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.

Population Size Estimate of Men who have Sex with Men, Female Sex Workers and People who Inject Drugs in Mozambique—A multiple methods approach

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Isabel Sathane ◽  
Makini A.S. Boothe ◽  
Roberta Horth ◽  
Cynthia Semá Baltazar ◽  
Noela Chicuecue ◽  
...  
Keyword(s):  
Population Size ◽  
Sex Workers ◽  
Female Sex Workers ◽  
People Who Inject Drugs ◽  
Multiple Methods ◽  
Female Sex ◽  
Population Size Estimate ◽  
Size Estimate ◽  
Sex With Men

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 Drug use practices among people who inject drugs in a context of drug market changes: Challenges for optimal coverage of harm reduction programs

2017 ◽  
Vol 45 ◽  
pp. 18-24 ◽  
Author(s):  
Élise Roy ◽  
Nelson Arruda ◽  
Pascale Leclerc ◽  
Carole Morissette ◽  
Caty Blanchette ◽  
...  
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
People Who Inject Drugs ◽  
Drug Market ◽  
Market Changes

scholarly journals Psychosocial Barriers to Viral Suppression in a Community-based Sample of Human Immunodeficiency Virus–infected Men Who Have Sex With Men and People Who Inject Drugs in India

2019 ◽  
Vol 70 (2) ◽  
pp. 304-313 ◽  
Author(s):  
Sandeep Prabhu ◽  
Allison M McFall ◽  
Shruti H Mehta ◽  
Aylur K Srikrishnan ◽  
Muniratnam Suresh Kumar ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Use ◽  
Alcohol Dependence ◽  
Viral Suppression ◽  
People Who Inject Drugs ◽  
Severe Depression ◽  
Recreational Drug ◽  
Immunodeficiency Virus ◽  
Recreational Drug Use ◽  
Sex With Men

Abstract Background Little is known about the impact of psychosocial factors and substance use on viral suppression among human immunodeficiency virus (HIV)–infected key populations in resource-limited settings. Accordingly, we examined the association and interactions between depression, alcohol use, and recreational drug use on viral suppression among men who have sex with men (MSM) and people who inject drugs (PWID) in India. Methods MSM and PWID were recruited across India using respondent-driven sampling (RDS). Correlates of viral suppression were determined using Poisson regression models incorporating RDS-II weights. Two-way multiplicative interactions were assessed with separate models of all combinations of the 3 variables of interest using interaction terms; 3-way interactions were evaluated by stratifying 2-way interactions by the third variable. Results Among 1454 treatment-eligible HIV-infected MSM and 1939 PWID, older age (adjusted prevalence ratio [aPR], 1.14 for MSM; 1.41 for PWID) and higher HIV treatment literacy (aPR, 1.58 for MSM; 3.04 for PWID) were positively associated with viral suppression. Among MSM, there was evidence of a synergistic negative association between severe depression and recreational drug use (aPR, 0.37 [95% confidence interval {CI}, .16–.84]), alcohol dependence and recreational drug use (aPR, 0.45 [95% CI, .20–.99]), and severe depression, alcohol dependence, and recreational drug use (aPR, 0.23 [95% CI, .09–.57]). Among PWID, daily injection (aPR, 0.51 [95% CI, .31–.82]) was the primary barrier to suppression. Conclusions Incorporating psychosocial and harm-reduction services into differentiated care models targeting MSM and PWID in low-resource settings is critical to achieving the 90-90-90 HIV/AIDS targets.

scholarly journals Impact of drug consumption rooms on risk practices and access to care in people who inject drugs in France: the COSINUS prospective cohort study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023683
Author(s):  
Marc Auriacombe ◽  
Perrine Roux ◽  
Laélia Briand Madrid ◽  
Sébastien Kirchherr ◽  
Charlotte Kervran ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis C ◽  
Drug Use ◽  
Harm Reduction ◽  
Access To Care ◽  
Social Services ◽  
People Who Inject Drugs ◽  
Drug Consumption ◽  
Risk Practices ◽  
The Impact

