From the very beginning of the human immunodeficiency virus (HIV) epidemic in the United States it was apparent that two major populations were affected: gay and bisexual men and injecting drug users (IDUs). Educational efforts aimed at behavioral change to reduce acquisition and transmission of the virus were considered the first line of defense. Such efforts had considerable impact in the gay and bisexual community, resulting in reductions in risk behaviors.1 However, many clinicians held the belief that behavioral change would be difficult, if not impossible, in the population of IDUs.2,3
There have been several indications that positive lifestyle changes and improved medical outcomes in IDUs can occur. It has been demonstrated that IDUs enrolled in a methadone program can receive primary care with high levels of attendance and compliance with medical regimens,4 and similar compliance rates with IDUs have been achieved in general medical settings.5,6
Wartenberg AA. 'Into Whatever Houses I Enter'HIV and Injecting Drug Use. JAMA. 1994;271(2):151–152. doi:10.1001/jama.1994.03510260083034
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