The most effective way to combat the spread of HIV spread by intravenous drug use is a combined program of drug substitution and anti-retroviral therapy for those already infected, according to a study conducted by Stanford University and the Veteran Affairs Palo Alto Health Care System.

The project, funded by the National Institute on Drug Abuse, the Department of Veterans Affairs and a Gabilan Stanford Graduate Fellowship, studied ways to combat the spread of HIV in Ukraine. The findings were released in the March issue of PLoS-Medicine.

Ukraine has the highest prevalence of HIV in Eastern Europe. Approximately half of drug users in the country are HIV-infected, and the disease is spreading into the broader population.

Through computer modeling, the authors of the study examined data such as the rate of HIV transmission and the outcomes of treatment and prevention efforts in the country. Using this information, they made assumptions about what would happen if current drug users received methadone as a substitution to their intravenous drugs.

Without these proposed interventions, the researchers calculated that 67.2 percent of drug users would be infected with HIV in the next 20 years. They predicted that if just 25 percent of drug users received methadone, the figure for HIV infection could be lowered to 53.1 percent.

Recently, the government of Ukraine endorsed a new law promoting this same substitution therapy and needle exchanges for drug users. Though the study looked specifically at Ukraine’s population, its conclusion can also be applied throughout Eastern Europe and Central Asia, regions that have the highest rates of HIV transmission in the entire world.

— Ivy Nguyen