2001/02/28 by B. Ann Hilton, Ray Thompson, Laura Moore‐Dempsey +1 · 1 citation
Medicine · Psychology · Nursing · #HIV, Drug Use, Sexual Risk #Substance Abuse Treatment and Outcomes #HIV/AIDS Research and Interventions #Harm reduction #Medicine #Harm #Heroin #Psychiatry #Needle sharing #Addiction #Criminology #Public health #Human immunodeficiency virus (HIV) #Drug #Psychology #Nursing #Family medicine #Social psychology #Condom
paper · doi:10.1046/j.1365-2648.2001.01672.x
openalex publication_date 2001/02/28 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
AIM: To provide a comprehensive review of the literature on harm reduction theories and strategies related primarily to licit and illicit drug use. BACKGROUND: Although human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) disease transmission is well understood, it continues to spread, particularly among injection drug users (IDUs). Despite early indications that HIV would be contained within the IDU community, it is spreading to non-IDU sexual partners and to children of IDUs, threatening a more widespread epidemic. METHODS: An examination of research studies and theoretical writings including reviews and policy papers published in English between 1990 and 2000. RESULTS: Harm reduction does not seek to eliminate drug use; it focuses on minimizing the personal and social harms and costs associated with drug use and spread of HIV. It seeks to ameliorate conditions surrounding drug use responsible for the spread of HIV in the IDU community: unequal access to health services; sharing of infected needles; racial and social discrimination; poverty; exposure to street violence; inadequate housing; lack of employment; poor general or mental health and other demographic and social determinants. Some controversial harm reduction strategies are described: methadone maintenance programmes, illegal drugs dispensing under controlled conditions, needle exchanges, HIV testing, vein maintenance, safe-sex and would-care programmes. CONCLUSION: The main challenge is to get IDUs to protect themselves against HIV when suffering physical and social privations and addiction needs. Diverse perspectives on harm reduction are problematic with consequences for success of drug use initiatives. Practical, ethical and theoretical complexities exist but further research is needed to build support for a harm-reduction orientation in practice and policy formulation.