scholarly journals Hidden populations: risk behaviours in drug-using populations in the Republic of Georgia through subsequent peer-driven interventions

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Cale Lawlor ◽  
Marine Gogia ◽  
Irma Kirtadze ◽  
Keti Stvilia ◽  
Guranda Jikia ◽  
...  
Keyword(s):  
High Risk ◽  
Drug Use ◽  
Harm Reduction ◽  
Dynamic Change ◽  
Significant Risk ◽  
Recruitment Strategy ◽  
Risk Behaviours ◽  
Hidden Populations ◽  
Hiv Knowledge ◽  
Overall Risk

Abstract Background Georgia has a significant risk of ongoing HIV and HCV outbreak. Within this context, harm reduction aims to reduce risk associated with drug use through community activities, such as peer recruitment and involvement. The aim of this study was to identify significant differences between known and hidden populations, and attest to the ongoing utility of peer-driven intervention across multiple years in recruiting high-risk, vulnerable populations through peer networks. It was hypothesised that significant differences would remain between known, and previously unknown, members of the drug-using community, and that peer-driven intervention would recruit individuals with high-risk, vulnerable individuals with significant differences to the known population. Methods Sampling occurred across 9 months in 11 cities in Georgia, recruiting a total of 2807 drug-using individuals. Standardised questionnaires were completed for all consenting and eligible participants, noting degree of involvement in harm reduction activities. These data underwent analysis to identify statistically significant different between those known and unknown to harm reduction activities, including in demographics, knowledge and risk behaviours. Results Peer recruitment was able to attract a significantly different cohort compared to those already known to harm reduction services. Peer-driven intervention was able to recruit a younger population by design, with 25.1% of PDI participants being under 25, compared to 3.2% of NSP participants. PDI successfully recruited women by design, with 6.9% of PDI participants being women compared to 2.0% in the NSP sample. Important differences in drug use, behaviour and risk were seen between the two groups, with the peer-recruited cohort undertaking higher-risk injecting behaviours. A mixture of risk differences was seen across different subgroups and between the known and unknown population. Overall risk, driven by sex risk, was consistently higher in younger people (0.59 vs 0.57, p = 0.00). Recent overdose was associated with higher risk in all risk categories. Regression showed age and location as important variables in overall risk. Peer-recruited individuals reported much lower rates of previous HIV testing (34.2% vs 99.5%, p = 0.00). HIV knowledge and status were not significantly different. Conclusions Significant differences were seen between the known and unknown drug-using populations, and between previous and current research, speaking to the dynamic change of the drug-using culture. The recruitment strategy was successful in recruiting females and younger people. This is especially important, given that this sampling followed subsequent rounds of peer-driven intervention, implying the ability of peer-assisted recruitment to consistently reach hidden, unknown populations of the drug-using community, who have different risks and behaviours. Risk differences were seen compared to previous samples, lending strength to the peer-recruitment model, but also informing how harm reduction programmes should cater services, such as education, to different cohorts.

scholarly journals Hidden Populations: Risk Behaviours in Drug-Using Populations in the Republic of Georgia Through Subsequent Peer-Driven Interventions

2021 ◽  
Author(s):  
Cale Lawlor ◽  
Irma Kirtadze ◽  
Ketevan Stvilia ◽  
Guranda Jikia ◽  
Tamar Zurashvili ◽  
...  
Keyword(s):  
High Risk ◽  
Drug Use ◽  
Harm Reduction ◽  
Significant Risk ◽  
Recruitment Strategy ◽  
Hidden Populations ◽  
Hiv Knowledge ◽  
Community Activities ◽  
The Republic ◽  
Overall Risk

