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Thi Thanh Huong N, Thi Hau N, Van Chau N, Trung Tan L, Thi Minh Tam N, Gray R, O’Connell KA, Neukom J. Perceived barriers and facilitators to uptake of HIV testing services among people who inject drugs in Vietnam. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1448473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ngo Thi Thanh Huong
- Population Services International (PSI)/Vietnam, Phạm Đình Hổ, Hai Bà Trưng, Hà Nội, Vietnam
| | - Nguyen Thi Hau
- Community Peer Researcher, Hai Bà Trưng, Hà Nội, Vietnam
| | | | - Le Trung Tan
- Community Peer Researcher, Phu Luong, Thai Nguyen, Vietnam
| | - Nguyen Thi Minh Tam
- Vietnam Authority of HIV/AIDS Control, Ministry of Health Head, Dept. of Health Organisation and Management, Hanoi Medical University, Hanoi, Vietnam
| | - Rob Gray
- Independent Consultants, Population Services International, Washington DC, USA
| | | | - Josselyn Neukom
- Population Services International (PSI)/Vietnam, Phạm Đình Hổ, Hai Bà Trưng, Hà Nội, Vietnam
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Trickey A, May MT, Hope V, Ward Z, Desai M, Heinsbroek E, Hickman M, Vickerman P. Usage of low dead space syringes and association with hepatitis C prevalence amongst people who inject drugs in the UK. Drug Alcohol Depend 2018; 192:118-124. [PMID: 30245460 PMCID: PMC6541923 DOI: 10.1016/j.drugalcdep.2018.07.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Syringes with attached needles (low dead space syringes [LDSS]) retain far less blood following injection than syringes with detachable needles (high dead space syringes [HDSS]). People who inject drugs (PWID) who share needles/syringes may be less likely to acquire Hepatitis C virus (HCV) infection using LDSS, compared with HDSS, but data are limited. METHODS Utilizing drug behavior and HCV antibody testing data from the UK 2014/2015 Unlinked Anonymous Monitoring Survey of PWID, we calculated the percentage of syringes used in the past month that were LDSS. We investigated which injecting characteristics and demographic factors were associated with 100% LDSS (against 0-99%) usage, and whether 100% LDSS use was associated with antibody HCV-status, after adjusting for confounders. RESULT Of 2174 participants, 55% always used LDSS, 27% always used HDSS, and 17% used both LDSS and HDSS. PWID that had injected into their groin during the past month were unlikely to use LDSS, adjusted odds ratio (aOR) 0.14 (95% confidence interval 0.11-0.17), compared to those not using the groin. Those injecting crack were less likely to use LDSS than those not, aOR 0.79 (0.63-0.98). Polydrug use was negatively associated with LDSS use, aOR 0.88 (0.79-0.98) per additional drug. LDSS use was associated with lower prevalent HCV among all PWID (aOR 0.77, [0.64-0.93]), which was stronger among recent initiates (aOR 0.53 [0.30-0.94]) than among experienced PWID (aOR 0.81 [0.66-0.99]). DISCUSSION People who inject into their groin were less likely to use LDSS. Exclusive LDSS use was associated with lower prevalence of HCV amongst PWID that started injecting recently, suggesting LDSS use is protective against HCV.
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Affiliation(s)
- Adam Trickey
- Population Health Sciences, University of Bristol, Beacon House, Queens Road, Bristol, BS8 1QU, UK; National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU), Evaluation of Interventions, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
| | - Margaret T May
- National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU), Evaluation of Interventions, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK
| | - Vivian Hope
- Liverpool John Moores University, 70 Mount Pleasant, Liverpool L3 5UA, UK; HIV and STI Department, National Infection Service, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Zoe Ward
- Population Health Sciences, University of Bristol, Beacon House, Queens Road, Bristol, BS8 1QU, UK; National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU), Evaluation of Interventions, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Monica Desai
- HIV and STI Department, National Infection Service, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Ellen Heinsbroek
- HIV and STI Department, National Infection Service, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Matthew Hickman
- Population Health Sciences, University of Bristol, Beacon House, Queens Road, Bristol, BS8 1QU, UK; National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU), Evaluation of Interventions, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Peter Vickerman
- Population Health Sciences, University of Bristol, Beacon House, Queens Road, Bristol, BS8 1QU, UK; National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU), Evaluation of Interventions, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
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Chen I, Thanh HNT, Lover A, Thao PT, Luu TV, Thang HN, Thang ND, Neukom J, Bennett A. Malaria risk factors and care-seeking behaviour within the private sector among high-risk populations in Vietnam: a qualitative study. Malar J 2017; 16:414. [PMID: 29037242 PMCID: PMC5644094 DOI: 10.1186/s12936-017-2060-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/09/2017] [Indexed: 12/02/2022] Open
Abstract
Background Vietnam has successfully reduced malaria incidence by more than 90% over the past 10 years, and is now preparing for malaria elimination. However, the remaining malaria burden resides in individuals that are hardest to reach, in highly remote areas, where many malaria cases are treated through the informal private sector and are not reported to public health systems. This qualitative study aimed to contextualize and characterize the role of private providers, care-seeking behaviour of individuals at high risk of malaria, as well as risk factors that should be addressed through malaria elimination programmes in Vietnam. Methods Semi-structured qualitative interviews were conducted with 11 key informants in Hanoi, 30 providers, 9 potential patients, and 11 individuals at risk of malaria in Binh Phuoc and Kon Tum provinces. Audio recorded interviews were transcribed and uploaded to Atlas TI™, themes were identified, from which programmatic implications and recommendations were synthesized. Results Qualitative interviews revealed that efforts for malaria elimination in Vietnam should concentrate on reaching highest-risk populations in remote areas as well their care providers, in particular private pharmacies, private clinics, and grocery stores. Among these private providers, diagnosis is currently based on symptoms, leaving unconfirmed cases that are not reported to public health surveillance systems. Among at-risk individuals, knowledge of malaria was limited, and individuals reported not taking full courses of treatment, a practice that threatens selection for drug resistance. Access to insecticide-treated hammock nets, a potentially important preventive measure for settings with outdoor biting Anopheles vectors, was also limited. Conclusions Malaria elimination efforts in Vietnam can be accelerated by targeting improved treatment, diagnosis, and reporting practices to private pharmacies, private clinics, and grocery stores. Programmes should also seek to increase awareness and understanding of malaria among at-risk populations, in particular the importance of using preventive measures and adhering to complete courses of anti-malarial medicines. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-2060-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ingrid Chen
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA.
