Journal of Urban Health

, Volume 81, Issue 1, pp 14–19 | Cite as

Updating the infection risk reduction hierarchy: Preventing transition into injection

  • David VlahovEmail author
  • Crystal M. Fuller
  • Danielle C. Ompad
  • Sandro Galea
  • Don C. Des Jarlais
Special Feature: Hepatitis C Virus


Current approaches to prevention of blood-borne infections in injection drug users include referral to drug abuse treatment, access to sterile syringes, bleach disinfection of injection equipment, and education about not sharing equipment. However, rates of some blood-borne infections (e.g., hepatitis C virus) remain elevated among injection drug users, especially early after initiation into injection drug use. With lower infection rates in noninjectors and transition into injection drug use occurring most commonly among these noninjectors, prevention of transition into injection drug use as an additional step to reduce risk for acquisition and transmission of blood-borne infections merits closer attention.


Hepatitis C virus Hierarchy Human immunodeficiency virus Infection Injection drug use Prevention 


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Copyright information

© The New York Academy of Medicine 2004

Authors and Affiliations

  • David Vlahov
    • 1
    Email author
  • Crystal M. Fuller
    • 1
    • 2
  • Danielle C. Ompad
    • 1
  • Sandro Galea
    • 1
  • Don C. Des Jarlais
    • 3
  1. 1.the Center for Urban Epidemiologic StudiesNew York Academy of MedicineNew York
  2. 2.the Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew York
  3. 3.the Baron Edmond de Rothschild Chemical Dependency InstituteBeth Israel Medical CenterNew York

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