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Epidemiology of HIV in Intravenous Drug Users and Public Health Policy in Germany

The paper assesses AIDS and drug policy development in Germany between 1982 and 1996 and relates it to the development of epidemiological research in HIV among injecting drug users (IDUs). In a historical review, this paper outlines how results of epidemiological HIV surveillance studies among IDUs and public health responses were mutually dependent. The authors argue that a specific development in HIV policy encouraged a confounding of basic methodological concepts (validity and precision) in epidemiological research, which in turn led to misinterpretation of available data on seroprevalence trends in Germany. In order to overcome methodological shortcomings under given legal and practical restrictions, pragmatic approaches to increase validity of seroprevalence and risk factor estimations are discussed.