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Can HIV-1-Contaminated Syringes Be Disinfected?
  Implications for Transmission Among Injection Drug Users
Nadia Abdala*; Alice A. Gleghorn; *John M. Carney; *Robert Heimer
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut; and ÝCommunity Substance Abuse Services, San Francisco Department of Public Health, San Francisco, California, U.S.A.
Bleaching of syringes has been advocated to prevent HIV-1 transmission among injection drug users (IDUs). Bleach is frequently distributed by needle exchange, outreach, and educational programs targeting IDUs. We applied a sensitive HIV-1 microculture assay to determine the effectiveness of bleach in disinfecting syringes contaminated with HIV-1. This study demonstrates that in a laboratory environment designed to replicate injection behaviors, undiluted bleach is highly effective in reducing the viability of HIV-1 even after minimal contact time. However, it did not reduce the HIV-1 recovery to z ero. Furthermore, three washes with water were nearly as effective as a single rinse with undiluted bleach in reducing the likelihood that contaminated syringes harbored viable HIV-1. Given the reality that IDUs share syringes and may not have access to a new, sterile syringe for each injection, the results suggest that they should be encouraged through harm reduction interventions to clean their syringes, preferably with undiluted bleach.
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