Programs That Protect Drug-Users from HIV Also Help General Population

Samuel R. Friedman PhD Institute of Infectious Disease Research National Development and Research Institutes, Inc. New York, NY Department of Epidemiology Johns Hopkins Bloomberg School of Public Health, Baltimore, MDMedicalResearch.com Interview with:
Samuel R. Friedman PhD
Institute of Infectious Disease Research
National Development and Research Institutes, Inc. Ny, NY
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD

MedicalResearch.com: What are the main findings of the study?

Dr. Friedman: The main finding is that programs that helped protect people who inject drugs from HIV and those that helped them to get medical care seem to be associated with less HIV disease and less death related to HIV disease among the heterosexual population of large United States metropolitan areas.

This is important.  Drug users in the US are widely despised, and their has been a lot of political opposition to programs like syringe exchange and drug abuse treatment. Our findings show that these programs are associated with better health and less death in the broader population.  It makes more sense to help people–even those you despise–stay uninfected, and to get medical care, than to restrict or attack programs for them.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Friedman: We had expected to find similar results for programs for men who have sex with men.  We are not sure why we did not do so.  More research on this is needed.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Friedman: This study is more oriented to public health than to clinical practice. However, I think that physicians and patients should learn from this that programs that protect the health of one group of people from an infectious disease can benefit other groups of people.  Thus, instead of thinking in terms of “me and mine,” it is useful to think in terms of how helping other groups also benefits everyone.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Friedman: Most research on HIV/AIDS has been “siloed” in that it focuses on one key population or another. Thus, much of it has been about programs and epidemiology among men who have sex with men, or among people who inject drugs, or among heterosexuals.  This research shows that we need to conduct research about how the epidemics among, and programs directed to, one key population affect other key populations.

Such research should be conducted at multiple levels of analysis. Thus, more research is needed at metropolitan area, network, and individual levels into HIV bridging across key populations and how interventions in one key population affect HIV epidemics in other key populations.

Citation:

Do metropolitan HIV epidemic histories and programs for people who inject drugs and men who have sex with men predict AIDS incidence and mortality among heterosexuals?

Samuel R. Friedman, Brooke S. West, Barbara Tempalski, Cory M. Morton, Charles M. Cleland, Don C. Des Jarlais, H. Irene Hall, Hannah L.F. Cooper

Annals of Epidemiology – 27 January 2014 (10.1016/j.annepidem.2014.01.008)

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