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Adult/Adolescent AIDS Cases
by Exposure Category

n=657,077 (98.8% of all cases)
Source: Centers for Disease Control and Prevention, HIV/AIDS Surveillance
Report, 1998:10(1)
Pediatric (<13 years old) AIDS cases
52.7 Percent of Pediatric AIDS Cases are Drug Related Pediatric AIDS = 1.2 Percent of Total Cases

n=8,280 (1.2% of total cases)
Source: Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, 1998:10(1)
Female Adult/Adolescent AIDS Cases
60.2 Percent of AIDS Cases Among Females Are Drug-Related Female AIDS = 15.6 Percent of Total Cases

n=104,028 (15.6% of total cases)
Source: Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, 1998:10(1)
NIDA Research Responds to the Drug-Related AIDS Epidemic

HIV infection is not limited to drug injectors and their sex partners. In
poor inner city communities young smokers of crack cocaine, particularly
women who have sex in exchange for money or drugs, are at high risk for
HIV infection, exhibiting HIV prevalence rates as high as 30%. While the
proportion of new HIV cases attributed to injection drug use has steadily
increased up to 50% in 1996, a significant proportion (up to 25%) of new
HIV cases may also be drug abuse-related through exposure associated with
other drug abuse or through heterosexual contact with an injection or intravenous
drug user (IDU).
NIDA has responded by building a multiple disciplinary program of research
which comprehensively addresses the AIDs and drug abuse problem. The focus
of the program has been to develop improved strategies to reduce drug-abuse
related behaviors that are linked to the transmission of HIV. These strategies
include drug abuse treatment and outreach strategies to drug abusers not
in treatment. In support of this effort, NIDA's program also includes
epidemiologic studies of seroincidence, seroprevalence, and progression
to disease among drug users (in and out of treatment), their sexual partners,
and their children; and studies of the effects of drugs of abuse on the
immune system.
NIDA has expanded its research on ways to improve drug abuse treatment,
as a means of reducing levels of HIV infection by reducing overall levels
of drug use, particularly drug injecting. NIDA research has demonstrated
that drug abusers in drug treatment are at lower risk for seroconversion
than those not in treatment. One recent study found a six fold difference
in the rate of seroconversion between injecting drug users in methadone
maintenance treatment (3.5%) and those who stayed out of treatment (22%).
NIDA will continue to support research to improve existing treatment approaches
and to develop new pharmacologic and behavioral therapies to improve drug
abuse treatment as an AIDS prevention strategy.
NIDA has established large scale studies to reach drug abusers not currently
in treatment. Through such community outreach studies, NIDA has assessed
strategies to inform and counsel drug abusers about AIDS, to encourage
them to seek treatment for their drug abusing behaviors, and to educate
them on methods to reduce their risk of transmitting and contracting HIV.
NIDA also conducts research on other community based strategies to reduce
HIV infection, such as needle exchange programs. About 85% of the chronic
drug abusers (primarily hardcore cocaine and heroin users) are not in
drug treatment. Out-of-treatment drug abusers have higher rates of high
risk behaviors, greater seroprevalence, and higher rates of seroincidence
than in-treatment populations. Significantly, these studies have shown
that even relatively small amounts of education and counseling can help
many drug users modify their HIV risk behaviors, even without achieving
total abstinence from drugs. NIDA will continue to conduct research to
improve educational and behavioral strategies to reduce HIV transmission
among drug abusers, and have begun new initiatives focussing on gender
and cultural issues, drug-using networks, and pediatric AIDS.
To support these efforts and to enhance the knowledge base about HIV
infection and AIDS in drug abusers, NIDA has also supported natural history
studies of drug abusers, studies of drugs of abuse as cofactors in HIV
disease, studies of behavior change and abuse as cofactors in HIV disease,
studies of behavior change and relapse prevention, and basic and clinical
research on the effects of drugs of abuse on the immune system. These
studies have provided critically important information on the epidemiology
of the AIDS epidemic among drug users, on the role of drug abuse in risky
behaviors, on the role of drugs of abuse in infection and progression
to AIDS, and on the effects on the immune system.
Drug abuse treatment and prevention programs that change high risk behaviors
can most effectively reduce the drug abuse-related transmission of HIV.
Consequently, NIDA has and plans to continue to develop and enhance effective
methods for treating and preventing drug abuse-related risky behaviors.
The continuation and strengthening of this research is central to the
Nation's hopes for developing effective HIV/AIDS prevention strategies.
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