longer, periods during which infected addicts are likely to be spreading the virus to others.
The relatively modest spread of AIDS in Britain, which has a significant IV-drug-using population, is clearly due to the more responsible policies toward the handling of drug addicts. Studies show that the provision of clean needles in Amsterdam and in Birmingham, England has reduced the incidence of AIDS ( Van den Hoek, Van Zadelhof, Goudsmit, & Coutinho, 1986). This has also clearly been true with regard to patients in Europe who were put in methadone maintenance programs ( Tidone, Sileo, Goglio, & Borra, 1987). The cutting of drug-treatment budgets and the closing of such programs in this country has clearly contributed to the magnitude of the AIDS epidemic.
While constituting a difficult social and political problem, prostitution is clearly a central element in the spread of AIDS in Africa, which education alone is unlikely to change. Stringent measures also need to be taken against the failure to screen blood and the re-use of needles and other medical equipment in several developing countries.
We should not underestimate the magnitude of the threat that the AIDS epidemic poses, especially in Africa. However, a strategy for controlling it based on a carefully researched and thorough understanding of the behavioral aspects of the disease offers the potential for drastically limiting its spread, regardless of whether an effective cure or a vaccine is developed in the foreseeable future. If we are capable of overcoming the emotional and political pressures that tend to distort the translation of scientific studies into public policy, then it appears that we have the tools already to minimize the real threat which this disease poses for the world.
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