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1994-10-25
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Document 2271
DOCN M94A2271
TI Evaluation dilemma: serotesting in needle-exchange programs, helpful or
counterproductive?
DT 9412
AU Schepp-Beelen JC; de Jongh-Wieth FE; de Wildt GR; Beaumont WJ; City
Health Department, Hague, Netherlands.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):342 (abstract no. PC0307). Unique
Identifier : AIDSLINE ICA10/94370304
AB PROBLEM DEFINITION: In The Hague in the Netherlands, the programme aimed
at controlling HIV and its consequences in intravenous drug users (IDUs)
involves health education, emotional support, needle-exchange, and the
provision of condoms. It focuses on visits by outreach workers to the
privacy of IDUs' homes and to places where high-risk behaviour takes
place, e.g. sites where soliciting takes place by commercial sex
workers, including IDU's. Outreach workers are covered by medical
confidentiality. Many recipients are not in contact with other health
services. Interviews showed that IDU's, especially those with high-risk
behaviour, were reluctant to get involved for fear of being tested. To
gain the trust of IDU's, deliberately no effort was made to collect
quantitative data on IDU's behaviour or seroprevalence of HIV. Trust was
established, which is also of benefit to TB control and other aspects of
public health. Output measures suggest that the programme has a large
coverage while HIV-prevalence in IDU's may be low. Thus, an evaluation
problem exists: While reticence with regard to serotesting and other
research is likely to have facilitated the building of trust and the
establishment of conditions which favour safe behaviour, the absence of
hard quantitative indicators poses a hurdle when it comes to evaluating
the outcome and impact of the programme and its replicability.
CONCLUSION: There is a need for the development of alternative methods
and indicators for evaluation which can be used in situations where
serosurveillance and other quantitative research efforts are not deemed
appropriate.
DE *AIDS Serodiagnosis Comprehensive Health Care Condoms Human HIV
Infections/EPIDEMIOLOGY/*PREVENTION & CONTROL/TRANSMISSION HIV
Seroprevalence Knowledge, Attitudes, Practice Needle Sharing/*ADVERSE
EFFECTS Netherlands/EPIDEMIOLOGY Program Evaluation Substance Abuse,
Intravenous/*COMPLICATIONS/REHABILITATION MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).