scholarly journals Risky injection practices and HCV awareness in Chiang Mai Province, Thailand: a respondent-driven sampling study of people who inject drugs

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Myrtille Prouté ◽  
Sophie Le Coeur ◽  
Métrey H. Tiv ◽  
Timothée Dub ◽  
Parinya Jongpaijitsakul ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Addiction Treatment ◽  
People Who Inject Drugs ◽  
Civil Society Organizations ◽  
Public Health Approach ◽  
Minority Ethnic Group ◽  
Respondent Driven Sampling ◽  
Chiang Mai ◽  
Chiang Mai Province ◽  
Injection Practices

Abstract Background People who inject drugs (PWID) are the most exposed to hepatitis C virus (HCV). In Thailand, drug use is highly criminalized, and harm reduction services are scarce. This study estimates risky injection practices and assesses the proportion of HCV awareness and screening in the PWID population in Northern Thailand. Methods We used respondent-driven sampling (RDS) to recruit PWID in Chiang Mai Province. Social and behavioural data were collected through face-to-face interviews at an addiction treatment facility. Weighted population estimates were calculated to limit biases related to the non-random sampling method. Univariate and multivariate analyses were performed to study factors associated with HCV awareness and screening. Results One hundred seventy-one PWID were recruited between April 2016 and January 2017. Median age was 33 (Interquartile range: 26–40) years, 12.2% were women, and 49.4% belonged to a minority ethnic group. Among participants, 76.8% injected heroin, 20.7% methadone, and 20.7% methamphetamine. We estimate that 22.1% [95% CI: 15.7–28.6] of the population had shared needles in the last 6 months and that 32.0% [95% CI: 23.6–40.4] had shared injection material. Only 26.6% [95% CI: 17.6–35.6] had heard of HCV. Factors independently associated with knowledge of HCV included belonging to a harm reduction organization (adjusted odds ratio (aOR) = 5.5 [95% CI: 2.0–15.3]) and voluntary participation in a drug rehabilitation programme (aOR = 4.3 [95% CI: 1.3–13.9]), while Lahu ethnicity was negatively associated (aOR = 0.3 [95% CI: 0.1–0.9]). We estimate that 5% of the PWID population were screened for HCV; the only factor independently associated with being screened was membership of a harm reduction organization (aOR = 5.7 [95% CI: 1.6–19.9]). Conclusion Our study reveals that the PWID population is poorly informed and rarely screened for HCV, despite widespread risky injection practices. A public health approach aimed at reducing the incidence of HCV should target the PWID population and combine harm reduction measures with information and destigmatization campaigns. Civil society organizations working with PWID are a major asset for the success of such an approach, based on their current positive interventions promoting awareness of and screening for HCV.

scholarly journals Diverse HIV epidemics among people who inject drugs in Thailand: Evidence from respondent-driven sampling surveys in Bangkok and Chiang Mai

2015 ◽  
Vol 148 ◽  
pp. 126-135 ◽  
Author(s):  
Dimitri Prybylski ◽  
Chomnad Manopaiboon ◽  
Prin Visavakum ◽  
Kovit Yongvanitjit ◽  
Apinun Aramrattana ◽  
...  
Keyword(s):  
People Who Inject Drugs ◽  
Respondent Driven Sampling ◽  
Chiang Mai

scholarly journals Personas que se inyectan drogas en Hermosillo, Sonora. Metodología para su registro

2016 ◽  
Vol 28 (67) ◽  
Author(s):  
Angélica Ospina-Escobar
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Population Size ◽  
Addiction Treatment ◽  
People Who Inject Drugs ◽  
Hiv Transmission ◽  
Multiplier Methods ◽  
Qualitative And Quantitative ◽  
Treatment Services ◽  
Mixed Approach