| | - Huong Ngo Thi Thanh
- Population Services International Vietnam, VinaFor Building, 127 Lò Đúc, Đồng Xuân, Hanoi, Vietnam
| | - Andrew Lover
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA
| | - Phung Thi Thao
- Population Services International Vietnam, VinaFor Building, 127 Lò Đúc, Đồng Xuân, Hanoi, Vietnam
| | - Tang Viet Luu
- Population Services International Vietnam, VinaFor Building, 127 Lò Đúc, Đồng Xuân, Hanoi, Vietnam
| | - Hoang Nghia Thang
- Population Services International Vietnam, VinaFor Building, 127 Lò Đúc, Đồng Xuân, Hanoi, Vietnam
| | - Ngo Duc Thang
- National Institute of Malaria, Parasitology, and Entomology (NIMPE), Vietnam, 35 Trung Van, Tu Liem, Hanoi, Vietnam
| | - Josselyn Neukom
- Population Services International Vietnam, VinaFor Building, 127 Lò Đúc, Đồng Xuân, Hanoi, Vietnam
| | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA
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Kesten JM, Ayres R, Neale J, Clark J, Vickerman P, Hickman M, Redwood S. Acceptability of low dead space syringes and implications for their introduction: A qualitative study in the West of England. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 39:99-108. [PMID: 27788406 DOI: 10.1016/j.drugpo.2016.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 09/08/2016] [Accepted: 09/28/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND It is recommended that needle and syringe programmes (NSP) distribute low dead space syringes (LDSS) to reduce blood-borne virus transmission. We explored the acceptability of detachable LDSS among people who inject drugs (PWID) and staff who work to support them. METHODS Semi-structured interviews were performed with 23 PWID (15 men and 8 women) and 13 NSP staff members (6 men and 7 women) in Bath and Bristol, England. Recruited PWID reflected varying demographic characteristics, drug use and injecting preferences. Interviews explored experiences of different types of injecting equipment, facilitators and barriers of changing this equipment and attitudes towards detachable LDSS. Interviews were audio recorded, transcribed verbatim and analysed using the Framework Method. RESULTS Decisions about injecting practices were underpinned by several factors, including early experiences and peer initiation; awareness and availability of alternatives; and the ability to inject successfully. Rinsing and re-using syringes represented a quandary where rinsing could encourage re-use, but not rinsing could result in the re-use of unclean equipment. Most PWID were reluctant to change equipment particularly in the absence of any problems injecting. Prioritising getting a 'hit' over the prevention of potential problems was an important barrier to change. Overall detachable LDSS are likely to be acceptable. Lower risk of transferring infections and reduced drug wastage were valued benefits of detachable LDSS. There was a preference for a gradual introduction of detachable LDSS in which PWID are given an opportunity to try the new equipment alongside their usual equipment. CONCLUSION Detachable LDSS are likely to be acceptable and should therefore be offered to those using detachable high dead space syringes and/or fixed 1ml LDSS syringes to inject into deeper femoral veins. An intervention is needed to support their introduction with 'training', 'education', 'persuasion' and eventual 'restriction' components.
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Affiliation(s)
- Joanna M Kesten
- NIHR Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; NIHR Health Protection Research Unit on Evaluation of Interventions, University of Bristol, UK; School of Social and Community Medicine, University of Bristol, UK.
| | | | | | | | - Peter Vickerman
- NIHR Health Protection Research Unit on Evaluation of Interventions, University of Bristol, UK; School of Social and Community Medicine, University of Bristol, UK
| | - Matthew Hickman
- NIHR Health Protection Research Unit on Evaluation of Interventions, University of Bristol, UK; School of Social and Community Medicine, University of Bristol, UK
| | - Sabi Redwood
- NIHR Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; School of Social and Community Medicine, University of Bristol, UK
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Crofts N, Azim T. Harm reduction in Asia and the Pacific: an evolving public health response. Harm Reduct J 2015; 12:47. [PMID: 26471163 PMCID: PMC4608147 DOI: 10.1186/s12954-015-0074-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 09/12/2015] [Indexed: 11/15/2022] Open
Affiliation(s)
- Nick Crofts
- Centre for Law Enforcement and Public Health, 309 George St, Doncaster, Vic, 3108, Australia.
| | - Tasnim Azim
- icddr,b, GPO Box 128, Dhaka, 1000, Bangladesh
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