Impact of a Harm-Reduction Policy on HIV and Hepatitis C Virus Transmission Among Drug Users: Recent French Data—The ANRS-Coquelicot Study

Abstract

In France a harm-reduction policy was implemented in the late 1980s with the aim of reducing the prevalence of HIV and hepatitis C virus (HCV) infection among drug users. The ANRS-Coquelicot survey was designed to measure the prevalence of HIV and HCV infection among drug users and to examine determinants of at-risk behaviors. In 2002, information was collected from 166 drug users recruited in all types of services specializing in drug use intervention and harm reduction in Marseille, France. Self-reported HIV and HCV serostatus was compared with the results of serological tests done on capillary blood collected on filter paper. The self-reported and biologically documented prevalence rates of HIV infection were identical (22%). In contrast, the self-reported prevalence of HCV infection was 52%, whereas the biologically documented prevalence was 73%. Overall, 30% of HCV-infected drug users were unaware of their status. Forty-four percent of drug users under 30 years of age were HCV seropositive, suggesting that they had been infected early during drug use. The harm-reduction policy seems to have had a marked impact on HIV transmission among drug users but a much more limited impact on HCV transmission. The limitations and implications of the study are discussed.

The changing epidemiology of hepatitis C virus infection in Europe

“…needleexchange and methadone substitution programs) decreased both incidence and prevalence of HCV among IDUs during the 1990s, their impact has been small in most countries [127,129,[137][138][139]. Indeed, with a few exceptions [140], HCV transmission among IDUs remains uncontrolled, with prevalence increasing among young IDUs, and incidence rates ranging between 11 and 42 per 100 person/years [120,132,141,142].…”

“…Prevalences over 60% are very common (the highest prevalence, >80%, corresponding to countries from the former Soviet Union). Prevalences below 40% have been reported in some regions of Belgium, Greece and the UK, as well as in Austria, the Czech Republic, Cyprus, Finland, Hungary, Malta, the Netherlands and Slovenia [123,[128][129][130][131][132].…”

Estado del Arte sobre el diseño, análisis y evaluación de Políticas de Reducción de Daño por Consumo de Sustancias Psicoactivas, en Europa y América entre 2003 a 2013

“…Desde hace varios años, el consumo de SPA se convirtió en un problema de salud pública (Becoña, 2002), no sólo por las consecuencias de su uso a nivel físico y mental, sino también por sus efectos a nivel social Del énfasis en la disminución del uso de SPA, a la necesidad de evitar la propagación de dichas enfermedades (Castaño, G., 2002;Jauffret-Roustide et al, 2006). Esta situación de salud pública sumada a la evaluación de las estrategias implementadas, fue llamada el fracaso de la "guerra contra las drogas" 1 (Translational Institute, 2008).…”

Trajectoires de vie et prises de risques chez les femmes usagères de drogues

“…Le premier registre concerne les rapports sexuels qui peuvent se produire au sein du couple avec plus ou moins de contrainte. [12]. Ces résultats devront être confirmés par une analyse plus approfondie aussi bien des données quantitatives que qualitatives.…”