NCJ Number
214691
Journal
Substance Use & Misuse Volume: 41 Issue: 6-7 Dated: 2006 Pages: 777-813
Date Published
2006
Length
37 pages
Annotation
This paper provides the results of an international review of the evidence on whether needle syringe programs reduce HIV infection among injecting drug users.
Abstract
The results on the effectiveness of international review of needle syringe programs (NSPs) indicate strong evidence that increasing the availability, accessibility, and both the awareness of the imperative to avoid HIV and utilization of sterile injecting equipment by injecting drug users (IDUs) reduces HIV infection substantially. In addition to this principle finding, results indicate that there is no convincing evidence of any major unintended negative consequences and that NSPs are seen as cost effective and have additional and worthwhile benefits apart from reducing HIV infection among IDUs. However, NSPs on their own are not enough to control HIV infection among IDUs. This study represents the first international review of NSPs and the first systematic review to consider the extent to which evidence for NSPs fulfills the Bradford Hill criteria. The Bradford Hill (1965) criteria are usually used to evaluate public health interventions and include: strength of association, replication of findings, temporal sequence, biological plausibility, biological gradient, experimental evidence, specificity of association, coherence of evidence, and reasoning by analogy. The only criteria not met under the Bradford-Hill assessment was the specificity of association, biological gradient, and experimental evidence. Tables, glossary, and references