Engaging people who inject drugs and their peers in HIV testing and harm reduction in Ukraine: do they make a difference?
| Autor: | Joshua Jayaraj, Rony Zachariah, Nataliia Kravchenko, Pavlo Smyrnov, Julia Kuznetsova, Olga Denisiuk |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Adolescent Human immunodeficiency virus (HIV) Active engagement HIV Infections Hiv testing medicine.disease_cause Microbiology Young Adult Harm Reduction Virology Disease Transmission Infectious medicine Humans Substance Abuse Intravenous Aged Retrospective Studies Harm reduction Diagnostic Tests Routine business.industry virus diseases General Medicine Middle Aged Diagnostic Services Infectious Diseases Case finding Female Parasitology Health Services Research Ukraine business Facilities and Services Utilization Demography |
| Zdroj: | The Journal of Infection in Developing Countries. 13:118S-125S |
| ISSN: | 1972-2680 |
| DOI: | 10.3855/jidc.11293 |
| Popis: | Introduction: People Who Inject Drugs (PWID) should be offered HIV-testing and harm reduction services. We assessed the effectiveness of including PWID and their peers in HIV-testing by comparing for a period before (2013-2014) and after their introduction (2015-2017), the a) numbers HIV tested b) number enrolled in harm reduction and c) frequency of HIV-testing. Methodology: An analysis of programme data involved PWID aged ≥ 14 years (1st January 2013-31st December 2017) in Ukraine. Between 2013-2014, HIV-testing (VCT) was done by trained health workers. From 2015, this was Directly Assisted HIV Self-testing (DAST) done by social workers and peers. Optimized HIV case finding (OCF) was introduced (in 2016) as an overlapping strategy with DAST. Results: A total of 844,837 HIV tests were done with 23,427 (2.8%) HIV-positive results. With VCT, there were 164,417 HIV tests compared to 639,685 after engagement of PWID and their peers (>3-fold increase). The highest HIV positive yield (20%) was when OCF was included. With increasing HIV-testing caseload, a progressive decrease in enrollment in harm reduction was seen (85% in 2014 to 47% in 2017, X2 for trend P < 0.001). OCF resulted in enrollment into harm reduction of 2722 HIV-positives, which was 35% higher than through DAST alone (7,5%). HIV re-testing almost doubled with DAST. Conclusion: Active engagement of PWID and their peers in HIV-testing increased uptake of HIV-testing. Including OCF has a synergistic effect in HIV-positive yield. Strategies are urgently needed to ensure that individuals who are HIV tested are enrolled in harm reduction. |
| Databáze: | OpenAIRE |
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