Abstract

PIP: 40% of Thailand's intravenous drug users and 50% of the heterosexual intravenous drug users in New York have AIDS. Association of intravenous drug use with AIDS is rarely reported in Third World countries probably because there has not been adequate surveillance in those countries. The spread of HIV infection is extremely rapid among intravenous drug users because of the high frequency of injection and the sharing of needles. Drug users usually draw some blood into the syringe in order to be sure that they have injected all of the drug before passing on the needle. In US shooting galleries a disposable needle may be used as many as 50 times. Drug users also transmit AIDS through heterosexual intercourse. In New York City 1/2 of the street prostitutes who were drug users were HIV-positive. In Thailand there are estimated to be 80,000 intravenous drug users. Both prostitutes and drug users are educable. Family Health International developed a training module for peer group education among prostitutes. Campaigns that focus on getting drug users to stop have not been successful, but outreach programs teaching them how to sterilize needles with household bleach are effective, as are sterile needle exchange programs, such as those used in Amsterdam, Sydney, New York City, and Tacoma, Washington. In Thailand the prevention and control of HIV among intravenous drug users has become the number 1 priority in the national AIDS prevention program.