Abstract BackgroundGeorgia has a significant risk of ongoing HIV and HCV outbreak. Within this context, harm reduction aims to reduce risk associated with drug use through community activities, such as peer recruitment and involvement. The aim of this study was to identify significant differences between known and hidden populations, and attest to the ongoing utility of peer-driven intervention across multiple years in recruiting high-risk, vulnerable populations through peer networks. It was hypothesised that significant differences would remain between known, and previously unknown, members of the drug-using community, and that peer-driven intervention would recruit individuals with high-risk, vulnerable individuals with significant differences to the known population.MethodsSampling occurred across 9 months in 11 cities in Georgia, recruiting a total of 2807 drug-using individuals. Standardised questionnaires were completed for all consenting and eligible participants, noting degree of involvement in harm reduction activities. This data underwent analysis to identify statistically significant different between those known and unknown to harm reduction activities, including in demographics, knowledge and risk behaviours.ResultsPeer recruitment was able to attract a significantly different cohort compared to those already known to harm reduction services. Peer-driven intervention was able to recruit a younger population, with 25.1% of PDI participants being under 25, compared to 3.2% of NSP participants. PDI successfully recruited women, with 6.9% of PDI participants being women compared to 2.0% in the NSP sample. Important differences in drug use, behaviour and risk were seen between the two groups, with the peer-recruited cohort undertaking higher-risk injecting behaviours. A mixture of risk differences was seen across different sub-groups and between the known and unknown population. Overall risk, driven by sex risk, was consistently higher in younger people (0.59 v. 0.57, p=0.00). Recent overdose was associated with higher risk in all risk categories. Regression showed age and location as important variables in overall risk. Peer-recruited individuals reported much lower rates of previous HIV testing (34.2% v. 99.5%, p=0.00). HIV knowledge and status were not significantly different.ConclusionsSignificant differences were seen between the known and unknown drug-using populations. The recruitment strategy was successful in recruiting females and younger people. This is especially important given that this sampling followed subsequent rounds of peer-driven intervention, implying the ability of peer-recruitment to consistently reach hidden, unknown populations of the drug using community, who have different risks and behaviours. Risk differences were seen compared to previous samples, lending strength to the peer-recruitment model, but also informing how harm reduction programmes should cater services, such as education, to different cohorts.

Hidden Populations: A Follow Up Study of Risk Behaviours in The Drug Using Populations in The Republic of Georgia

2020 ◽  
Author(s):  
Cale Lawlor ◽  
Irma Kirtadze ◽  
Keti Stvilia ◽  
Guranda Jikia ◽  
Tamar Zurashvili ◽  
...  
Keyword(s):  
High Risk ◽  
Drug Use ◽  
Harm Reduction ◽  
Significant Risk ◽  
Recruitment Strategy ◽  
Risk Behaviours ◽  
Hidden Populations ◽  
Hiv Knowledge ◽  
Community Activities ◽  
The Republic

Abstract Background:Georgia has a significant risk of ongoing HIV and HCV outbreak. Within this context, harm reduction aims to reduce risk associated with drug use through community activities, such as peer recruitment and involvement. The aim of this study was to compliment earlier research, and attest to the ongoing utility of peer-driven intervention across multiple years in recruiting high-risk, vulnerable populations through peer networks. It was hypothesised that significant differences would remain between known, and previously unknown, members of the drug-using community, and that peer-driven intervention would continue to recruit individuals with high-risk, vulnerable individuals.Methods:Sampling occurred across 9 months in 11 cities in Georgia, recruiting a total of 2807 drug-using individuals. Standardised questionnaires were completed for all consenting and eligible participants, noting degree of involvement in harm reduction activities. This data underwent analysis to identify statistically significant different between those known and unknown to harm reduction activities, including in demographics, knowledge and risk behaviours. Results:Peer recruitment was able to attract a significantly different cohort compared to those already known to harm reduction services. Important differences in drug use, behaviour and risk were seen between the two groups, with the peer-recruited cohort undertaking higher-risk injecting behaviours. A mixture of risk differences was seen across different sub-groups and between the known and unknown population. Overall risk, driven by sex risk, was consistently higher in younger people (0.59 v. 0.57, p=0.00). Recent overdose was associated with higher risk in all risk categories. Peer-recruited individuals reported much lower rates of previous HIV testing (34.2% v. 99.5%, p=0.00). HIV knowledge and status were not significantly different.Conclusions:Significant differences were seen between the known and unknown drug-using populations. The recruitment strategy was successful in recruiting females and younger people. This is especially important given that this sampling followed subsequent rounds of peer-driven intervention, implying the ability of peer-recruitment to consistently reach hidden, unknown populations of the drug using community, who have different risks and behaviours. Risk differences were seen compared to previous samples, lending strength to the peer-recruitment model, but also informing how harm reduction programmes should cater services, such as education, to different cohorts.

Problems and Prospects of Implementing Harm Reduction for HIV and Injecting Drug Use in High Risk Sub-Saharan African Countries

1997 ◽  
Vol 27 (1) ◽  
pp. 97-116 ◽  
Author(s):  
Moruf L. Adelekan ◽  
Gerry V. Stimson
Keyword(s):  
High Risk ◽  
Drug Use ◽  
Harm Reduction ◽  
Psychosocial Problems ◽  
Causative Factor ◽  
Injecting Drug Use ◽  
Hiv And Aids ◽  
African Countries ◽  
Demand Reduction ◽  
Sub Saharan

