Reducing the transmission of HIV-1: Needle bleaching as a means of disinfection

OBJECTIVE: To review the efficacy, safety, and proper methods for use of bleach (sodium hypochlorite) as a means of needle disinfection. DATA SOURCES: Controlled studies cited in MEDLINE between 1966 and 1999 using indexing terms: needle, bleach, HIV/AIDS, and disinfection. STUDY SELECTION AND DATA EXTRACTION: Studies were categorized based on experimental conditions produced and specific testing procedures used. DATA SYNTHESIS: Used properly, undiluted bleach (sodium hypochlorite 5.25%) appears to be an effective disinfection solution for used needles. Proper needle disinfection with undiluted bleach may reduce the risk of HIV transmission among injection drug users from needle sharing. CONCLUSION: Pharmacists can play a role in reducing HIV transmission among injection drug users by advocating cessation of drug use, drug treatment programs, and avoidance of needle sharing. Pharmacists should be prepared to educate patients who are unwilling to cease illicit drug use or participate in drug treatment programs on the proper methods of bleach disinfection of used needles.