IntroductionThe high prevalence of hepatitis C and the persistence of HIV and hepatitis C virus (HCV) risk practices in people who inject drugs (PWID) in France underlines the need for innovative prevention interventions. The main objective of this article is to describe the design of the COSINUS cohort study and outline the issues it will explore to evaluate the impact of drug consumption rooms (DCR) on PWID outcomes. Secondary objectives are to assess how DCR (a) influence other drug-related practices, such as the transition from intravenous to less risky modes of use, (b) reduce drug use frequency/quantity, (c) increase access to treatment for addiction and comorbidities (infectious, psychiatric and other), (d) improve social conditions and (e) reduce levels of violence experienced and drug-related offences. COSINUS will also give us the opportunity to investigate the impact of other harm reduction tools in France and their combined effect with DCR on reducing HIV-HCV risk practices. Furthermore, we will be better able to identify PWID needs.Methods and analysisEnrollment in this prospective multi-site cohort study started in June 2016. Overall, 680 PWID in four different cities (Bordeaux, Marseilles, Paris and Strasbourg) will be enrolled and followed up for 12 months through face-to-face structured interviews administered by trained staff to all eligible participants at baseline (M0), 3 month (M3), 6 month (M6) and 12 month (M12) follow-up visits. These interviews gather data on socio-demographic characteristics, past and current drug and alcohol consumption, drug-use related practices, access to care and social services, experience of violence (as victims), offences, other psychosocial issues and perception and needs about harm reduction interventions and services. Longitudinal data analysis will use a mixed logistic model to assess the impact of individual and structural factors, including DCR attendance and exposure to other harm reduction services, on the main outcome (HIV-HCV risk practices).Ethics and disseminationThis study was reviewed and approved by the institutional review board of the French Institute of Medical Research and Health (opinion number: 14–166). The findings of this cohort study will help to assess the impact of DCR on HIV-HCV risk practices and other psycho-social outcomes and trajectories. Moreover, they will enable health authorities to shape health and harm reduction policies according to PWID needs. Finally, they will also help to improve current harm reduction and therapeutic interventions and to create novel ones.

Trends in HIV prevalence among people injecting drugs, men having sex with men, and female sex workers in Ukraine

2018 ◽  
Vol 29 (13) ◽  
pp. 1337-1344 ◽  
Author(s):  
Kostyantyn Dumchev ◽  
Yana Sazonova ◽  
Tetiana Salyuk ◽  
Olga Varetska
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
People Who Inject Drugs ◽  
Hiv Prevalence ◽  
New Wave ◽  
Female Sex ◽  
Hiv Epidemic ◽  
Nationally Representative ◽  
Sex With Men ◽  
Generation Surveillance

Once recognized as the most severe in Europe, the HIV epidemic in Ukraine is concentrated among people who inject drugs, men who have sex with men, and female sex workers. Integrated biobehavioral surveys, as a part of the second generation surveillance, are used to monitor HIV infection trends in key populations since 2002. The present paper is focused on the analysis of HIV prevalence trends in four nationally representative rounds of integrated biobehavioral surveys from 2008/9, 2011, 2013, and 2015 in people who inject drugs, men who have sex with men, and female sex workers. Between 2008/9 and 2015, the HIV prevalence has decreased significantly in people who inject drugs (24.2 to 22.0%) and female sex workers (13.6 to 6.3%), while the change in men who have sex with men was not significant (8.5 to 7.8%). There was a significant increase in people who inject drugs and men who have sex with men between 2013 and 2015. In subgroups younger than 25 years, prevalence increased more than twofold in men who have sex with men (1.9 to 4.3%), with no changes in people who inject drugs and female sex workers. The observed decline in prevalence, especially in young subgroups, may result from the effect of extensive prevention efforts on drug injection-related transmission. Recent increase in young men who have sex with men may be a sign of a new wave of the epidemic in this group.

Injection site infections and injuries in men who inject image- and performance-enhancing drugs: prevalence, risks factors, and healthcare seeking

2014 ◽  
Vol 143 (1) ◽  
pp. 132-140 ◽  
Author(s):  
V. D. HOPE ◽  
J. McVEIGH ◽  
A. MARONGIU ◽  
M. EVANS-BROWN ◽  
J. SMITH ◽  
...  
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Injection Site ◽  
People Who Inject Drugs ◽  
Open Wound ◽  
Factors Associated ◽  
Risks Factors ◽  
And Performance ◽  
Performance Enhancing Drugs ◽  
Performance Enhancing

SUMMARYPeople who inject drugs are vulnerable to infections and injuries at injection sites, but these have rarely been studied in those injecting image- and performance-enhancing drugs (IPEDs). This study examined the factors associated with reported symptoms of injection site infections and injuries in IPED injectors. Of the 366 male IPED injectors surveyed, 42% reported ever having redness, swelling and tenderness (36% in the preceding year), and 6·8% had ever had an abscess or open wound at an injection site. Having these symptoms was associated with a range of factors related to drug use and healthcare utilization. One sixth (17%) of those reporting redness, tenderness and swelling had ever sought treatment, as had the majority (76%) of those reporting an abscess, sore or open wound. Most common sources of advice were emergency clinics and General Practitioners. Interventions are needed to support access to appropriate injecting equipment and provide targeted harm reduction advice.

