The Swiss model of HIV prevention among drug users demonstrated high efficiency

The pragmatic policy of the Swiss in the field of HIV prevention among injecting drug users has shown extremely high efficiency, writes Medical Xpress. As evidenced by the data obtained by specialists from the University of Zurich and the University Hospital of Zurich, they managed to prevent thousands of new HIV infections and AIDS through harm reduction activities.

Using the results obtained during the analysis of preventive measures in the key group (IDU), and also by applying mathematical modeling to cohort study data and the current epidemiological situation in Switzerland, the researchers were able to quantify the program's successes.

In particular, specialists analyzed harm reduction measures, including needle exchange, methadone substitution therapy, controlled heroin use programs and counseling services for IDUs.

Dr. Alex Marzel of the Institute of Medical Virology in Zurich and his colleagues were able to demonstrate that these measures have prevented a total of more than 15 thousand HIV infections among drug users.

"Previously, the HIV epidemic often penetrated the general population from among IDUs through sexual contacts, which means that preventive measures among drug users also indirectly prevented more than 2,500 cases of HIV infection in people who do not use intravenous drugs, - said the head of the study, Professor Roger Kouos (Roger Kouyos).

Thus, the evaluation of Dr. Marcel and his colleagues not only confirmed the success of a pragmatic approach to HIV prevention among IDUs, but also demonstrated that harm reduction measures can protect against the virus and the general population.

The analysis also showed the extremely high value of the Swiss cohort study on HIV. "Without data from a cohort study that started 30 years ago, it would be impossible to conduct such a detailed quantitative analysis," explained Professor Kouos.

As the experts concluded, even without a detailed cost analysis, the economic consequences of the "Swiss preventive policy" are obvious: based on a conservative estimate of the annual cost of treatment of CHF 20,000 per person, the country's healthcare system spent an additional 340 million CHF per year on 17 thousand prevented HIV. These data indicate that preventive measures over the past 10 years have saved more than 3.4 billion CHF.

The results of the analysis are clear evidence of the effectiveness of harm reduction measures and HIV prevention among IDUs. Nevertheless, researchers write, in many countries of the world, especially in Eastern Europe, the use of such tools is still considered controversial, and somewhere there is no preventive measures at all.

"Many cases of HIV transmission through intravenous drug use could probably be avoided through the introduction of preventive measures. Given that 1.7 million IDUs worldwide are HIV-positive worldwide, and about 30% of new infections in sub-Saharan Africa occur in this risk group, this is another noteworthy result of our study, "said Dr. Alex Marzel.

We add that the Swiss study on HIV-infection started in the country more than 30 years ago and to date has collected anonymous data on more than 20 thousand people living with HIV. Also during this time, an extensive biobank containing more than 1.5 million blood samples was created. All university hospitals in Switzerland, many cantonal hospitals, and also owners of specialized practices contribute to the cohort study.