The challenge of implementation of preventive programs in a developing country: experiences, situations, and...

In recent years, Uruguay has seen an alarming increase in the percentage of persons with human immunodeficiency virus infection/acquired immunodeficiency syndrome who are injection drug users (IDUs) and their sex partners, which has consequently contributed to the rate of perinatal transmission. Development of preventive harm reduction and risk reduction strategies has become imperative. These strategies must be suitable for a developing country and focused on its population of IDUs. These strategies must include, as a preliminary step, a comprehensive analysis of the current local legal system and knowledge about the kinds of drugs used, the ways in which they are used, and their effects on public health. The conclusions of some studies and a pilot program that Institute of Social Research and Development, Instituto de Investigación y Desarrollo Social, Uruguay, implemented in 2001 have pointed to new avenues for the control of the epidemic spread among IDUs and to their social environment.