Current and Emerging Research Needs in Studying the NYC HIV–Drug Use Epidemic

Abstract

As we begin the fourth decade of the epidemic, it is clear that, as demonstrated by the articles in this Special Issue, much has been learned about factors contributing to the decline in HIV prevalence among drug users in New York. However, there are a number of outstanding research questions that remain or are emerging. Following is a summary of some of the topics requiring further research. While this summary does not represent a comprehensive list, it is based on many of the questions raised in the articles in this Special Issue and identifies some of the directions to be investigated during the next decade.

Combined HIV Prevention, the New York City Condom Distribution Program, and the Evolution of Safer Sex Behavior Among Persons Who Inject Drugs in New York City

“…11 Syringe exchange programs were implemented on a large scale in the mid-1990s 12–15 and over-the-counter sales of needles and syringes to drug users was authorized in 2001. 16,17 Highly active antiretroviral treatment for HIV was implemented for PWID in the late 1990s/early 2000s 18 and led to a substantial reduction in deaths from AIDS among PWID in the city. 19–22 …”

The HIV and Drug Abuse Prevention Research Ethics Training Institute

“…The evolving nature of the HIV pandemic, dynamic shifts in drug use patterns, criminalization of drug use, and other HIV risk behaviors, along with the use of new technologies and other rapid advances in treatment and prevention, create continuously changing ethical challenges for HIV research involving people who use and abuse drugs and other vulnerable populations (Loue & Pike, 2010). Advocates for the human rights of drug users and international organizations championing the rights of vulnerable populations affected by the HIV pandemic have found common cause in urging investigators, funders, and ethics review committees to give greater attention to the development of HIV prevention research ethics policies and practices that are sensitive to the discrimination, stigmatization, police harassment, and social marginalization experienced by persons who use drugs (Centers for Disease Control and Prevention [CDC], 2013; Deren et al, 2011; Des Jarlais et al, 2013; Fisher, 2004; Joint United Nations Programme on HIV/AIDS [UNAIDS], 2013). Addressing such challenges requires investigators with both knowledge of and ability to generate empirical data that can enhance practices and policies directed at protecting the rights and welfare of participants in HIV/drug abuse prevention studies.…”