Reducing the risk of sexual HIV transmission by injecting drug users (IDUs) is important for controlling the HIV epidemic among all drug users and for controlling the larger epidemic. Over the past few years, several qualitative and meta-analyses reviews have been published. Most of these reviews involved numerous studies conducted in resource-rich countries, while a few covered the smaller number of studies undertaken in resource-constrained countries. In order to make greater strides in controlling the HIV epidemic, we assessed the generalisability of the results of the major studies and reviews for use in developing programmes in resource-constrained countries. We also discuss the implications for global research efforts and public health practice. The reviews show that IDUs in both resource-rich and resource-constrained countries have changed their sexual risk behaviours, reflecting rational and altruistic responses to a major health threat. Findings show that IDUs changed their sexual risk behaviour to avoid becoming infected with HIV and to avoid transmitting HIV to their sexual partners. Although the risk-reduction effect is moderate, it is important to implement programmes to reduce the sexual risk behaviour of IDUs in all countries. Providing evidence-based interventions is ethically responsible compared to providing no interventions. As interventions are implemented in different settings, it is important to bear in mind that stigmatisation of HIV/AIDS, or drug or condom use may limit an intervention’s effectiveness. There is a need for research on adapting interventions to different cultural or national settings, and to develop and evaluate new interventions that may produce greater reductions in sexual risk behaviours.
Interventions to reduce the sexual risk behaviour of injecting drug users
International Journal of Drug Policy, 16 (Suppl 1), S58-S66. doi: 10.1016/j.drugpo.2005.02.005.