New syringe design could curb HIV transmission

SWITCHING the type of syringe used by people who inject drugs could help curb HIV transmission in countries with injection-driven epidemics within eight years, according to a new article by researchers at RTI International and Futures Institute.

The commentary, published in the January issue of International Journal of Drug Policy (IJDP), summarizes existing evidence regarding how low dead-space syringes can help reduce HIV transmission and estimates potential impacts on HIV transmission among people who inject drugs.

According to the authors, when a plunger on a syringe is fully depressed, all syringes retain fluid in what has been termed "dead space." In high dead-space syringes, a 1000 times more blood is retained in the syringe after washing than in low dead-space syringes.

This suggests that if a person who injects drugs shares a high dead-space syringe with an HIV-positive injecting partner, they are more likely to be exposed to HIV than if he or she shared a low dead-space syringe.

Using a simulation model, the authors found that switching to low dead-space syringes could lead to major reductions in HIV transmission in countries with injection-driven epidemics, such as China, Indonesia, Russia, Ukraine and Vietnam. According to the model, the change could reduce annual HIV infections from syringe sharing to nearly zero within eight years.

“Although additional research is needed, this intervention should be implemented and evaluated as soon as possible,” said William Zule, Dr.P.H., a senior research health analyst at RTI International and lead author of the paper. “Switching from high dead-space to low dead-space syringes should be viewed as an additional component to comprehensive HIV prevention packages.”

Preventing or controlling concentrated HIV epidemics among persons who inject drugs may also prevent the sexual diffusion of HIV from people who inject drugs to other groups.
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