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Black tar heroin use explains lower HIV levels among injection drug users in the Western US

njecting black tar heroin, it must be heated to about 165 degrees F, according to research done elsewhere. This temperature is sufficient for killing the HIV virus, which limits the likelihood of HIV transmission through sharing of drug preparation paraphernalia, according to the UCSF researchers.

In addition, black tar heroin clogs syringes, they note. Frequent rinsing and flushing is required, reducing the amount of residual blood and HIV virus present.

"In California, injectors are constantly complaining that their needles clog. They almost always rinse their syringes immediately after shooting up in order to keep them from jamming. The grounds of shooting encampments and the walls of shooting galleries are wet from the water that they squirt through their used needles. This is not the case in New York, where white powder heroin does not 'gum up' needles. Laboratory studies have shown that rinsing syringes copiously with water works well to clean out HIV," said the study's co-author, Philippe Bourgois, PhD, professor and chair of the UCSF Department of Anthropology, History, and Social Medicine.

Moreover, using gummy black tar heroin ruins syringes, leading to increased turnover of syringes. "Black tar injectors rarely report using a single syringe more than five times, while powder heroin users claim many more uses out of their syringes," said Ciccarone.

The study also noted that injecting black tar heroin leads rapidly to venous sclerosis - a condition that results in the loss of veins for injection sites. Thus, black tar heroin users are much quicker to move to subcutaneous and intramuscular injecting. Studies have shown that these are not as efficient as venous injection for transmitting HIV.

"We believe that we have solved this longstanding epidemiological puzzle thanks to multidisciplinary science and data from the DEA on the types and distribution patterns of heroin. This data is valuable to public health authorit
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Contact: Jeff Sheehy
jsheehy@psg.ucsf.edu
415-597-8165
University of California - San Francisco
26-Jan-2004


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