AIDS and intravenous drug use: the real heterosexual epidemic.

Moss, A. R.

doi:10.1136/bmj.294.6569.389

Cited by 98 publications

(36 citation statements)

References 7 publications

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“…Since the emergence of the acquired immunodeficiency syndrome (AIDS) epidemic most studies have focused on HIV incidence, prevalence, and risk behaviors among intravenous drug users (IVDUs) [1][2][3][4][5] with less attention devoted to overall morbidity and mortality data in this population. There are some indications, however, that IVDUs are at increased risk of overall mortality, deaths from overdose, trauma, infectious diSeaseS.…”

Section: Inrodictonmentioning

confidence: 99%

Mortality of intravenous drug users in Rome: a cohort study.

Perucci¹,

et al. 1991

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A historical cohort study was carried out in Rome to examine overall and cause-specific mortality among intravenous drug users (IVDUs). A total of 4200 IVDUs (3411 men and 789 women) enrolled in methadone treatment centers between 1980 and 1988 were studied. There were 239 deaths during the follow-up period. The overall SMR was 10.10 in the entire cohort (95% confidence interval, 8.86-11.47), 9.30 in males and 18.07 in females. A large excess of mortality in both sexes was found for infectious, circulatory, respiratory, and digestive diseases as well as for violence, overdose, AIDS, and unknown or ill-defined causes. Tumors and suicide were excessive only in males. Deaths due to drug overdose, violence or trauma, and cirrhosis accounted for 63.6%, AIDS for 7.1%, endocarditis and other bacterial infections for 7.1%, and neoplasms for 3.8% of total mortality. These findings document serious health consequences of drug abuse in Italy.

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Section: Inrodictonmentioning

confidence: 99%

Mortality of intravenous drug users in Rome: a cohort study.

Perucci¹,

et al. 1991

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“…There was no protective effect after 5 years. 45,46 It is becoming increasingly clear 11,19,20,[23][24][25][26][27][28][29][30][31][32][33]42-47 that some of the main claims made about HIV and the transmission of AIDS are open to question or inadmissible scientifically. This applies particularly to the core claims of the HIV hypothesis that AIDS has spread outside the main risk groups by heterosexual transmission in general populations, and that all who are seropositive to HIV will inevitably lose their natural immunity and develop AIDS.…”

Section: The Hiv Hypothesismentioning

confidence: 99%

Scientific surveillance and the control of AIDS: A call for open debate

Stewart

1994

Health Care Anal

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“…An amalgam of debilitating infectious and wasting disease had been noted from the late 1960s onward in young adults and adolescents who injected themselves repeatedly with impure and unsterile, illegallyobtained psychoactive drugs (Gay, 1972;Moss, 1987;Selwyn, 1989). This practice causes bizarre, often intractable infections in the blood and various organs from contaminants in the drugs.…”

Section: Use Of Psychoactive and Immuno-toxic Drugsmentioning

confidence: 99%

“…This practice causes bizarre, often intractable infections in the blood and various organs from contaminants in the drugs. Needle-sharing, promiscuous sexual intercourse and general disregard of hygiene -a notorious feature of the drug scene everywhere -leads to sharing also of whatever infections are endemic in that community -PCP, HIV, hepatitis, herpes, EBV, VZ and CMV which may impair cell-mediated immunity and reverse T4/T8 ratios (Louria, Hensle & Rose, 1967, McDonough, Madden & Falek, 1980Drew, Mills & Levy, 1985;Creglev & Mark, 1986;Moss, 1987). All the psychoactive drugs currently in use in this way, especially heroin and experimental mixtures, are profoundly depressing to appetite, general health and immunity.…”

Section: Use Of Psychoactive and Immuno-toxic Drugsmentioning

confidence: 99%

The epidemiology and transmission of AIDS: A hypothesis linking behavioural and biological determinants to time, person and place

Stewart

1995

Genetica

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Epidemiologically, the Acquired Immune Deficiency Syndrome, AIDS, is transmitted and distributed in the USA and Europe almost entirely in well-defined subsets of populations engaging in, or subjected to, the effects of behaviours which carry high risks of genital and systemic infections. The persons predominantly affected are those engaging in promiscuous homosexual and bisexual activity, regular use of addictive drugs, and their sexual and recreational partners. In such persons and in subsets of populations with corresponding life-styles, the risk of AIDS increases by orders of magnitude. Because of continuity of risk behaviour and of associated indicator infections, the incidence of AIDS over 3-5 year periods is predictable to within 10% of actual totals of registered cases in the USA and UK. Secondary transmission of AIDS beyond these groups is minimal or, in many locations, absent. There is no indication of appreciable spread by heterosexual transmission to the general population. The Human Immunodeficiency Virus, HIV, is transmissible to some extent in general populations, and more so among promiscuous persons. It may cause viraemia, lymphadenopathy and latent infection (HIV disease) in anyone. In persons engaging in risk behaviours which themselves alter or suppress immune responses, it can interact with MHC, antibodies to other organisms and to semen, and other allogenic antigens to initiate a programmed death of CD4 lymphocytes and other defensive cells, as in graft-host rejections. This occurs also in haemophiliacs receiving transfusions of blood products, and is more pronounced in persons with reactive HLA haplotypes. The susceptibility of particular subsets of populations to AIDS is thereby largely explained. But these changes occur in the absence of HIV, and so do Kaposi's sarcoma, lymphadenopathies and opportunistic infections which are regarded as main indicators of AIDS. The hypothesis that HIV-1 can do all this by itself and thereby cause AIDS is falsifiable on biological as well as epidemiological grounds. An alternative hypothesis is proposed, linking the incidence of AIDS to the evolution of contemporary risk behaviour in particular communities and locations in the USA, UK and probably in most of Europe. It does not pretend to explain the reported incidence of AIDS in Africa and other developing regions where data are insufficient to provide validation of the pattern of disease and contributory variables. The immediate, practical implication of this alternative hypothesis is that existing programmes for the control of AIDS are wrongly orientated, extremely wasteful of effort and expenditure, and in some respects harmful.

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AIDS and intravenous drug use: the real heterosexual epidemic.

Cited by 98 publications

References 7 publications

Mortality of intravenous drug users in Rome: a cohort study.

Mortality of intravenous drug users in Rome: a cohort study.

Scientific surveillance and the control of AIDS: A call for open debate

The epidemiology and transmission of AIDS: A hypothesis linking behavioural and biological determinants to time, person and place

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