XIX International AIDS Conference


THAC04 Evidence-Based Prevention for Injecting Drug Users: It Works!
  Oral Abstract Session : Track C
Venue: Session Room 4
Time: 26.07.2012, 16:30 - 18:00
Co-Chairs: Anya Sarang, Russian Federation
Daniel Wolfe, United States
 
 

16:30
THAC0401
Abstract
The cost-effectiveness of needle-syringe exchange programs in Eastern Europe and Central Asia: costing, data synthesis, modeling and economics for eight case study countries
D. Wilson1, L. Zhang1, C. Kerr1, A. Kwon1, A. Hoare1, M. Williams-Sherlock2, C. Avila3, EECA NSEP evaluation working group
1University of New South Wales, Sydney, Australia, 2UNAIDS, Moscow, Russian Federation, 3UNAIDS Office, Geneva, Switzerland
D. Wilson, Australia

16:45
THAC0402
Abstract
Powerpoint
Webcast
Switching people who inject drugs from high dead space to low dead space syringes as a structural intervention to prevent injection-related HIV epidemics
W. Zule1, H. Cross2
1RTI International, Research Triangle Park, United States, 2RTI International, Global Health Group, Research Triangle Park, United States
W. Zule, United States

17:00
THAC0403
Abstract
Predictors of dropping out of methadone maintenance treatment in China: a six-year cohort study
X. Cao, Z. Wu, K. Rou, L. Pang
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Division of Health Eduction and Behavioral Intervention, Beijing, China
X. Cao, China

17:15
THAC0404
Abstract
Powerpoint
Webcast
Effects of an HIV/AIDS peer prevention intervention on sexual and injecting risk behaviours among injecting drug users (IDU) and their risk partners in Thai Nguyen, Vietnam: a randomized controlled trial
V. Go1, C. Frangakis2, M. Nguyen Le3, H. Tran Viet4, C. Latkin5, M. Tran Thi4, T. Sripaipan1, W. Davis1, V. Pham The3, Q. Vu Minh1
1Johns Hopkins University, Bloomberg School of Public Health, Epidemiology, Baltimore, United States, 2Johns Hopkins University, Bloomberg School of Public Health, Biostatistics, Baltimore, United States, 3Center for Preventive Medicine, Thai Nguyen, Viet Nam, 4Johns Hopkins University, Bloomberg School of Public Health, Epidemiology, Hanoi, Viet Nam, 5Johns Hopkins University, Bloomberg School of Public Health, Health Behavior and Society, Baltimore, United States
V. Go, United States

17:30
THAC0405
Abstract
Powerpoint
Webcast
Peer-delivered HIV testing and counseling among people who inject drugs in Bangkok, Thailand
L. Ti1, K. Hayashi1,2, K. Kaplan3, P. Suwannawong3, J. Montaner1,4, E. Wood1,4, T. Kerr1,4
1BC Centre for Excellence in HIV/AIDS, Vancouver, Canada, 2University of British Columbia, Interdisciplinary Studies Graduate Program, Vancouver, Canada, 3Thai AIDS Treatment Action Group, Bangkok, Thailand, 4University of British Columbia, Department of Medicine, Vancouver, Canada
L. Ti, Canada

Powerpoints presentations
Switching people who inject drugs from high dead space to low dead space syringes as a structural intervention to prevent injection-related HIV epidemics - William Zule

Effects of an HIV/AIDS peer prevention intervention on sexual and injecting risk behaviours among injecting drug users (IDU) and their risk partners in Thai Nguyen, Vietnam: a randomized controlled trial - Vivian Go

Peer-delivered HIV testing and counseling among people who inject drugs in Bangkok, Thailand - Lianping Ti



Rapporteur report

Track C report by Christopher Hurt  


The impact on HIV and HCV incidence and overall cost-effectiveness of needle-exchange programs (NEPs) was evaluated in a study of 8 countries in eastern Europe and central Asia. Estimates suggested that 10-40% of HIV infections were averted, though NEPs successfully averted a smaller proportion of HCV infections (5-25%). With respect to HIV, NEPs were already cost-effective (or cost-saving) in half the countries; in terms of HCV, NEPs were cost-effective in all 8 nations.

Different syringes retain varying amounts of blood following injection, resulting in variable risk for transmission of HIV (and HCV). Bill Zule from RTI International described research into the barriers experienced by harm reduction organizations, international agencies, syringe manufacturers, and IDUs themselves in switching from high dead-space syringes (HDSS) to low dead-space syringes (LDSS). Multi-level structural interventions are being developed for transitioning to LDSS, involving all stakeholders.

Data from eight methadone maintenance therapy (MMT) clinics around China were used to determine predictors of dropping out of treatment. Nearly two-thirds dropped out over 6 years of follow-up, generally within 1.5 years after enrolling. Incarceration was the most frequent cause of dropouts. In Cox models, higher daily doses of methadone, having relatives also receiving MMT, and higher urine morphine positivity were associated with lower hazard of dropping out of MMT. Clients who shared needles and those having frequent contact with active users were more likely to leave MMT programs.

In Viet Nam, the HIV epidemic has concentrated among IDUs, now accounting for 75% of all new infections. In a 2-arm randomized controlled trial evaluating an intervention to reduce sexual and needle-sharing risks among communities of IDUs, needle sharing decreased in both arms, from 14% at baseline to 3% at 3 months, and exhibited a durable effect over the next 9 months of follow-up. The proportion of unprotected sexual activity fell nearly 25% by 3 months, but at the 12 month visit, intervention-arm subjects exhibited a 14% greater decline than controls – explained in part by more missed study visits among control participants.

The acceptability of peer-delivered HIV testing and counseling was evaluated among IDUs in Bangkok. Subjects were willing to receive pre-test counseling (44%), rapid HIV testing (38%), and post-test counseling (37%) from former drug-using peers. Peer-delivered counseling and testing seemed to be more acceptable to IDUs who might ordinarily be missed by “conventional” programs – especially those with high-intensity drug use or a history of incarceration.




   

    The organizers reserve the right to amend the programme.


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