Sexual behavior of 175 patients of the drug addiction outpatient ward of the Psychiatric University Clinic of Vienna was measured using a standardized questionaire (9). HIV antibodies were found in 26.9% of the intravenous drug users. The majority of these clients were sexually active, 13% of females, 20% of male and 26% of the HIVD-infected had no sexpartners. 46% females, 42% males and 26% HIV-1-infected drug users had sexual partners who were not infected. HIV-1-infected IVDUs modified sexual behavior as can be seen in condome use 31% of non infected but 69% of infected never used condomes. Drug users in a methadon maintenance programm suffered on a decrease of sexual activity, HIV-1-infected had a reduction in 60%, and non infected in 47%. This leads to the notion that HIV-1 infection lowers sexual activity itself. Summing up, the infected drug users changed their sexual activities to safer sex practices, compared to non infected drug users.

In Austria it is illegal to sell tobacco to young adolescents. A diverse sample of 358 narcotic addicts was investigated at the Psychiatric University Clinic of Vienna. Data were obtained from onsite confidential interviews and a HIV-test was conducted. The individual drug use history was recorded and, interestingly, tobacco addiction was the first stage in starting a drug career. Furthermore, a strong correlation was observed between onset of heroin use and HIV-I infection. It is concluded that in Austria not only the availability nicotine and alcohol to young adolescents should be prohibited, but also their use should be punishable. Easy access to nicotine as in public restaurants or from automatic distributers, has to be withdrawn. Tobacco advertisements may drive vulnerable young adolescents to early nicotine abuse and this may be followed by addition to other drugs and diseases causing death, including AIDS. Socioeconomic data, as well as the methadone data are presented. 180 out of the 358 patients were on methadone maintenance. Methadone treatment offers a first step toward social rehabilitation for drug addicts who have been living as criminals on the fringe of society. Physicians have a clear responsibility to lead the effort on all fronts against tobacco, especially in view of the HIV epidemic.

To slow the spread of AIDS, on September 25 th , 1987 methadone was legalized for therapeutic use in the treatment of drug addiction in Austria. Since then 266 patients were treated at the outpatient clinic of the university clinic of Vienna. This article describes the Austrian methadone program and goals, its referrals and patient admission process, medical care, counseling procedures, tolerance of misbehavior and procedures that maintain confidentiality. The paper also describes the current dilemmas in the field and a profile of what problems one may expect

In Austria it is illegal to sell tobacco to young adolescents. A diverse sample of 358 narcotic addicts was investigated at the Psychiatric University Clinic of Vienna. Data were obtained from on site confidential interviews and a HIV-test was conducted. The individual drug use history was recorded and, interestingly, tobacco addiction was the first stage in starting a drug career. Furthermore, a strong correlation was observed between onset of heroin use and HIV-1 infection. It is concluded that in Austria not only the availability nicotine and alcohol to young adolescents should be prohibited, but also their use should be punishable. Easy access to nicotine as in public restaurants or from automatic distributors, has to be withdrawn. Tobacco advertisements may drive vulnerable young adolescents to early nicotine abuse and this may be followed by addition to other drugs and diseases causing death, including AIDS. Socioeconomic data, as well as the methadone data are presented. 180 out of the 358 patients were on methadone maintenance. Methadone treatment offers a first step toward social rehabilitation for drug addicts who have been living as criminals on the fringe of society. Physicians have a clear responsibility to lead the effort on all fronts against tobacco, especially in view of the HIV epidemic.

Current research and clinical experience with AIDS in the population of intravenous drug users demonstrates that members of this group have multiple opportunities for exposure to HIV (Friedland & Klein 1987). Following the introduction of HIV into a community of intravenous drug users (IVDUs), it may infect over 50% of individuals within three to four years (Des Jarlais et al. 1988), the potential for a major heterosexual epidemic remains a subject of speculation (Johnson, 1988). The time until AIDS diagnosis after infection is estimated with a mean of 9.8 years (Bacchetti & Moss 1990). The second wave of HIV epidemic in Europe has already formed the injecting drug users into the major component of this epidemic. There has been a dramatic increase in the incidence of AIDS among IVDUs in Europe (Ferroni et al.1985; Fuchs et al. 1985; Ancelle-Park et al. 1987; Robertson et al. 1986, Harms et al. 1987; France et al. 1988; Loimer et al. 1990a) and in the United States (Chamberland et al. 1984; Des Jarlais et al. 1987; Drucker 1987; Allen et al. 1988; Hahn et al. 1989). In Europe higher though less than exponential rates of growth are observed among intravenous drug users. Projections of total cumulated cases to the end of 1991 lie in the range of 23,000 – 33,000 cases among this group (Downs et al. 1990).