Resumen: conocer el tamaño de las poblaciones es fundamental para estimar universos de necesidad, planear intervenciones y evaluarlas. La estigmatización y criminalización del uso de drogas en México hace que las personas que se las inyectan sean difíciles de alcanzar, sin embargo tienen derecho a la salud, y el Estado está obligado a garantizarla, lo que incluye diseñar acciones efectivas para prevenir el sida. En Hermosillo, Sonora, el peso de la trasmisión del virus de inmunodeficiencia humana por drogas inyectadas ha ganado relevancia en la última década, no obstante, se desconoce el tamaño de la población que se inyecta drogas. En este artículo se describe detalladamente cómo se construye una aproximación mixta de metodologías cualitativas y cuantitativas para estimar el tamaño de dicha población en Hermosillo, y se ofrecen recomendaciones para mejorar los sistemas para registrarla en los servicios de tratamiento de adicciones, y cómo potenciar las intervenciones comunitarias de reducción de daños en la ciudad.Palabras clave: métodos multiplicadores; métodos mixtos; personas que se inyectan drogas; reducción de daños; Hermosillo.Abstract: having estimations of the size of populations is critical to estimate universes of need, plan and evaluate interventions. Stigmatization and criminalization of drug use in Mexico makes pwid constitute a hard-to-reach population; however, they have a right to health and it is an obligation of the State to guarantee it, which includes designing effective actions to prevent aids. In Hermosillo, Sonora, the weight of hiv transmission via injecting drug use has gained prominence in the last decade; nevertheless, there are no estimations of pwid population size. In this paper we describe in detail how to build a mixed approach combining qualitative and quantitative techniques to estimate the population size of pwid in Hermosillo. We present recommendations to improve pwid registration systems in addiction treatment services and how to improve community harm reduction interventions in the city.Key words: multiplier methods; mixed methods; people who inject drugs; harm reduction; Hermosillo.

scholarly journals Municipal police support for harm reduction services in officer-led referrals of people who inject drugs in Tijuana, Mexico

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Pieter Baker ◽  
Jaime Arredondo ◽  
Annick Borquez ◽  
Erika Clairgue ◽  
Maria L. Mittal ◽  
...  
Keyword(s):  
Law Enforcement ◽  
Drug Use ◽  
Harm Reduction ◽  
Addiction Treatment ◽  
People Who Inject Drugs ◽  
Police Training ◽  
Prevalence Ratio ◽  
Crime Reduction ◽  
High Drug ◽  
Addiction Services

Abstract Background Police constitute a structural determinant of health and HIV risk of people who inject drugs (PWID), and negative encounters with law enforcement present significant barriers to PWID access to harm reduction services. Conversely, police may facilitate access via officer-led referrals, potentiating prevention of HIV, overdose, and drug-related harms. We aimed to identify police characteristics associated with support for officer-led referrals to addiction treatment services and syringe service programs (SSP). We hypothesized that officers who believe harm reduction services are contradictory to policing priorities in terms of safety and crime reduction will be less likely to support police referrals. Methods Between January and June 2018, police officers (n = 305) in Tijuana, Mexico, completed self-administered surveys about referrals to harm reduction services during the 24-month follow-up visit as part of the SHIELD police training and longitudinal cohort study. Log-binomial regression was used to estimate adjusted prevalence ratios and model policing characteristics and attitudes related to officers’ support for including addiction treatment and SSP in referrals. Results Respondents were primarily male (89%), patrol officers (86%) with a median age of 38 years (IQR 33–43). Overall, 89% endorsed referral to addiction services, whereas 53% endorsed SSP as acceptable targets of referrals. Officers endorsing addiction services were less likely to be assigned to high drug use districts (adjusted prevalence ratio [APR] = 0.50, 95% CI 0.24, 1.08) and more likely to agree that methadone programs reduce crime (APR = 4.66, 95% CI 2.05, 9.18) than officers who did not support addiction services. Officers endorsing SSPs were younger (adjusted prevalence ratio [APR] = 0.96 95% CI 0.93, 0.98), less likely to be assigned to high drug use districts (APR = 0.50, 95% CI 0.29, 0.87), more likely to believe that methadone programs reduce crime (APR = 2.43, 95% CI 1.30, 4.55), and less likely to believe that SSPs increase risk of needlestick injury for police (APR = 0.44, 0.27, 0.71). Conclusions Beliefs related to the occupational impact of harm reduction services in terms of officer safety and crime reduction are associated with support for referral to related harm reduction services. Efforts to deflect PWID from carceral systems toward harm reduction by frontline police should include measures to improve officer knowledge and attitudes about harm reduction services as they relate to occupational safety and law enforcement priorities. Trial Registration: NCT02444403.

scholarly journals High levels of used syringe use and unsafe sex among people who inject drugs in Kumasi, Ghana: an urgent call for a comprehensive harm reduction approach

