Epidemiological studies of injecting drug users have revealed that the human immunodeficiency virus type 1 (HIV-1) is transmitted by shared injections. However, no rigorous virological studies have documented HIV-1 survival and transmission in the milieu of injection equipment in part due to the insensitivity of HIV-1 culture from the small volumes of blood remaining in syringes and other injection paraphernalia, and in part due to the division of scientific expertise that separates investigators from disparate disciplines. Therefore, a team of researchers including a molecular epidemiologist, a virologist, and two ethnographers has been assembled to determine HIV-1 transmission via injection equipment involving laboratory simulations of syringe use, syringe-mediated sharing, syringe disinfection, and non-syringe sharing informed by careful descriptions of actual drug injection behaviors provided by expert observers. The simulations will rely on a whole blood HIV-1 microculture assay (WBMA) that can propagate HIV-1 from microliter quantities of blood and other injectior solutions. Simulations will measure the longevity of HIV-1 infectivity in syringes, the rate at which infectivity is lost, the relative risks of sharing syringes and other paraphernalia, and the ability to disinfect syringes all under conditions encountered by drug injectors. Once these studies are completed, the information about HIV-1 survival and the likelihood of its transmission by the practices simulated can be integrated into the policy and practices of outreach programs to slow the spread of HIV-1 among drug injectors.
The specific aims of this project are: 1) Develop a WBMA to detect viable HIV-1 in the small volumes of residual blood that remain in syringes. 2) Use the WBMA to quantify the duration of HIV-1 viability in syringes. 3) Use the WBMA to determine the potential for common injection practices to transmit HIV-1. 4) Use the WBMA to determine the effectiveness of bleach and other common disinfection agents. 5) Expand the WBMA to determine the risks of transmitting infectious HIV-1 from non-syringe drug injection paraphernalia such as cookers, cotton, and standing water both via laboratory simulations and in paraphernalia obtained directly from shooting galleries.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA009945-03
Application #
2700893
Study Section
Special Emphasis Panel (SRCD (08))
Project Start
1996-06-15
Project End
1999-12-31
Budget Start
1998-05-01
Budget End
1999-12-31
Support Year
3
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Heimer, Robert (2008) Community coverage and HIV prevention: assessing metrics for estimating HIV incidence through syringe exchange. Int J Drug Policy 19 Suppl 1:S65-73
Heimer, Robert; Kinzly, Mark L; He, Helen et al. (2007) The effect of acids on the survival of HIV during drug injection. J Acquir Immune Defic Syndr 45:144-50
Abdala, Nadia; Crowe, Michelle; Tolstov, Yanis et al. (2004) Survival of human immunodeficiency virus type 1 after rinsing injection syringes with different cleaning solutions. Subst Use Misuse 39:581-600
Abdala, N; Gleghorn, A A; Carney, J M et al. (2001) Can HIV-1-contaminated syringes be disinfected? Implications for transmission among injection drug users. J Acquir Immune Defic Syndr 28:487-94
Kyriakides, T C; Heimer, R R (2001) Development and application of a genotypic AZT resistance assay: quantitative assessment of the resistance profile of clinical samples and the relative predictive ability of a resistance index. J Acquir Immune Defic Syndr 28:211-20
Heimer, R; Abdala, N (2000) Viability of HIV-1 in syringes: implications for interventions among injection drug users. AIDS Read 10:410-7
Abdala, N; Reyes, R; Carney, J M et al. (2000) Survival of HIV-1 in syringes: effects of temperature during storage. Subst Use Misuse 35:1369-83
Abdala, N; Stephens, P C; Griffith, B P et al. (1999) Survival of HIV-1 in syringes. J Acquir Immune Defic Syndr Hum Retrovirol 20:73-80
Clatts, M C; Heimer, R; Abdala, N et al. (1999) HIV-1 transmission in injection paraphernalia: heating drug solutions may inactivate HIV-1. J Acquir Immune Defic Syndr 22:194-9
Rich, J D; Dickinson, B P; Carney, J M et al. (1998) Detection of HIV-1 nucleic acid and HIV-1 antibodies in needles and syringes used for non-intravenous injection. AIDS 12:2345-50