The use and misuse of a broad spectrum of psychoactive substances, including heroin and cocaine, is of growing concern in many African countries. Approximately one-third of global HIV and AIDS cases are reported from Africa, but injecting drug use has not yet been documented as a causative factor. The drug supply control strategy has recorded only limited success in Africa, and the currently adopted demand reduction programs are beset with many problems. In this paper we review possible constraining and facilitating factors in the adoption of harm reduction approaches in high risk sub-Saharan African countries. We conclude that appropriate needs assessments are urgently required to establish the extent of problem drug use and of injecting. This exercise may identify clinical and psychosocial problems that could benefit from an intervention approach based on a combination of the principles of harm reduction and demand reduction.

scholarly journals Knowledge about Tuberculosis among Drug Users in Kathmandu Valley

2013 ◽  
Vol 12 (1) ◽  
pp. 1-6
Author(s):  
P Shrestha
Keyword(s):  
High Risk ◽  
Drug Use ◽  
Drug Users ◽  
Service Providers ◽  
Significant Risk ◽  
Signs And Symptoms ◽  
Structured Interview ◽  
Correct Knowledge ◽  
Depth Interview ◽  
Source Of Information

Background Drug use is a significant risk factor for acquiring tuberculosis (TB) infection and progressing to active TB due to high Human Immunodeficiency Virus (HIV) seroprevalence, low socio-economic status, poor environmental conditions and problems of access to health care. Illicit drug users are at high risk for TB. Objective To assess the knowledge about TB among drug users whereas the specific objectives are to assess the knowledge about how TB is acquired, transmitted and prevented, the signs and symptoms of TB including diagnosis, curability and the source of information. Methodology Descriptive cross sectional study among 45 male and 18 female drug users in two centers each of Kathmandu and Lalitpur. Semi structured interview schedule was used to collect data. In Depth Interview (IDI) was conducted among 5 drug service providers using IDI guidelines. Results Majority of users (42%) were between 25-29 years and male (71%). About 13% respondents had family history of drug use. Major source of information was print media. Only 33% respondents had the correct knowledge about the causes of TB; however knowledge regarding signs and symptoms was found to be good. About 64% respondents had correct knowledge regarding transmission and 44% about its diagnosis. About 97% respondents knew that TB can be cured but not about the medications and treatment duration. Most users (71%) were familiar with preventive measures. In-depth Interview with drug service providers revealed that drug users are at high risk of acquiring TB as their knowledge regarding TB was poor and drug users ignored about TB. Conclusion Although drug users are at high risk for contracting and spreading TB, the level of knowledge about TB was low. It is necessary to provide them with TB related information and education to reduce the burden of TB. DOI: http://dx.doi.org/10.3126/hprospect.v12i1.8719   Health Prospect: Journal of Public Health Vol.12(1) 2013: 1-6

Rural Incarcerated Women: HIV/HCV Knowledge and Correlates of Risky Behavior

2018 ◽  
Vol 45 (6) ◽  
pp. 977-986 ◽  
Author(s):  
Bridgette Peteet ◽  
Michele Staton ◽  
Brittany Miller-Roenigk ◽  
Adam Carle ◽  
Carrie Oser
Keyword(s):  
High Risk ◽  
Drug Use ◽  
Sexual Behaviors ◽  
Sexual Minority ◽  
Risky Behavior ◽  
Incarcerated Women ◽  
Minority Women ◽  
Sexual Minority Women ◽  
Hiv Knowledge ◽  
Increased Risk

Rural incarcerated women have an increased risk of acquiring the human immunodeficiency virus (HIV) and the hepatitis C virus (HCV) due to prevalent engagement in drug use and sexual behaviors. Limited research has investigated HIV and HCV knowledge in this high-risk population. Furthermore, the interplay of sociodemographic factors (i.e., education, age, income, and sexual orientation) and risky behavior is understudied in this population. The present study evaluated a sample of adult, predominately White women from rural Kentucky ( n = 387) who were recruited from local jails. The sample had high HIV and HCV knowledge but also reported extensive risk behaviors including 44% engaging in sex work and 75.5% reporting a history of drug injection. The results of multiple regression analysis for risky sexual behavior indicated that sexual minority women and those with less HIV knowledge were more likely to engage in high-risk sexual behaviors. The regression model identifying the significant correlates of risky drug behavior indicated that HIV knowledge, age, and income were negative correlates and that sexual minority women were more likely to engage in high-risk drug use. When HCV knowledge was added to the regression models already including HIV knowledge, the interaction was significant for drug risk. Interventions for rural imprisoned women should consider the varied impact of sociodemographic background and prioritize HIV education to more effectively deter risky sexual and drug behaviors.

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.

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