New York—A report released today by leading scientists finds that access to sterile injecting equipment and opiate substitution treatment is effective in reducing HIV risk behavior and the spread of HIV among injecting drug users (IDUs).

The International Harm Reduction Development Program (IHRD) of the Open Society Institute hailed the report as validating years of trying to bring treatment to drug users.

"This comprehensive scientific review confirms what many programs know from experience—that harm reduction works," said IHRD Director Kasia Malinowska-Sempruch.  "Needle exchange, substitution treatment, and outreach to drug users can help stop HIV not only in wealthy nations, but also in countries in Asia and the former Soviet Union where injection drives the HIV epidemic."

The report, prepared by scientists at the National Academy of Sciences Institute of Medicine (IOM)—the leading U.S. provider of authoritative information on health and science policy—evaluates potential HIV prevention measures in "high risk" countries in Asia and the former Soviet Union where injecting drug use accounts for a significant percentage of HIV cases.

The IOM report stresses that access to sterile injecting equipment reduces needle sharing and other risky behavior, and that substitution treatment with methadone or buprenorphine reduces an individual's risk of HIV.

The report concludes by calling on governments to take immediate action to curb HIV among IDUs.

The result of an exhaustive literature review and testimony by experts from over 13 countries, the report also highlights the chilling effect of repressive drug laws on HIV prevention efforts across the globe:

• In China, authorities have sharply increased opiate substitution treatment in the past year and a half, and have funded needle and syringe exchange programs. Yet policies promoting the arrest and incarceration of drug users have made drug users reluctant to access HIV prevention services.
• In Thailand, an official "war on drugs" has resulted in the incarceration of large numbers of IDUs, hastening the spread of HIV in prisons where risk behaviors continue but prevention services and drug treatment are often unavailable.
• In Russia, methadone maintenance therapy—one of the best-studied and most effective forms of drug treatment and HIV prevention—remains illegal, and most needle and syringe exchange programs reach only 1 to 5 percent of the IDUs in their region.  The IOM study found that many Russian IDUs avoid drug treatment and HIV testing for fear that they will be registered as drug users and face discrimination. 

Outside Africa, UNAIDS estimates that nearly one in three HIV infections is due to injecting drug use. Yet HIV prevention services reach only 5 percent of the world's injection drug users.

"The evidence base is clear," said Malinowska-Sempruch.  "The challenge will be for countries to turn science into practice.  We cannot afford to wait."

The full report, Preventing HIV Infection among Injecting Drug Users in High Risk Countries: An Assessment of the Evidence, can be found on the National Academies Press website at http://newton.nap.edu/catalog/11731.html.

The International Harm Reduction Development Program (IHRD), part of Open Society Institute's Public Health program, works to reduce HIV and other harms related to injecting drug use, and to press for policies that reduce stigmatization of illicit drug users and protect their human rights.  IHRD has supported more than 200 programs in Central and Eastern Europe, the former Soviet Union, and Asia.