20th International AIDS Conference - Melbourne, Australia


THAC04 People Who Inject Drugs: Risks and Responses
  Oral Abstract Session : Track C
Venue: Melbourne Room 1
Time: 24.07.2014, 14:30 - 16:00
Co-Chairs: Ruth Birgin, Australia
Thomas Kerr, Canada

14:30
THAC0401
Abstract
Powerpoint
Webcast
How do PWID prevention activities impact the HIV epidemic? Case of Ukraine
O. Varetska, A. Klepikov, T. Salyuk
ICF 'International HIV/AIDS Alliance in Ukraine', Kyiv, Ukraine

14:45
THAC0402
Abstract
Powerpoint
Webcast
Trends in HIV-1 incidence during an outbreak among injecting drug users in Athens, Greece: results of a serobehavioral survey (ARISTOTLE program)
V. Sypsa1, G. Nikolopoulos2, D. Paraskevis1, A. Katsoulidou1, M. Kantzanou1, M. Psichogiou3, A. Pharris4, L. Wiessing5, M. Donoghoe6, S. Friedman7, D. Des Jarlais8, M. Malliori3, A. Hatzakis1
1University of Athens, Dept. of Hygiene, Epidemiology and Medical Statistics, Athens, Greece, 2IAS/NIDA Fellow, Hellenic Center for Diseases Control and Prevention, Athens, Greece, 3University of Athens, Athens, Greece, 4European Centre for Disease Prevention and Control, Stockholm, Sweden, 5European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal, 6World Health Organization-Regional Office for Europe, Copenhagen, Denmark, 7National Development and Research Institutes, New York, United States, 8Beth Israel Medical Center, New York, United States

15:00
THAC0403
Abstract
Powerpoint
Webcast
Innovative peer-to-peer educational intervention to reduce HIV and other blood-borne infection risks in difficult-to-reach people who inject drugs: results from the ANRS AERLI study
P. Carrieri1,2,3, J.-M. Le Gall4, M. Debrus5, B. Demoulin1,2,3, C. Lions1,2,3, A. Haas6, M. Mora1,2,3, P. Roux1,2,3, M. Suzan-Monti1,2,3, B. Spire1,2,3
1INSERM, UMR 912 (SESSTIM), Marseille, France, 2Aix Marseille Université, UMR_S 912, IRD, Marseille, France, 3ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France, 4Aides, Pantin, France, 5Médecins du Monde, Paris, France, 6Aides, Paris, France

15:15
THAC0405
Abstract
Powerpoint
Webcast
Risk factors associated with HCV infection and prevalence of HIV-HCV co-infection among people who inject drugs receiving medication-assisted treatment in Dar es Salaam, Tanzania
O. Chang1, R.D. Bruce1,2, F. Masao3, N. Sabuni4, E. Matiko5, S. Mccurdy6, J. Mbwambo3, B. Lambdin1,7
1Pangaea Global AIDS, Oakland, United States, 2Yale University, New Haven, United States, 3Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of, 4Ministry of Health and Social Welfare, Dar es Salaam, Tanzania, United Republic of, 5US Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Dar es Salaam, Tanzania, United Republic of, 6University of Texas, School of Public Health, Houston, United States, 7University of Washington, Seattle, United States

15:30
THAC0406
Webcast
Moderated discussion

15:30
THAC0406
Powerpoint
Webcast
Experiences with compulsory drug detention in Thailand: evidences from the Mitsampan community research project
K. Hayashi, Canada

Powerpoints presentations
How do PWID prevention activities impact the HIV epidemic? Case of Ukraine - Olga Varetska

Trends in HIV-1 incidence during an outbreak among injecting drug users in Athens, Greece: results of a serobehavioral survey (ARISTOTLE program) - Vana Sypsa

Innovative peer-to-peer educational intervention to reduce HIV and other blood-borne infection risks in difficult-to-reach people who inject drugs: results from the ANRS AERLI study - Marie Suzan-Monti

