Target Groups for 3 Preventing AIDS Among Intravenous Drug Users
Don C. Des Jarlais Samuel R. Friedman New York State Division of Substance Abuse Services and Narcotic and Drug Research, Inc.
With the continuing difficulties in developing either effective treatment or a vaccine for AIDS, there has been increasing emphasis on trying to prevent infections through behavior change of persons at risk for human immunodeficiency virus (HIV) infection. The response of IV drug users to the threat of AIDS will be critical to the future spread of HIV in the U.S. Intravenous drug users are the second largest group of persons to have developed AIDS and the primary source of heterosexual and perinatal transmission in the United States. There is a commmon stereotype of the "drug addict" in the United States that hinders AIDS prevention efforts in two ways. Like all stereotypes, it is frequently an inaccurate image of the actual behavior of persons addicted to either heroin or cocaine (and more frequently inaccurate for persons injecting these drugs without being addicted), and it does not present the variety of different subgroups among persons injecting illicit drugs. AIDS prevention strategies will be facilitated through targeting different subgroups of IV drug users and designing specific strategies for those different groups.
In this chapter, we will identify different target groups of IV drug users for AIDS prevention efforts; present available evidence about behavior change in these groups; and then briefly discuss how to prevent transmission of HIV to heterosexual partners who are not themselves IV drug users, and to the children of IV drug users.