Health education and knowledge assessment of HTLV-III diseases among intravenous drug users.

Abstract

The human T-cell lymphotropic virus, type III (HTLV-III) is the causative agent of acquired immunodeficiency syndrome (AIDS). Since AIDS is not curable, public health efforts must be focused on decreasing AIDS transmission. 72% of all AIDS cases are male homosexuals; 17% are intravenous (IV) drug users; and 3% are hemophiliacs, blood recipients, and infants of these groups. The gay community is sufficiently organized to provide the necessary infrastructure for AIDS education and treatment; the drug users are not, and at least 1/3 of IV drug users share needles and syringes. In 1984 a cooperative study was undertaken in New Jersey by the New Jersey State Department of Health, the National Cancer Institute (NCI), and the National Institute on Drug Abuse (NIDA) to determine the seroprevalence of HTLV-III among IV drug users and to assess their knowledge about AIDS. Over 95% knew the severer symptoms of AIDS; 76% knew that most AIDS patients die within 2 years of diagnosis; but 9% thought AIDS could be treated. A year later in 1985 a similar knowledge assessment survey was done among 577 clients entering drug treatment programs in New Jersey. 90% of these respondents knew that homosexuals and IV drug users were the primary risk groups, but 11% thought alcoholics were also at risk, and 43% did not know that the infants of drug users were at risk. 84% knew that sex and shared needles were the major modes of transmission, but 1/3 thought that an infected person would immediately show visible signs of illness, and many did not know how rapidly AIDS killed. Also, many did not know how to adequately clean syringes. They thought boiling would damage the syringes, and only 1/3 knew that a dilute solution of household bleach kills the virus. New Jersey decided to use indigenous health workers, recruited from rehabilitated drug users, to educate the drug community. The core message was: get treatment; don't share needles; and if you must share needles, clean them. The same message reaches drug users on late-night television and radio and English language newspapers. Drug users are educable; whether education and peer pressure will effect behavior modification remains to be seen.