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HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage.

Creator:

Bradley M Mathers, Louisa Degenhardt, Hammad Ali, Lucas Wiessing, Matthew Hickman, Richard P Mattick, Bronwyn Myers, Atul Ambekar, Steffanie A Strathdee

Type: Report
Region: Republic of Ireland
Northern Ireland
Description:

Background: Previous reviews have examined the existence of HIV prevention, treatment, and care services for injecting drug users (IDUs) worldwide, but they did not quantify the scale of coverage. We undertook a systematic review to estimate national, regional, and global coverage of HIV services in IDUs. Methods: We did a systematic search of peer-reviewed (Medline, BioMed Central), internet, and grey-literature databases for data published in 2004 or later. A multistage process of data requests and verification was undertaken, involving UN agencies and national experts. National data were obtained for the extent of provision of the following core interventions for IDUs: needle and syringe programmes (NSPs), opioid substitution therapy (OST) and other drug treatment, HIV testing and counselling, antiretroviral therapy (ART), and condom programmes. We calculated national, regional, and global coverage of NSPs, OST, and ART on the basis of available estimates of IDU population sizes. Findings: By 2009, NSPs had been implemented in 82 countries and OST in 70 countries; both interventions were available in 66 countries. Regional and national coverage varied substantially. Australasia (202 needleââ,¬â?syringes per IDU per year) had by far the greatest rate of needleââ,¬â?syringe distribution; Latin America and the Caribbean (0Ã,·3 needleââ,¬â?syringes per IDU per year), Middle East and north Africa (0Ã,·5 needleââ,¬â?syringes per IDU per year), and sub-Saharan Africa (0Ã,·1 needleââ,¬â?syringes per IDU per year) had the lowest rates. OST coverage varied from less than or equal to one recipient per 100 IDUs in central Asia, Latin America, and sub-Saharan Africa, to very high levels in western Europe (61 recipients per 100 IDUs). The number of IDUs receiving ART varied from less than one per 100 HIV-positive IDUs (Chile, Kenya, Pakistan, Russia, and Uzbekistan) to more than 100 per 100 HIV-positive IDUs in six European countries. Worldwide, an estimated two needleââ,¬â?syringes (range 1ââ,¬â?4) were distributed per IDU per month, there were eight recipients (6ââ,¬â?12) of OST per 100 IDUs, and four IDUs (range 2ââ,¬â?18) received ART per 100 HIV-positive IDUs. Interpretation: Worldwide coverage of HIV prevention, treatment, and care services in IDU populations is very low. There is an urgent need to improve coverage of these services in this at-risk population. (c) The Lancet

Date:

01/01/2010

Rights: Public
Suggested citation:

Bradley M Mathers, Louisa Degenhardt, Hammad Ali, Lucas Wiessing, Matthew Hickman, Richard P Mattick, Bronwyn Myers, Atul Ambekar, Steffanie A Strathdee. (2010) HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. [Online]. Available from: http://www.thehealthwell.info/node/68824 [Accessed: 17th July 2018].

  

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National Drugs Library
 
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