On September 25th, 1987 methadone was legalized in Austria for therapeutic use in drug addiction treatment in case of: 1. Long-term drug addiction with intravenous application of the drug, and several unsuccessful withdrawal therapies and/or 2. opiate addiction through intravenous application of the drug along with an existing HIV-1 infection. Since than, 291 patients were treated with methadone at the drug-dependency outpatient clinic of the Psychiatric Clinic of the University of Vienna. In 1990, 96 patients treated for more than one year were investigated using a standardized questionnaire. The image in which crime, prostitution, poverty, ill health all merge was broken by this decriminalization. Methadone treatment offers a first step toward social rehabilitation for drug addicts who have been living as criminals on the fringe of society.

On September 25th, 1987 methadone was legalized in Austria for therapeutic use in drug addiction treatment in case of: 1. Long-term drug addiction with intravenous application of the drug, and several unsuccessful withdrawal therapies and/or 2. opiate addiction through intravenous application of the drug along with an existing HIV-1 infection. Since than, 291 patients were treated with methadon at the drug - dependency outpatient clinic of the Psychiatric Clinic of the University of Vienna. In 1990, 96 patients treated for more than one year were investigated using a standardized questionaire. The image in which crime, prostitution, poverty, ill health all merge was broken by this decriminalisation. Methadone treatment offers a first step toward social rehabilitation for drug addicts who have been living as criminals on the fringe of society.

48 fatalities (11 female, 37 male) among drug addicts are registered in Vienna in 1988. 96 committed suicides and 401 suicide attempts are reported among young Viennese in 1987. In order to examine the connection between suicide, parasuicide and drug addiction at the drug out patient clinic of the Psychiatric University Hospital of Vienna, 223 patients were investigated in February 1989.

We report the results of a survey of a total of 553 intravenous drug users (IVDUs) investigated at the drug addiction out-patient unit of the Psychiatric Department of Vienna University for antibodies to human immunodeficiency virus (HIV-1) using both enzyme-linked immuno sorbent and Western blot assays. HIV-1 antibodies were found 1985/86 in 8.5%, 1986/87 in 14.5%, 1988 in 27.7% and 1989 in 29.7% of IVDUs. The introduction of methadone maintenance in 1987 attracted many IVDUs and increased the number of patients at the out-patient clinic. In 1989 more than 50% of the IVDUs are on methadone maintenance and already 84.5% of the HIV-1 infected drug users are treated with methadone.

A standardised method to monitor HIV-1 infection levels and trends among injecting drug users (IDUs) was periodically administered at the drug addiction outpatient ward of the Psychiatric University Clinic of Vienna. A total of 715 injecting drug users were examined. HIV-1 antibodies were found in 8.5% of the IDUs in 1985/86, 14.5% in 1986/87, 27.7% in 1988, 29.7% in 1989 and 26.9% in 1990. Sharing was extensive in infected IDUs. After introduction of methadone maintenance in Austria more than 50% of the IDUs were receiving methadone and, in 1990, 88% of the infected IDUs were treated with methadone.

The rapid spread of HIV infection among intravenous drug abusers plays an increasing role in the AIDS epidemic. In this context the Austrian government changed politics and introduced a methadone maintenance program 1987, to reach more intravenous drug addicts and to stop intravenous drug abuse of this clients. 119 intravenous drug users were anonymously tested for HIV antibodies between April 18 and May 17, 1988 at the out-patient clinic of the Psychiatric University clinic of Vienna and were examined by means of a standardized questionnaire. The data are discussed in respect of the benefits of a methadone maintenance program to decrease HIV-infection among intravenous drug abusers in Vienna.