scholarly journals “Bureaucracy & Beliefs”: Assessing the barriers to accessing opioid substitution therapy by people who inject drugs in Ukraine

2015 ◽  
Vol 22 (3) ◽  
pp. 255-262 ◽  
Author(s):  
Martha J. Bojko ◽  
Alyona Mazhnaya ◽  
Iuliia Makarenko ◽  
Ruthanne Marcus ◽  
Sergii Dvoriak ◽  
...  
Keyword(s):  
People Who Inject Drugs ◽  
Substitution Therapy ◽  
Opioid Substitution Therapy ◽  
Opioid Substitution

scholarly journals People Who Inject Drugs and have tuberculosis: Opioid Substitution Therapy improves treatment outcomes in Ukraine

2021 ◽  
Vol 15 (09.1) ◽  
pp. 51S-57S
Author(s):  
Tetiana Fomenko ◽  
Anna Meteliuk ◽  
Larysa Korinchuk ◽  
Olga Denisiuk ◽  
Garry Aslanyan ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
People Who Inject Drugs ◽  
Treatment Success ◽  
Scale Up ◽  
Drug Resistant ◽  
Health Coverage ◽  
Substitution Therapy ◽  
Opioid Substitution Therapy ◽  
Tb Treatment ◽  
Opioid Substitution

Introduction: Opioid substitution therapy (OST) is one of the pillars of harm reduction strategies for People Who Inject Drugs (PWID). It should be an integral part of tuberculosis (TB) care to increase the uptake, compliance and effectiveness of treatment and also curtail risk behaviors. We aimed to compare TB treatment outcomes in relation to OST among PWID in six regions of Ukraine. Methodology: A retrospective cohort study using routine programmatic data from centers offering integrated TB and OST (December 2016 – May 2020). OST involved use of methadone or buprenorphine. TB treatment outcomes were standardized. Results: Of 228 PWID (85% male) diagnosed with TB, 104 (46%) had drug-sensitive and 124 (64%) drug-resistant TB. The majority had pulmonary TB (95%), 64 (28%) were HCV-positive and 179 (78%) were HIV-positive, 91% of the latter were also on antiretroviral therapy. There were 114 (50%) PWID with TB on OST. For drug-sensitive TB (n=104), treatment success was significantly higher (61%) in those on adjunctive OST than those not on OST (42%, P<0.001). Similarly, for drug-resistant TB (n=124) treatment success was also significantly higher when individuals were on OST (43%) compared to when not on OST (26%, P<0.001). Conclusions: This operational research study shows that OST is associated with significantly improved treatment success in PWID and can contribute to achieving Universal Health Coverage and the WHO Flagship Initiative “Find.Treat.All. #End TB”. We advocate for the scale-up of this intervention in Ukraine.

scholarly journals Efficacy of Direct-acting Antivirals for Chronic Hepatitis C Virus Infection in People Who Inject Drugs or Receive Opioid Substitution Therapy: A Systematic Review and Meta-analysis

2019 ◽  
Vol 70 (11) ◽  
pp. 2355-2365 ◽  
Author(s):  
Christiana Graf ◽  
Marcus M Mücke ◽  
Georg Dultz ◽  
Kai-Henrik Peiffer ◽  
Alica Kubesch ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Treatment Outcomes ◽  
People Who Inject Drugs ◽  
Discontinuation Rate ◽  
Direct Acting Antivirals ◽  
Substitution Therapy ◽  
Opioid Substitution Therapy ◽  
Direct Acting ◽  
Opioid Substitution

Abstract Background Treatment uptake for hepatitis C virus (HCV) infection in people who inject drugs (PWID) and patients on opioid substitution therapy (OST) is still low despite treatment guidelines that advocate the use of direct-acting antivirals (DAAs) in all patients. Our aim in this review was to investigate treatment outcomes among PWID and patients on OST in comparison to control cohorts. Methods A search of Embase, Medline, PubMed, and Web of Science (from October 2010 to March 2018) was conducted to assess sustained virologic response (SVR), discontinuation rates, adherence, and HCV reinfection in PWID and patients on OST. Results We identified 11 primary articles and 12 conference abstracts comprising 1702 patients on OST, 538 PWID, and 19 723 patients who served as controls. Among patients on OST, the pooled SVR was 90% (95% confidence interval [CI], 87% to 93%) and pooled treatment discontinuation rate was 7% (95% CI, 4% to 11%). Similarly, the pooled SVR was 88% (95% CI, 80% to 93%) in PWID and the pooled treatment discontinuation rate was 9% (95% CI, 5% to 15%). There was no significant difference regarding pooled rates of SVR, adherence, and discontinuation between patients on OST and controls as well as between PWID and controls. HCV reinfection rates among patients on OST ranged from 0.0 to 12.5 per 100 person-years. Conclusions HCV treatment outcomes in PWID and patients on OST are similar to those in patients without a history of injecting drugs, supporting current guideline recommendations to treat HCV in these patient populations.

scholarly journals Impact of opioid substitution therapy on the HIV prevention benefit of antiretroviral therapy for people who inject drugs

AIDS ◽  
2017 ◽  
Vol 31 (8) ◽  
pp. 1181-1190 ◽  
Author(s):  
Christinah Mukandavire ◽  
Andrea Low ◽  
Gitau Mburu ◽  
Adam Trickey ◽  
Margaret T. May ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Prevention ◽  
People Who Inject Drugs ◽  
Substitution Therapy ◽  
Opioid Substitution Therapy ◽  
Prevention Benefit ◽  
Opioid Substitution

scholarly journals The effects of needle-sharing and opioid substitution therapy on incidence of hepatitis C virus infection and reinfection in people who inject drugs

2016 ◽  
Vol 145 (4) ◽  
pp. 796-801 ◽  
Author(s):  
C. K. AITKEN ◽  
P. A. AGIUS ◽  
P. G. HIGGS ◽  
M. A. STOOVÉ ◽  
D. S. BOWDEN ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
People Who Inject Drugs ◽  
Hcv Infection ◽  
Protective Effects ◽  
Needle Sharing ◽  
Substitution Therapy ◽  
Opioid Substitution Therapy ◽  
Cross Model ◽  
Opioid Substitution

SUMMARYAlthough high hepatitis C virus (HCV) prevalence has been observed in people who inject drugs (PWID) for decades, research suggests incidence is falling. We examined whether PWIDs’ use of opioid substitution therapy (OST) and their needle-and-syringe sharing behaviour explained HCV incidence. We assessed HCV incidence in 235 PWID in Melbourne, Australia, and performed discrete-time survival with needle-sharing and OST status as independent variables. HCV infection, reinfection and combined infection/reinfection incidences were 7·6 [95% confidence interval (CI) 4·8–11·9], 12·4 (95% CI 9·1–17·0) and 9·7 (95% CI 7·4–12·6) per 100 person-years, respectively. Needle-sharing was significantly associated with higher incidence of naive HCV infection [hazard ratio (HR) 4·9, 95% CI 1·3–17·7] but not reinfection (HR 1·85, 95% CI 0·79–4·32); however, a cross-model test suggested this difference was sample specific. Past month use of OST had non-significant protective effects against naive HCV infection and reinfection. Our data confirm previous evidence of greatly reduced HCV incidence in PWID, but not the significant protective effect of OST on HCV incidence detected in recent studies. Our findings reinforce the need for greater access to HCV testing and prevention services to accelerate the decline in incidence, and HCV treatment, management and support to limit reinfection.

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