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Miracle on 34th Street: Success With Injectors

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Science  13 Jul 2012:
Vol. 337, Issue 6091, pp. 178-180
DOI: 10.1126/science.337.6091.178

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HIV typically spreads more readily between people who share needles than in sexual networks, which means a large community of injecting drug users (IDUs) can mark the emergence of an epidemic with great precision. New York City, a dense city of about 8 million residents, had an estimated 200,000 IDUs in the late 1970s, more than any city in the world. A retrospective analysis of blood samples taken from users in 1978 found that 10% were already infected with HIV. By 1981, the prevalence had jumped to 50%, which helped make the Big Apple the center of the country's AIDS epidemic. Today, studies have shown that the incidence of HIV in New York City IDUs is 1%. Although the city's IDU population has dwindled to an estimated 100,000, that doesn't explain the steep drop in incidence. The main reason is that users stopped sharing needles.