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National Institute on Drug Abuse -  NIDA NOTES
AIDS Research
Volume 12, Number 2
March/April 1997

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 HIV."


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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