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lisa J. Messersmith ◽  
Rose Adjei ◽  
Jennifer Beard ◽  
Angela R. Bazzi ◽  
Joel J. Earlywine ◽  
...  
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Population Size ◽  
Sex Workers ◽  
People Who Inject Drugs ◽  
Syringe Sharing ◽  
Unsafe Sex ◽  
Lack Of Information ◽  
Sex With Men ◽  
Major Drug

Abstract Background Drug use is a growing concern in Ghana. People who inject drugs (PWID) are highly vulnerable to HIV and other infectious diseases. Ghana’s National Strategic Plan for HIV/AIDS 2016–2020 identifies PWID as a key population, but efforts to address the needs of PWID have lagged behind those targeting sex workers and men who have sex with men. Lack of information about PWID is a critical barrier to implementing effective HIV prevention and treatment. We aimed to learn more about the vulnerability of the PWID population in order to inform much-needed harm reduction interventions. Methods From April to July 2018, we conducted a mixed methods study in Kumasi, Ghana, to identify all major drug using locations, count the numbers of PWID to obtain rough population size estimations, and administer anonymous surveys to 221 PWID regarding drug use and sexual behavior. We also tested for HIV, HCV, and HBV from syringes used by survey participants. Results Key informants identified five major drug using locations and estimated the total PWID population size to be between 600 and 2000. Enumerators counted between 35 and 61 individuals present at each of the five bases. Sharing syringes and reusing discarded syringes are common practices. Over half of survey participants (59%) reported past-month syringe sharing (34% used a used syringe and 52% gave away a used syringe). Individuals with higher injection frequency (≥ 21 times weekly) and who injected with four or more people had higher odds of syringe sharing. Of the survey participants reporting sex in the last month (23%), most reported having one partner, but only 12% used condoms. Nearly all women (11/13) reported exchanging sex for drugs and 6/13 reported exchanging sex for money in the last six months. Fifteen percent of participants (all men) reported paying for sex using drugs or money. Of the used syringes, prevalence estimates were 3% (HIV), 2% (HCV), and 9% (HBV). Conclusions Our findings confirm the urgent need to implement harm reduction interventions targeting PWID and to build a strong and enabling legal and policy environment in Ghana to support these efforts.

Extremely low and sustained HIV incidence among people who inject drugs in a setting of harm reduction

AIDS ◽  
2014 ◽  
Vol 28 (2) ◽  
pp. 275-278 ◽  
Author(s):  
Jenny Iversen ◽  
Handan Wand ◽  
Libby Topp ◽  
John Kaldor ◽  
Lisa Maher
Keyword(s):  
Harm Reduction ◽  
People Who Inject Drugs ◽  
Hiv Incidence

Healthcare seeking and hospital admissions by people who inject drugs in response to symptoms of injection site infections or injuries in three urban areas of England

2014 ◽  
Vol 143 (1) ◽  
pp. 120-131 ◽  
Author(s):  
V. D. HOPE ◽  
F. NCUBE ◽  
J. V. PARRY ◽  
M. HICKMAN
Keyword(s):  
Hospital Admission ◽  
Injection Site ◽  
Urban Areas ◽  
People Who Inject Drugs ◽  
Hospital Admissions ◽  
Medical Advice ◽  
Respondent Driven Sampling ◽  
Open Wound ◽  
Factors Associated ◽  
Healthcare Burden

SUMMARYPeople who inject drugs (PWID) are vulnerable to infections and injuries at injection sites. The factors associated with reporting symptoms of these, seeking related advice, and hospital admission are examined. PWID were recruited in Birmingham, Bristol and Leeds using respondent-driven sampling (N = 855). During the preceding year, 48% reported having redness, swelling and tenderness (RST), 19% an abscess, and 10% an open wound at an injection site. Overall, 54% reported ⩾1 symptoms, with 45% of these seeking medical advice (main sources emergency departments and General Practitioners). Advice was often sought ⩾5 days after the symptom first appeared (44% of those seeking advice about an abscess, 45% about an open wound, and 35% for RST); the majority received antibiotics. Overall, 9·5% reported hospital admission during the preceding year. Ever being diagnosed with septicaemia and endocarditis were reported by 8·8% and 2·9%, respectively. Interventions are needed to reduce morbidity, healthcare burden and delays in accessing treatment.

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