Risk factors for loss to follow-up of persons who inject drugs enrolled at syringe services programs in Kentucky.


Journal

The International journal on drug policy
ISSN: 1873-4758
Titre abrégé: Int J Drug Policy
Pays: Netherlands
ID NLM: 9014759

Informations de publication

Date de publication:
09 2021
Historique:
received: 16 09 2020
revised: 23 02 2021
accepted: 01 04 2021
pubmed: 15 4 2021
medline: 9 11 2021
entrez: 14 4 2021
Statut: ppublish

Résumé

Syringe services programs (SSP) are an effective strategy to reduce blood-borne infections of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) in persons who inject drugs (PWID). The objectives of this study were to determine the frequency and risk factors for loss to follow-up (LTFU) in PWID enrolled at SSPs in Kentucky. A retrospective cohort study was conducted which included data of PWID enrolled at 32 SSP. Demographics, use of drugs, HIV testing, HCV testing, and medical services were analyzed. A generalized linear model (GLM), family binomial was used to determine risk factors for LTFU. The analysis included 5742 PWID. LTFU by year of enrollment was 287/770 (37.3%) in 2017, 796/1874 (42.5%) in 2018, and 1479/3,098 (47.7%) in 2019. LTFU was significantly associated with distance to SSP from home of more than five miles (RR 1.25; 95%CI 1.09-1.43; p = 0.002) and SSPs housed in rural counties (RR 1.22; 95%CI 1.06-1.40; p = 0.004), adjusted by age, sex, and race. The use of buprenorphine was associated with less risk of LTFU (RR 0.79, p = 0.034). The distance to an SSP from home and SSPs in rural counties were identified as risk factors for LTFU. Initiatives that bring health services closer to PWID homes and offer opioid use disorder treatment may improve repeated participation in SSPs.

Sections du résumé

BACKGROUND
Syringe services programs (SSP) are an effective strategy to reduce blood-borne infections of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) in persons who inject drugs (PWID). The objectives of this study were to determine the frequency and risk factors for loss to follow-up (LTFU) in PWID enrolled at SSPs in Kentucky.
METHODS
A retrospective cohort study was conducted which included data of PWID enrolled at 32 SSP. Demographics, use of drugs, HIV testing, HCV testing, and medical services were analyzed. A generalized linear model (GLM), family binomial was used to determine risk factors for LTFU.
RESULTS
The analysis included 5742 PWID. LTFU by year of enrollment was 287/770 (37.3%) in 2017, 796/1874 (42.5%) in 2018, and 1479/3,098 (47.7%) in 2019. LTFU was significantly associated with distance to SSP from home of more than five miles (RR 1.25; 95%CI 1.09-1.43; p = 0.002) and SSPs housed in rural counties (RR 1.22; 95%CI 1.06-1.40; p = 0.004), adjusted by age, sex, and race. The use of buprenorphine was associated with less risk of LTFU (RR 0.79, p = 0.034).
CONCLUSION
The distance to an SSP from home and SSPs in rural counties were identified as risk factors for LTFU. Initiatives that bring health services closer to PWID homes and offer opioid use disorder treatment may improve repeated participation in SSPs.

Identifiants

pubmed: 33853033
pii: S0955-3959(21)00160-2
doi: 10.1016/j.drugpo.2021.103255
pii:
doi:

Substances chimiques

Pharmaceutical Preparations 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103255

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declarations of Interest The authors have no conflicts of interests to declare.

Auteurs

Jaime Soria (J)

KADAP Income Reinvestment Program (KIRP), Division of Infectious Diseases, University of Kentucky, United States. Electronic address: jaime.soria@uky.edu.

Tisha Johnson (T)

Kentucky Department for Public Health, KY, United States.

Jana Collins (J)

KADAP Income Reinvestment Program (KIRP), Division of Infectious Diseases, University of Kentucky, United States.

Greg Corby-Lee (G)

KADAP Income Reinvestment Program (KIRP), Division of Infectious Diseases, University of Kentucky, United States.

James Thacker (J)

KADAP Income Reinvestment Program (KIRP), Division of Infectious Diseases, University of Kentucky, United States.

Connie White (C)

Kentucky Department for Public Health, KY, United States.

Ardis Hoven (A)

KADAP Income Reinvestment Program (KIRP), Division of Infectious Diseases, University of Kentucky, United States.

Alice Thornton (A)

KADAP Income Reinvestment Program (KIRP), Division of Infectious Diseases, University of Kentucky, United States.

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Classifications MeSH