Prevention of heterosexual transmission of HIV between and from drug users is important for controlling the local and global HIV heterosexual epidemic. Sex risk reduction interventions and health-related interventions are important for reducing the sex risk behaviors of drug users. Sex risk reduction interventions address individual-level, peer-level, and structural-level determinants of risk reduction. Health-related interventions include HIV counseling and testing, prevention and treatment of sexually transmitted diseases, and delivery of highly active antiretroviral therapy. It is important to adapt effective interventions implemented in resource-rich countries to the realities of the resourceconstrained settings and to address relevant contextual factors.RESUMEN-Il est important de prévenir la transmission hétérosexuelle du VIH à partir des usagers de drogue pour contrôler l'épidémie hétérosexuelle locale et mondiale de VIH. Des interventions ciblant à la fois la réduction de risque sexuel et la santé des usagers de drogue sont nécessaires. Les interventions de réduction de risque sexuel prennent en compte le niveau individuel, le niveau des pairs et celui des déterminants structurels de la réduction des risques. Les interventions visant l'amélioration de la santé comprennent le conseil et le dépistage du VIH, la prévention et le traitement des infections sexuellement transmissibles et la prescription d'antirétroviraux. Il est important d'adapter les interventions efficaces mises en place dans les pays riches aux réalités des contextes de pays à ressources limitées et de tenir compte des facteurs contextuels pertinents. Keywords global research; HIV; injection drug use; research interventions; sexual risk HIV Infection and Injection Drug UsersInjection drug use continues to complicate the control of the global HIV epidemic (UNAIDS, 2004). In 2003, 136 countries reported injecting drug use and 93 countries reported HIV infection among injection drug users (IDUs) (World Health Organization, 2003). IDUs are at risk for infection with HIV through both multiperson use ("sharing") of drug injection equipment and through unsafe sex behaviors (Aceijas et al., 2004). Although the scope and effectiveness of interventions aimed at reducing HIV infection through drug injection equipment has been well documented in the literature (Des Jarlais et al., 2005;Quan et This review describes sex risk reduction interventions with drug users and their effectiveness in reducing sexual risk behaviors of IDUs and other drug users. We highlight the needs and opportunities for these interventions, discuss the generalizability of the results to resourceconstrained settings, and outline the implications for global research efforts and public health practice. Although our literature review is not comprehensive, it highlights many areas that affect sexual transmission of HIV to and from drug users in both resource-rich and resourceconstrained settings. Efforts to reduce substance abuse and HIV risk associated with injection behav...

OBJECTIVES: The potential role of private health care providers and privatization has been under heavy discussion in many countries. In the Hungarian health care, there was a clearly supporting health policy regarding the increasing role of private health care providers. The aim of the study is to analyze the market share of for-profit private sector from the public health insurance expenditures on medical services. METHODS: Data were derived from the nationwide administrative dataset of the National Health Insurance Fund Administration (OEP), the only health care financing agency in Hungary, covering the period 2006-2009. The analysis includes the medical provisions (primary care, health visitors, dental care, out-and inpatient care, home care, kidney dialysis, CT-MRI). We calculated the health insurance reimbursement according to the following categories of health care providers' ownership status: local authorities, central government, for-profit companies and non-profit providers. RESULTS: In 2006 only 15.8% (112.8 billion Hungarian Forint, HUF) of total expenditure for medical services went to for-profit private providers, 53.9% to local authorities, 24.7% to central government and 5.6% to nonprofit sector. For 2009, the market share of private for-profit health care providers increased to 30.9% (222.3 billion HUF), the local authorities had 43.8%, the central government 22.7% and the non-profit sector 2.5% market share. We found the largest increase of private for-profit health care providers in acute (from 0.8% in 2006 to 14.3 in 2009) and chronic care (from 1.1% in 2006 to 20.6% in 2009). CONCLUSIONS: In line with the health policy objectives between 2006-2009, we found a significant increase of private for-profit companies from health insurance financing: they doubled their market share from 15.8% (2006) to 30.9% (2009). This increase was attributed to the "functional" privatization of acute and chronic care hospitals.