A community-based intervention to decrease the prevalence of HIV viremia among people who inject drugs in Vietnam.
Community based organization
HIV elimination
Linkage to care
People who inject drugs
Testing
Viral suppression
Journal
The Lancet regional health. Western Pacific
ISSN: 2666-6065
Titre abrégé: Lancet Reg Health West Pac
Pays: England
ID NLM: 101774968
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
entrez:
20
7
2022
pubmed:
21
7
2022
medline:
21
7
2022
Statut:
epublish
Résumé
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. 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. 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 ( 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. NIDA (USA) and ANRS (France).
Sections du résumé
Background
UNASSIGNED
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
UNASSIGNED
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
UNASSIGNED
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 (
Interpretation
UNASSIGNED
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
UNASSIGNED
NIDA (USA) and ANRS (France).
Identifiants
pubmed: 35856068
doi: 10.1016/j.lanwpc.2022.100538
pii: S2666-6065(22)00153-5
pmc: PMC9287471
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100538Informations de copyright
© 2022 The Author(s).
Déclaration de conflit d'intérêts
The authors declare no competing interest.
Références
Drug Alcohol Depend. 2013 Nov;132 Suppl 1:S61-4
pubmed: 23916319
Harm Reduct J. 2021 Dec 18;18(1):133
pubmed: 34922548
PLoS One. 2021 Nov 18;16(11):e0259983
pubmed: 34793523
Drug Alcohol Depend. 2018 Apr 01;185:106-111
pubmed: 29432973
J Infect Dis. 2017 May 15;215(10):1496-1505
pubmed: 28407106
AIDS Behav. 2019 Apr;23(4):1084-1093
pubmed: 30306437
Harm Reduct J. 2013 Aug 19;10:13
pubmed: 23957896
Sci Transl Med. 2017 Dec 13;9(420):
pubmed: 29237762
Sci Rep. 2020 Apr 24;10(1):6999
pubmed: 32332986
Eur J Clin Pharmacol. 2007 Nov;63(11):1019-29
pubmed: 17694300
Lancet HIV. 2019 May;6(5):e283-e296
pubmed: 30952565
Lancet. 2010 Mar 20;375(9719):1014-28
pubmed: 20189638
Lancet HIV. 2019 Feb;6(2):e128-e136
pubmed: 30558843
J Virus Erad. 2016 Apr 01;2(2):94-101
pubmed: 27482442
Lancet. 2018 Sep 1;392(10149):747-759
pubmed: 30191830
AIDS. 2020 Dec 1;34(15):2305-2311
pubmed: 33048884
J Public Health Policy. 2018 May;39(2):217-230
pubmed: 29531303
PLoS One. 2018 Aug 30;13(8):e0203262
pubmed: 30161255
Biomed Res Int. 2020 Sep 10;2020:8037193
pubmed: 32964044
J Clin Epidemiol. 2015 Dec;68(12):1463-71
pubmed: 26112433
Lancet HIV. 2019 May;6(5):e270-e271
pubmed: 30952564
AIDS. 2021 Mar 1;35(3):485-494
pubmed: 33252482
Clin Infect Dis. 2018 Apr 3;66(8):1254-1260
pubmed: 29186391
Lancet Glob Health. 2017 Dec;5(12):e1208-e1220
pubmed: 29074410
J Acquir Immune Defic Syndr. 2017 Feb 1;74(2):166-174
pubmed: 27861239
J Clin Epidemiol. 2021 Nov;139:38-48
pubmed: 34280476
PLoS One. 2016 Aug 31;11(8):e0161718
pubmed: 27579772
Harm Reduct J. 2022 Feb 11;19(1):16
pubmed: 35148776
Lancet HIV. 2016 Apr;3(4):e183-90
pubmed: 27036994