scholarly journals Population Size Estimation Methods: Searching for the Holy Grail (Preprint)

2020 ◽  
Author(s):  
Joyce J Neal ◽  
Dimitri Prybylski ◽  
Travis Sanchez ◽  
Wolfgang Hladik
Keyword(s):  
Population Size ◽  
Sex Workers ◽  
Population Size Estimation ◽  
Estimation Methods ◽  
Size Estimation ◽  
Empirical Methods ◽  
Program Outcomes ◽  
Gold Standard Method ◽  
Response Planning ◽  
Sex With Men

UNSTRUCTURED Accurate size estimates of key populations (eg, sex workers, people who inject drugs, transgender people, and men who have sex with men) can help to ensure adequate availability of services to prevent or treat HIV infection; inform HIV response planning, target setting, and resource allocation; and provide data for monitoring and evaluating program outcomes and impact. A gold standard method for population size estimation does not exist, but quality of estimates could be improved by using empirical methods, multiple data sources, and sound statistical concepts. To highlight such methods, a special collection of papers in JMIR Public Health and Surveillance has been released under the title “Key Population Size Estimations.” We provide a summary of these papers to highlight advances in the use of empirical methods and call attention to persistent gaps in information.

scholarly journals Availability and Quality of Surveillance and Survey Data on HIV Prevalence Among Sex Workers, Men Who Have Sex With Men, People Who Inject Drugs, and Transgender Women in Low- and Middle-Income Countries: Review of Available Data (2001-2017) (Preprint)

2020 ◽  
Author(s):  
Sonia Arias Garcia ◽  
Jia Chen ◽  
Jesus Garcia Calleja ◽  
Keith Sabin ◽  
Chinelo Ogbuanu ◽  
...  
Keyword(s):  
Sex Workers ◽  
People Who Inject Drugs ◽  
Hiv Prevalence ◽  
Prevalence Data ◽  
Middle Income ◽  
Middle Income Countries ◽  
Data Points ◽  
Sex With Men ◽  
Low And Middle Income

BACKGROUND In 2019, 62% of new HIV infections occurred among key populations (KPs) and their sexual partners. The World Health Organization (WHO) recommends implementation of bio-behavioral surveys every 2-3 years to obtain HIV prevalence data for all KPs. However, the collection of these data is often less frequent and geographically limited. OBJECTIVE This study intended to assess the availability and quality of HIV prevalence data among sex workers (SWs), men who have sex with men (MSM), people who inject drugs, and transgender women (transwomen) in low- and middle-income countries. METHODS Data were obtained from survey reports, national reports, journal articles, and other grey literature available to the Global Fund, Joint United Nations Programme on HIV/AIDS, and WHO or from other open sources. Elements reviewed included names of subnational units, HIV prevalence, sampling method, and size. Based on geographical coverage, availability of trends over time, and recency of estimates, data were categorized by country and grouped as follows: nationally adequate, locally adequate but nationally inadequate, no recent data, no trends available, and no data. RESULTS Among the 123 countries assessed, 91.9% (113/123) presented at least 1 HIV prevalence data point for any KP; 78.0% (96/123) presented data for at least 2 groups; and 51.2% (63/123), for at least 3 groups. Data on all 4 groups were available for only 14.6% (18/123) of the countries. HIV prevalence data for SWs, MSM, people who inject drugs, and transwomen were available in 86.2% (106/123), 80.5% (99/123), 45.5% (56/123), and 23.6% (29/123) of the countries, respectively. Only 10.6% (13/123) of the countries presented nationally adequate data for any KP between 2001 and 2017; 6 for SWs; 2 for MSM; and 5 for people who inject drugs. Moreover, 26.8% (33/123) of the countries were categorized as locally adequate but nationally inadequate, mostly for SWs and MSM. No trend data on SWs and MSM were available for 38.2% (47/123) and 43.9% (54/123) of the countries, respectively, while no data on people who inject drugs and transwomen were available for 76.4% (94/123) and 54.5% (67/123) of the countries, respectively. An increase in the number of data points was observed for MSM and transwomen. Overall increases were noted in the number and proportions of data points, especially for MSM, people who inject drugs, and transwomen, with sample sizes exceeding 100. CONCLUSIONS Despite general improvements in health data availability and quality, the availability of HIV prevalence data among the most vulnerable populations in low- and middle-income countries remains insufficient. Data collection should be expanded to include behavioral, clinical, and epidemiologic data through context-specific differentiated survey approaches while emphasizing data use for program improvements. Ending the HIV epidemic by 2030 is possible only if the epidemic is controlled among KPs.

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