A community-based intervention to decrease the prevalence of HIV viremia among people who inject drugs in Vietnam.
Lancet Reg Health West Pac
; 27: 100538, 2022 Oct.
Article
in En
| MEDLINE
| ID: mdl-35856068
ABSTRACT
Background:
In most low-to-middle-income countries, HIV control at the population level among people who inject drugs (PWID) remains a major challenge. We aimed to demonstrate that an innovative intervention can identify HIV-positive PWID in the community who are not treated efficiently, and get them treated efficiently.Methods:
Between 2016 and 2020, we implemented an intervention consisting of mass HIV screening of PWID using three annual respondent-driven sampling surveys (RDSS) and a post-intervention evaluation RDSS in community-based organisation (CBO) sites, coupled with peer support to facilitate/improve access to antiretroviral and methadone therapy in Haiphong, Vietnam. The primary outcome was the proportion of identified uncontrolled HIV-positive PWID who achieved viral control. We also estimated the potential effect of the intervention on the proportion of PWID with HIV RNA >1000 copies/mL among all PWID during the study period.Findings:
Over the three RDSS, 3150 different PWID were screened, i.e. two-thirds of the estimated population size. They all injected heroin, their median age was of 39 years, 95% were male, 26.5% were HIV-infected, and 78.6% of the latter had HIV RNA ≤1000 copies/mL. Among the 177 PWID identified with an unsuppressed viral load, 73 (41.2%) achieved viral suppression at the final visit. HIV viremia decreased from 7.2% at baseline to 2.9% at the final RDSS (p<0.001). Up to 42% of this observed reduction may be explained by the intervention, in the absence of any external intervention targeting PWID during the study period.Interpretation:
Mass community-based screening using RDSS coupled with CBO support is a powerful tool to rapidly identify untreated HIV-positive PWID and (re)link them to care.Funding:
NIDA (USA) and ANRS (France).
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
Lancet Reg Health West Pac
Year:
2022
Document type:
Article
Affiliation country:
Vietnam