Volume 12, Number 2
Other Drug-Use Paraphernalia Besides Needles May Increase
HIV Infection Risk
Educating injecting drug users (IDUs) to reduce their risks of HIV transmission
by using clean needles and by switching to other drug use practices may
be communicating only part of the message necessary to effectively change
high-risk behaviors, according to a NIDA-funded study.
The study is among the first to show that drug paraphernalia other than
needles and syringes also may place IDUs at increased risk of HIV infection,
according to Drs. Paul Shapshak, Syed Shah, and Clyde B. McCoy of the University
of Miami and their colleagues, who conducted the study. The researchers
detected evidence of the AIDS-causing virus in injection paraphernalia found
in Miami "shooting galleries," where drugs regularly are injected
and traded, often in exchange for sex. Their evidence indicates that using
contaminated water for rinsing needles, cotton swabs for filtering drug
solutions, and "cookers" such as spoons or bottle caps for dissolving
drugs possibly may be responsible for transmitting the AIDS virus.
The researchers used HIV's distinctive genetic structure, its DNA, as
a marker to detect its presence in the injection paraphernalia. They found
evidence of HIV DNA in up to 85 percent of contaminated needles collected
from shooting galleries and in up to 36 percent of cotton swabs, 54 percent
of cookers, and 67 percent of rinse water samples.
AIDS prevention efforts targeting IDUs have focused on encouraging them
to clean their needles or to not swap needles, points out Dr. McCoy. This
strategy implies that using clean needles eliminates the risk of HIV transmission
when that may not be true, he warns.
"These drug users need to understand that all of the paraphernalia-the
rinse water, cottons, cookers-are potential vehicles for transmission of
Shah, S.M.; Shapshak, P.; Rivers, J.E.; Stewart, R.V.; Weatherby, N.L.;
Xin, K.-Q.; Page, J.B.; Chitwood, D.D.; Mash, D.C.; Vlahov, D.; and McCoy,
C.B. Detection of HIV-1 DNA in needle/syringes, paraphernalia, and washes
from shooting galleries in Miami: A preliminary report. Journal of Acquired
Immune Deficiency Syndromes 11(3):301-306, 1996.
From NIDA NOTES, March/April 1997
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