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The global HIV epidemics among people who inject drugs (Inglês)

This publication addresses research questions related to an increase in the levels of access and utilization for four key interventions that have the potential to significantly reduce HIV infections among People Who Inject Drugs (PWID) and their sexual and injecting partners, and hence morbidity and mortality in low and middle-income countries (LMIC). These interventions are drawn from nine consensus interventions that comprise a 'comprehensive package' for PWID. The four interventions are: Needle and Syringe Programs (NSP), Medically Assisted Therapy (MAT), HIV Counseling and Testing (HCT), and Antiretroviral Therapy (ART). The book summarizes the results from several recent reviews of studies related to the effectiveness of the four key interventions in reducing risky behaviors in the context of transmitting or acquiring HIV infection. Overall, the four key interventions have strong effects on the risk of HIV infection among PWID via different pathways, and this determination is included in the documents proposing the comprehensive package of interventions. In order to attain the greatest effect from these interventions, structural issues must be addressed, especially the removal of punitive policies targeting PWID in many countries. The scientific evidence presented here, the public health rationale, and the human rights imperatives are all in accord: we can and must do better for PWID. The available tools are evidence-based, right affirming, and cost effective. What are required now are political will and a global consensus that this critical component of global HIV can no longer be ignored and under-resourced.


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    Baral,Stefan David, Beyrer,Chris, Cleghorn, Farley, Dutta,Arindam, Hader, Shannon, Haworth, Caroline, Oelrichs,Robert, Pretorius, Carel, Semini,Iris, Stanciole,Anderson Eduardo, Wirtz, Andrea

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    Regiões Mundiais,

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  • Nome do documento

    The global HIV epidemics among people who inject drugs

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    men who have sex with men;hiv epidemic;hiv incidence;needle and syringe;infections among adults;harm reduction interventions;number of new infections;quality of life measures;School of Public Health;hiv prevalence;Drug use;sexual risk behavior;injecting behavior;human rights perspective;hiv risk behavior;human rights abuse;body of knowledge;international aid;cost of healthcare;cost of prevention;incidence of hiv;reducing risk behavior;human rights imperative;sterile injection equipment;risk of infection;population at risk;privileges and immunity;networks of people;access to treatment;expansion of coverage;country case study;Human Immunodeficiency Virus;Sexually Transmitted Infection;public health efforts;public health perspective;abstinence from opiates;risky sexual behavior;number of adults;hiv transmission;risky behavior;hiv counseling;mathematical model;Antiretroviral therapies;antiretroviral therapy;cohort study;needle sharing;injecting equipment;sexual practice;drug treatment;sexual partner;substitution therapy;unsafe sex;sexual transmission;negative effect;study including;concentrated epidemics;general population;disease burden;aids response;baseline scenario;global response;condom distribution;community level;injecting practices;sterile syringe;base year;commercial sex;injecting drugs;model result;literature review;viral load;demographic projection;expert opinion;selection bias;ecological study;point estimate;political will;heterosexual transmission;clinical trial;treatment technologies;evaluation study;scientific evidence;social vulnerability;global consensus;policy target;needle exchange;equal share;prevention measures;long-term projection;community intervention;patient management;health effect;behavioral surveillance;criminal activity;legal environment;sexual networks;surveillance datum;mental comorbidity;bacterial infection;intervention district;care service;exchange program;individual level;unsafe injection;high frequency;social marketing;employment status;contaminated needles;effective approach;cumulative effect;hiv morbidity;sensitivity analysis;rehabilitation program;affected country;sexual exposure;non-governmental organization;incremental cost;voluntary counseling;aids program;antenatal clinic;international stakeholders;high-burden countries;insufficient fund;treatment access;epidemiological overview;heavily dependent;Art Program;political support;disproportionate burden;care options;global aids;health systems;global distribution;high-risk population;heroin use;commercial purpose;hiv-positive adults;weighted average;constructive criticism;sexual encounter;drug counseling;individual policy;longer period;global spread;population group;fiscal space;increasing investment;hiv testing;population size;current investment;disease prevalence;antiretroviral treatment;research agenda;behavioral risk;geographic setting;adult population;service coverage;high-risk group;drug injection;cell count;estimate impact;police brutality;epidemiological situation;syringe exchange;longitudinal study;



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