AEGiS-08IAC: HIV prevention strategies and legal sanctions of drug use (DU): methodological approach & preliminary results.

8th International AIDS Conference

Amsterdam, Netherlands — July 19-24, 1992

HIV prevention strategies and legal sanctions of drug use (DU): methodological approach & preliminary results.

Int Conf AIDS 1992 Jul 19-24; 8:We59 (abstract no. WeD 1077)
Brodin M, Serfaty A, Lombrail P, Alfaro C; Department of Public Health, Xavier Bichat School of Medicine, University of Paris, France.

OBJECTIVE: to analyze and compare the time between the 1st reports of AIDS cases related to IDU, and the implementation date of preventive interventions (PI) addressing HIV infection among IDUs as a function of the level of intensity of sanction against DU. MATERIAL &

METHOD: The study examined: 1)epidemiologic data on AIDS in the 12 member states of the EEC, 2)Official documents written in response to AIDS, and 3)National legislation on drug control policy. The time period means between the 1st reports of AIDS cases related to IDU, and the implementation date of PI addressing HIV among IDUs were compared across the countries according to the intensity level of legal sanctions against DU. Three levels were defined depending upon criminal concepts on DU control policy.

RESULTS: Preliminary results are: 1- IDUs AIDS cases were 1st diagnosed in Belgium(Bel) on 6.30.81. in Spain(Sp) on 6.30.82. in Italy(It) on 12.31.83. in France(Fr) & Germany(Ger) on 6.30.84. in the UK on 12.31.84, in The Netherlands(Net) & Portugal(Por) on 6.30.85. in Ireland(Ir) & Luxembourg(Lux) on 6.30.85. in Denmark(Den) & Greece(Gr) on 12.31.86. In 1984, AIDS incidence for an IDU was about 0.0001 for Fr and It. 0.000018 for the UK, and 0.0002 for Sp. Between 1984-90, annual rates were increased by a factor of 127 in It. 104 in Sp. 103 in Fr. and 67.4 in the UK. Between 1985-88, it increased by a factor of 51 in the Net: it remained stable for 1988, 89 and 90 (0.0046-0.0051). 2- PI addressing HIV among IDU were first implemented in The Net. Needle/Syringe exchange (NSE) programs initiated in late 1984, 6 months before the 1st IDU AIDS cases. In the UK, NSE were implemented in April 1987, less than 2&1/2 years after the 1st diagnosed cases related to IDU. On May 13th, 1987, Fr adopted a deregulation for purchasing syringes in pharmacists: 3 years after the 1st diagnosed cases related to IDU. In Sp, syringes availability was not developed: since 1985, syringes were sold at drug stores with containers & condoms for the same price. In It, pharmacists sell syringe with sterilized water. Few syringe dispensing machines were implemented in 1990. 3- The time period mean between the 1st reports of AIDS cases related to IDU, and the implementation date of PI addressing HIV among IDUs is about 39 months for the least repressive countries (Sp. The Net). 50.4 months for the moderate countries (Den, Ger, Ir, It, Por, the UK) and 70 months for the most severe countries (Bel. Fr., Lux).

CONCLUSION: It is observed that countries which are less repressive are more likely to have responded to prevent AIDS among IDUs. This result put forward the need for analyzing other factors, e.g. traditions in coping with IDUs & DU. severity of DU & HIV problem. This conceptual framework is proposed to compare the dynamics of governmental responses in various countries and its determinants. It can have considerable value for future governmental decisions concerning public health policies.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Infections, Syringes, Substance-Related Disorders, Needles, Drug and Narcotic Control, Pharmacists, Incidence, European Union, Greece, Ireland, Portugal, Italy, Spain, Germany, France, Belgium, Netherlands, Luxembourg, Denmark, prevention & control, ICA8
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WeD1077