Lugoboni F, Mezzelani P, Venturini L, Fibbia GC, Des Jarlais DC; International Conference on AIDS.

Int Conf AIDS. 1992 Jul 19-24; 8: C375 (abstract no. PoC 4796).

Institute of Clinica Medica, University of Verona, Italy.

OBJECTIVES: Injecting drug users (IDUs) are often considered "non-compliant" patients and have been excluded from many AIDS clinical trials. We examine compliance among IDUs in a continuing HBV vaccination program. METHODS: From December 1988, the seronegative IDUs were recruited for vaccination with a recombinant vaccine requiring an initial injection followed by 1 and 6 month boosters. The dangers of HBV infection were stressed in the one-to-one long term therapeutic counselling performed by the Center. No additional types of drug abuse treatment (i.e. methadone or naltrexone maintenance, admission to hospital or to a therapeutic community) that would have increased compliance with the vaccination program were offered to the participants. RESULTS: Compliance with the vaccination program was very high: 133 IDUs (70% of 190 HBV seronegatives) were recruited into the vaccination program, and only 12 (11%) dropped out. Of the 111 IDUs who started the vaccination program six or more months ago, 99 (91%) completed all 3 injections. Antibody response was measured in 88 patients, of whom 81 (92%) developed anti-HBV. There were no statistically significant differences in age, gender, length of injection history, or HIV or HCV seropositivity between IDUs who began the vaccination program versus those who did not begin. There were too few who dropped out of the program for meaningful statistical comparisons with those who remained in the program. CONCLUSIONS: The relatively high number of HBV seronegative IDUs and their increased awareness towards health education (probably the result of AIDS concern) together with the availability of an effective, safe and low-cost vaccine make an HBV vaccination campaign highly desirable. Such a campaign, performed by public health services and therapeutic communities, is undoubtedly advantageous for IDUs, their partners and the general population. In our opinion, the relatively high compliance with the HBV vaccination program is partly a result of the global health education campaigns against AIDS and reflects an increased awareness among IDUs of the need to protect their health. While further research is needed to unequivocally identify reasons for high compliance, this experience suggests guarded optimism towards targeting IDUs for vaccination programs. We suggest that additional HBV vaccination programs be undertaken and planning started for possible testing of hepatitis C virus and HIV vaccines with IDUs.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Crack Cocaine
• HIV
• HIV Infections
• HIV Seropositivity
• Humans
• Methadone
• Patient Compliance
• Research Design
• Substance-Related Disorders
• Vaccination

Other ID:

• 92402460

UI: 102200174

From Meeting Abstracts