PMID- 29074410
OWN - NLM
STAT- MEDLINE
DCOM- 20180402
LR  - 20180504
IS  - 2214-109X (Electronic)
IS  - 2214-109X (Linking)
VI  - 5
IP  - 12
DP  - 2017 Dec
TI  - Global, regional, and country-level coverage of interventions to prevent and
      manage HIV and hepatitis C among people who inject drugs: a systematic review.
PG  - e1208-e1220
LID - S2214-109X(17)30373-X [pii]
LID - 10.1016/S2214-109X(17)30373-X [doi]
AB  - BACKGROUND: People who inject drugs (PWID) are a key population affected by the
      global HIV and hepatitis C virus (HCV) epidemics. HIV and HCV prevention
      interventions for PWID include needle and syringe programmes (NSP), opioid
      substitution therapy (OST), HIV counselling and testing, HIV antiretroviral
      therapy (ART), and condom distribution programmes. We aimed to produce
      country-level, regional, and global estimates of coverage of NSP, OST, HIV
      testing, ART, and condom programmes for PWID. METHODS: We completed searches of
      peer-reviewed (MEDLINE, Embase, and PsycINFO), internet, and grey literature
      databases, and disseminated data requests via social media and targeted emails to
      international experts. Programme and survey data on each of the named
      interventions were collected. Programme data were used to derive country-level
      estimates of the coverage of interventions in accordance with indicators defined 
      by WHO, UNAIDS, and the UN Office on Drugs and Crime. Regional and global
      estimates of NSP, OST, and HIV testing coverage were also calculated. The
      protocol was registered on PROSPERO, number CRD42017056558. FINDINGS: In 2017, of
      179 countries with evidence of injecting drug use, some level of NSP services
      were available in 93 countries, and there were 86 countries with evidence of OST 
      implementation. Data to estimate NSP coverage were available for 57 countries,
      and for 60 countries to estimate OST coverage. Coverage varied widely between
      countries, but was most often low according to WHO indicators (<100
      needle-syringes distributed per PWID per year; <20 OST recipients per PWID per
      year). Data on HIV testing were sparser than for NSP and OST, and very few data
      were available to estimate ART access among PWID living with HIV. Globally, we
      estimate that there are 33 (uncertainty interval [UI] 21-50) needle-syringes
      distributed via NSP per PWID annually, and 16 (10-24) OST recipients per 100
      PWID. Less than 1% of PWID live in countries with high coverage of both NSP and
      OST (>200 needle-syringes distributed per PWID and >40 OST recipients per 100
      PWID). INTERPRETATION: Coverage of HIV and HCV prevention interventions for PWID 
      remains poor and is likely to be insufficient to effectively prevent HIV and HCV 
      transmission. Scaling up of interventions for PWID remains a crucial priority for
      halting the HIV and HCV epidemics. FUNDING: Open Society Foundations, The Global 
      Fund, WHO, UNAIDS, United Nations Office on Drugs and Crime, Australian National 
      Drug and Alcohol Research Centre, University of New South Wales Sydney.
CI  - Copyright (c) 2017 The Author(s). Published by Elsevier Ltd. This is an Open
      Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All
      rights reserved.
FAU - Larney, Sarah
AU  - Larney S
AD  - National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.
      Electronic address: s.larney@unsw.edu.au.
FAU - Peacock, Amy
AU  - Peacock A
AD  - National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.
FAU - Leung, Janni
AU  - Leung J
AD  - School of Public Health, Faculty of Medicine, University of Queensland, Herston, 
      QLD, Australia.
FAU - Colledge, Samantha
AU  - Colledge S
AD  - National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.
FAU - Hickman, Matthew
AU  - Hickman M
AD  - Population Health Sciences, Bristol Medical School, University of Bristol,
      Bristol, UK.
FAU - Vickerman, Peter
AU  - Vickerman P
AD  - Population Health Sciences, Bristol Medical School, University of Bristol,
      Bristol, UK.
FAU - Grebely, Jason
AU  - Grebely J
AD  - Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
FAU - Dumchev, Kostyantyn V
AU  - Dumchev KV
AD  - Ukrainian Institute for Public Health Policy, Kiev, Ukraine.
FAU - Griffiths, Paul
AU  - Griffiths P
AD  - European Monitoring Centre on Drugs and Drug Addiction, Lisbon, Portugal.
FAU - Hines, Lindsey
AU  - Hines L
AD  - National Addiction Centre, King's College London, London, UK.
FAU - Cunningham, Evan B
AU  - Cunningham EB
AD  - Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
FAU - Mattick, Richard P
AU  - Mattick RP
AD  - National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.
FAU - Lynskey, Michael
AU  - Lynskey M
AD  - National Addiction Centre, King's College London, London, UK.
FAU - Marsden, John
AU  - Marsden J
AD  - National Addiction Centre, King's College London, London, UK.
FAU - Strang, John
AU  - Strang J
AD  - National Addiction Centre, King's College London, London, UK.
FAU - Degenhardt, Louisa
AU  - Degenhardt L
AD  - National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.
LA  - eng
GR  - G1000021/Medical Research Council/United Kingdom
GR  - MR/K006525/1/Medical Research Council/United Kingdom
GR  - R01 DA037773/DA/NIDA NIH HHS/United States
GR  - RP-DG-0610-10055/Department of Health/United Kingdom
PT  - Journal Article
PT  - Review
PT  - Research Support, Non-U.S. Gov't
DEP - 20171023
PL  - England
TA  - Lancet Glob Health
JT  - The Lancet. Global health
JID - 101613665
RN  - 0 (Anti-Retroviral Agents)
SB  - IM
CIN - Lancet Glob Health. 2017 Dec;5(12 ):e1162-e1163. PMID: 29132603
MH  - Anti-Retroviral Agents/therapeutic use
MH  - Disease Management
MH  - Global Health
MH  - HIV Infections/drug therapy/*prevention & control/transmission
MH  - Hepatitis C/drug therapy/*prevention & control/transmission
MH  - Humans
MH  - Needle-Exchange Programs/methods/trends
MH  - Opiate Substitution Treatment/methods/trends
MH  - Risk-Taking
MH  - Substance Abuse, Intravenous/*complications/*rehabilitation
PMC - PMC5683737
EDAT- 2017/10/28 06:00
MHDA- 2018/04/03 06:00
CRDT- 2017/10/28 06:00
PHST- 2017/08/22 00:00 [received]
PHST- 2017/09/07 00:00 [accepted]
PHST- 2017/10/28 06:00 [pubmed]
PHST- 2018/04/03 06:00 [medline]
PHST- 2017/10/28 06:00 [entrez]
AID - S2214-109X(17)30373-X [pii]
AID - 10.1016/S2214-109X(17)30373-X [doi]
PST - ppublish
SO  - Lancet Glob Health. 2017 Dec;5(12):e1208-e1220. doi:
      10.1016/S2214-109X(17)30373-X. Epub 2017 Oct 23.