Impact of a harm-reduction policy on HIV and hepatitis C virus transmission among drug users: recent French data--the ANRS-Coquelicot Study.
In France a harm-reduction policy was implemented in the late 1980s with the aim of reducing the prevalence of HIV and hepatitis C virus (HCV) infection among drug users. The ANRS-Coquelicot survey was designed to measure the prevalence of HIV and HCV infection among drug users and to examine determinants of at-risk behaviors. In 2002, information was collected from 166 drug users recruited in all types of services specializing in drug use intervention and harm reduction in Marseille, France. Self-reported HIV and HCV serostatus was compared with the results of serological tests done on capillary blood collected on filter paper. The self-reported and biologically documented prevalence rates of HIV infection were identical (22%). In contrast, the self-reported prevalence of HCV infection was 52%, whereas the biologically documented prevalence was 73%. Overall, 30% of HCV-infected drug users were unaware of their status. Forty-four percent of drug users under 30 years of age were HCV seropositive, suggesting that they had been infected early during drug use. The harm-reduction policy seems to have had a marked impact on HIV transmission among drug users but a much more limited impact on HCV transmission. The limitations and implications of the study are discussed.
Jauffret-Roustide
M
M
National Institute for Public Health Surveillance, Saint-Maurice, France. m.jauffret@invs.sante.fr
Emmanuelli
J
J
Quaglia
M
M
Barin
F
F
Arduin
P
P
Laporte
A
A
Desenclos
J-C
JC
D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006679:HIV Seropositivity / Q000453:epidemiology / Q000635:transmission*; D040261:Harm Reduction; D006291:Health Policy; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D015819:Substance Abuse, Intravenous; D011795:Surveys and Questionnaires