europe more quickly than in any other part of the world," said Margaret Brandeau, the Coleman F. Fung Professor of Engineering at Stanford University and senior author of the study. "Our study shows that substitution therapy for injection drug users is an inexpensive and effective means of curbing HIV transmission in the region."
With no further intervention, the study predicts that HIV prevalence will reach 67.2 percent in intravenous drug users in 20 years. The authors further show that providing drug-substitution to just 25 percent of intravenous drug users today could lower that figure considerably.
"Not only does drug substitution therapy work, but it is remarkably cost-effective when you consider total costs of treating and caring for a growing HIV-infected community," said lead author Sabina Alistar.
"Providing effective drug substitution therapy and HIV antiretroviral therapy together to the injection-drug-using community protects the entire population "“ it actually prevents more infections in non-drug users than in the drug-using community," said Douglas K. Owens, co-author and a senior investigator at the VA Palo Alto Health Care System and professor of medicine at Stanford University.
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