
Maintaining Low HIV Seroprevalence Among Injecting Drug Users-Reply
Don C. Des Jarlais, PhD
Beth Israel Medical Center
Samuel R. Friedman, PhD
National Development and Research Institutes New York, NY
Holly Hagan, MPH
Seattle-King County Health Department Seattle, Wash
JAMA. 1996;275(8):597-598.
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In Reply.
—Drs Wong and Lee present an interesting description of the situation of HIV infection among IDUs in Hong Kong. We were aware of the Hong Kong drug treatment program seroprevalence data, but not of their unpublished data from IDUs not in treatment. It would appear that Hong Kong meets our criteria for "stable low HIV prevalence" among IDUs.1 We did consider pharmacy sales as "provision of sterile injection equipment" if pharmacists did not discriminate against IDUs and IDUs could carry injection equipment without fear of arrest or harassment by police. The data from Hong Kong thus seem fully parallel to the data from the five cities in our study.
Given the effectiveness of methadone maintenance treatment in reducing heroin injection (and therefore HIV risk),2 we would agree that the Hong Kong methadone treatment program probably was important in reducing HIV transmission there. We would also note
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