Home Page of the DPNA Website Learn about the Drug Prevention Network of the Americas, its history, principles, members, supporters, and board Looking for information about drug prevention?  Check out our web page links, books, presentations, position papers, and brochures Want to connect with national, regional or international drug prevention sites?  Visit our extensive Links section. Keep up with the latest drug prevention news and events. Ready to become a part of the Drug Prevention Network of the Americas?  Sign up on line.



WWW
DPNA News and Updates
Drug Research
Opinions
Drug Effects
Drug Information
Drug Trends
Best Practices
Drug Legalization
Drug Policy
Books and Guides
Brochures
Courses
Presentations
Funding Sources
 


HIV incidence was 75 percent higher among daily users of Vancouver ís needle exchange program (NEP) than among drug abusers that did not use the program, according to a new study published in the latest edition of the American Journal of Medicine.  Vancouver , Canada boasts the largest NEP in the Western Hemisphere

 

Frequent Needle Exchange Use and HIV Incidence in
Vancouver, Canada

American Journal of Medicine
Volume 120, Issue 2, Pages 172-179 (February 2007)

Abstract

Purpose

Opposition to needle exchange programs has been fueled by a Vancouver study showing an association between frequent program use and elevated rates of human immunodeficiency virus (HIV) infection among injection drug users.

Methods

We evaluated possible explanations for the observed association between elevated HIV rates and frequent needle exchange attendance using a prospective observational cohort study of injection drug users in Vancouver , BC , Canada . HIV incidence rates were examined using stratified Kaplan-Meier methods and Cox proportional hazards regression.

Results

Between May 1996 and December 2004, 1035 individuals were recruited. At 48 months after recruitment, the cumulative HIV incidence rate was 18.1% among those reporting daily needle exchange use at baseline, compared with 10.7% among those who did not report this behavior (P <.001). However, comparing HIV incidence among daily versus nondaily exchange users, while stratifying the cohort into those who did (23.2% vs 16.8%; P=.157) and did not (11.4% vs 9.0%; P=.232) report daily cocaine injection at baseline, the association between daily exchange use and HIV incidence was no longer significant. In an adjusted Cox model, daily exchange use was not associated with the time to HIV seroconversion (relative hazard=1.41 [95% confidence interval, 0.95-2.09]).

Conclusions

Differential HIV incidence rates between frequent and nonfrequent needle exchange attendees can be explained by the higher risk profile of daily attendees. Causal factors, including the high rates of cocaine injection and other local injection drug user characteristics, explain the Vancouver HIV outbreak.

References

a British Columbia Centre for Excellence in HIV/AIDS, St. Paul ís Hospital, Vancouver , BC , Canada

b Department of Medicine, University of British Columbia , Vancouver

c Department of Health Care and Epidemiology, University of British Columbia , Vancouver

d Department of Family and Preventive Medicine, University of California , San Diego .

Requests for reprints should be addressed to Evan Wood, PhD, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver , BC V6Z 1Y6 , Canada .

PII: S0002-9343(06)00279-8

doi:10.1016/j.amjmed.2006.02.030

© 2007 Elsevier Inc. All rights reserved.