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September 8, 1989

Intravenous Drug Users and Human Immunodeficiency Virus Testing and Counseling

JAMA. 1989;262(10):1331. doi:10.1001/jama.1989.03430100065027

To the Editor.—  Curtis et al1 present evidence that voluntary human immunodeficiency virus antibody testing and counseling for intravenous (IV) drug users is a desirable addition to methadone maintenance treatment programs. However, we are concerned by the authors' conclusion that "in the current year 89.8% of our sample reported no needle sharing, which certainly would argue against a plan to give clean needles or bleach."The needle-sharing potential of clients who relapse after methadone maintenance therapy and those currently in treatment is high. Clients in treatment represent only 15% of the estimated 1.1 to 1.3 million IV drug abusers in this country, 70% to 90% of whom are thought to share injection equipment.2 Interviews with more than 1700 active IV drug abusers recruited into our study by community-based acquired immunodeficiency syndrome outreach educators in five cities indicate that many active users not in treatment report prior methadone maintenance