Systematic Review - Effective Prevention Strategies to Reduce Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) in Intravenous Drug Users in the United States



BACKGROUND: According to the Centers for Disease Control and Prevention (CDC) (2014), over 70% of intravenous drug (IVD) users with Human Immunodeficiency Syndrome (HIV) are also infected with Hepatitis C (HCV). Co-infection of HIV and HCV more than triples the risk of liver disease and death associated with HVC (Lekas et al., 2012). Co-infected patients are difficult to treat as medications are costly and drug regimens may result in adverse drug interactions (Chen, Feeney, & Chung, 2014). This poster explored successful prevention strategies for IVD users that reduce HIV and HCV co-infection. EFFECTIVE PREVENTION STRATEGIES: • Needle exchange programs demonstrated the highest success across all prevention strategies. Des Jarlais et al. (2005) reported a 29% drop in HCV infection and 40% drop in co-infection. Additional studies supported this conclusion in the US (Strathdee & Beyrer, 2015) and throughout the world (Abdul-Quader et al., 2013). • Educational programs on HIV/HCV co-infection reduced the spread of disease (Lambert et al., 2002; Shen et al., 2011). • Counseling to reduce high risk behaviors which increase HIV/HCV co-infection were effective (Higgins et al., 1991; Casadonte, et al, 1990; Calsyn et al. 1992). CONCLUSIONS: • Proven prevention strategies such as needle exchange should be strengthened to reduce HIV/HCV in IVD populations. • Programs that combined strategies (education, needle exchange, counseling, outreach, and referrals) by Joseph et al. (2014) should be adopted as best practice. • Prevention efforts focused on early rapid testing and increased provider education regarding treatment strategies for HIV/ HCV co-infection are necessary. KEY WORDS: Communicable Diseases, Health Promotion KEY MESSAGES 1)Roughly 8% of IV drug users have AIDS, but 70% also have Hepatitis C (HCV). IV drug users can act as “super-spreaders” infecting up to 20 individuals with HCV in two years. 2)New technologies such as point of care testing which identifies Hepatitis C quickly and physician education on treatment of co-morbidity is important. 3)Needle exchange programs are the most effective deterrent. It is a proven solution that should be re-emphasized due to the resilience of the HCV virus with certain syringes.


Cheryl Nelson Theuninck & Melanee Tiura