To the Editor.—
"Treatment is prevention" in the area of acquired immunodeficiency syndrome and intravenous drug users (IVDUs). However, treatment suffers from three disadvantages: it is expensive, a long lead time is needed to gear up a treatment program, and only about half of IVDUs will enter treatment even if offered their choice among cost-free alternatives. These disadvantages have impelled human immunodeficiency virus (HIV) prevention workers in many localities to develop outreach education programs as a cost-effective supplement to treatment.It is instructive to compare costs and benefits of methadone maintenance and outreach risk-reduction education in a city hard hit by HIV.There are about 13 000 heterosexual IVDUs in San Francisco, Calif, of whom about 17% are currently HIV infected.1 Survey research conducted in 1985 and 1986 showed that more than 80% of IVDUs reported recent sharing of injection equipment.2 Arguably, this population in a few years
Newmeyer J. Outreach Education Among Intravenous Drug Users: Use CHOWs. JAMA. 1989;262(22):3130–3131. doi:10.1001/jama.1989.03430220051021
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