More HIV testing for drug users poor use of funds

By David Douglas

NEW YORK (Reuters Health) - Most injection drug users in the US have undergone HIV testing, and expensive efforts to increase testing do not appear to be a worthwhile investment, investigators report in the American Journal of Public Health

The clearest implication of the study findings, lead researcher Dr. Robert Heimer told Reuters Health, "is that expanding testing as a means to prevent HIV transmissions among urban drug injectors in the US is not a sensible allocation of resources."

The conclusion is based on a study conducted by Heimer, of Yale University School of Medicine, New Haven, Connecticut, and colleagues, of 1543 injection drug users from five US cities.

Ninety-three percent had undergone HIV testing. Ninety percent of those who were told they were not HIV positive said that they had been tested within the previous 3 years.

Women were more likely to have been tested than men (95.5 versus 91.8 percent) and those in needle exchange programs were significantly more likely to have been tested than those who were not (96.1 versus 91.8 percent).

Using these data, the researchers estimate that the number of injection drug users in the US who have not undergone HIV testing is less than 40,000.

Heimer concluded that instead of being used for expanding HIV testing, "scarce prevention dollars should be spent on proven measures such as syringe exchange and substitution therapy for opiate addiction, as well as secondary prevention for HIV-positive injectors" that stresses entering and staying in drug rehab programs and adherence to HIV treatment.

SOURCE: American Journal of Public Health, January 2007.