Risk factors associated with HCV infection and prevalence of HIV-HCV Co-infection among people who inject drugs receiving medication-assisted treatment in Dar es Salaam, Tanzania - Olivia Chang

Experiences with compulsory drug detention in Thailand: evidences from the Mitsampan community research project - Kanna Hayashi



Rapporteur report

Track C report by Kanna Hayashi


O. Varetska presented study findings evaluating the impact of the largest HIV prevention programs implemented by International HIV/AIDS Alliance in Ukraine. While HIV prevalence and rates of syringe sharing among people who inject drugs (PWID) have declined since 2007, HIV prevalence among the general population has continued to increase with heterosexual risk behavior emerging as a common HIV transmission mode. A triangulation study suggested that heterosexual HIV transmission patterns were linked to risky sexual practices among PWID. These results suggest that the HIV prevention programs focusing on PWID have been effective in reducing injection-related risk of HIV transmission. Therefore, in the wake of diminishing international funding in this area, Varetska called on the Ukrainian government to increase and sustain the funding for these programs. Further, new HIV prevention programs targeting sexual partners of PWID are needed. Being asked by one of the audience about the possibility of introducing PrEP for sexual partners of PWID, Varetska responded that the current financial situation in Ukraine may not make it a viable option. 

T. Sypsa presented trends in HIV incidence among PWID in Athens, Greece, where an HIV outbreak was observed among this population in 2011. Drawing on data from the ARISTOTLE, a serial cross-sectional study utilizing RDS and providing HIV testing (n = 3,320), they found an estimated 75–91% decline in HIV incidence among their sample. During the study period, there was a slight scale-up of opiate substitution therapy (OST) provision, but no scale-up of needle and syringe programs (NSP). Sypsa suggested that while many factors may have contributed to the observed decline in HIV incidence, including the scale-up of OST, the provision of HIV testing through the ARISTOTLE, and reductions in risk behavior as PWID learned about HIV.

M. Suzan-Monti conducted a clustered intervention study to evaluate the effectiveness of a peer-based, low-cost and short intervention providing training and education about HIV and other blood-borne infection risk reduction in France. A total of 305 PWID were enrolled in the intervention (n = 168) or control arms (n = 137). They found a significant decline in both HIV-HCV risk injection practices (at 6-month follow-up) and injection-related complications (at 12-month follow-up) among the intervention group after adjustment for potential confounders.

O. Chang highlighted high prevalence of HIV-HCV co-infection among PWID in Dar es Salaam, Tanzania. Chang set up a cross-sectional study using routine programmatic data on methadone clients enrolled between February 2011 and January 2013 at a local hospital where HIV and HCV serological testing was conducted routinely. Of 494 clients receiving HCV tests, prevalence of HCV seropositivity was 57%(95%CI: 53–62). Among 168 HIV-positive clients who were tested for HCV, the prevalence of HIV-HCV co-infection was 87% (95%CI: 81–92). Factors independently and positively associated with HCV seropositivity included: engaging in flashblood (i.e., injecting blood from another person who has recently injected heroin), sharing needles and/or other injection equipment, and having a criminal record. Recommendations were made for comprehensive and tailored harm reduction interventions in this setting.

K. Hayashi presented a summary of study findings regarding experiences with compulsory drug detention centers among PWID in Bangkok, Thailand. Referring to findings from a serial cross-sectional mixed-methods study, Hayashi highlighted that compulsory drug detention exposure was associated with various forms of police misconduct and violence, elevated HIV risk behaviour, interruptions in HIV treatment, and relapse into injecting. Further, the system of compulsory drug detention appeared to shape healthcare access among PWID in this setting by perpetuating stigma, shame and avoidance of healthcare. Hayashi recommended that the system of compulsory drug detention should be replaced with voluntary evidence-based harm reduction and addiction treatment programs.

This session highlighted the importance of taking into account social and structural factors shaping HIV risk behavior among PWID and HIV prevention and treatment intervention efforts targeting this population.




   

    The organizers reserve the right to amend the programme.