Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programs
Abstract Background Many people with high-risk sexual or injection behaviors use harm reduction services with different identities and are therefore counted more than once in client databases. This practice results in inaccurate statistics on the number of clients served and the effective reach of t...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12954-023-00851-5 |
| _version_ | 1797453392798285824 |
|---|---|
| author | Fatemeh Tavakoli Willi Mcfarland Nima Ghalekhani Mehrdad Khezri Ali Akbar Haghdoost Mohammad Mehdi Gouya Marzieh Mahboobi Ali Mohammad Hosseionpour Ali Komasi Mehdi Ghorbanian Nasim Nasiri Moghadam Maryam Taghipour Hamid Sharifi |
| author_facet | Fatemeh Tavakoli Willi Mcfarland Nima Ghalekhani Mehrdad Khezri Ali Akbar Haghdoost Mohammad Mehdi Gouya Marzieh Mahboobi Ali Mohammad Hosseionpour Ali Komasi Mehdi Ghorbanian Nasim Nasiri Moghadam Maryam Taghipour Hamid Sharifi |
| author_sort | Fatemeh Tavakoli |
| collection | DOAJ |
| description | Abstract Background Many people with high-risk sexual or injection behaviors use harm reduction services with different identities and are therefore counted more than once in client databases. This practice results in inaccurate statistics on the number of clients served and the effective reach of these services. This study aimed to determine the levels of double counting of clients of harm reduction services, including needle and syringe programs, condom distribution, HIV testing and counseling, and methadone maintenance in five cities in Iran. Methods Between September and March 2020, our study included 1630 clients, 115 staff of harm reduction centers, and 30 experts in the field of harm reduction in five cities in Iran. Clients of harm reduction services were asked about using harm reduction services multiple times at the same center or at different centers in the last year using different identities. Estimates of double counting derived from client responses were validated by panels of center staff and experts in harm reduction. Results Synthesizing data from clients, staff, and experts, the final estimates of double counting of clients using harm reduction services were: HIV testing 10% (95% confidence interval [CI] 0–15), needle and syringe programs 17% (95% CI 8.5–20), condom distribution programs 13% (95% CI 3–19), HIV/STI counseling 10% (95% CI 0–16), and methadone maintenance 7% (95% CI 2–10). Conclusion Double counting of clients in harm reduction services in Iran is substantial. Data on clients reach by harm reduction services need to be corrected for double counting to improve program planning, client population size estimation, and efficient resource allocation. |
| first_indexed | 2024-03-09T15:22:10Z |
| format | Article |
| id | doaj.art-2813738356dc4c9bb3b5d3bc6f7c1b93 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-03-09T15:22:10Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-2813738356dc4c9bb3b5d3bc6f7c1b932023-11-26T12:44:48ZengBMCHarm Reduction Journal1477-75172023-08-012011710.1186/s12954-023-00851-5Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programsFatemeh Tavakoli0Willi Mcfarland1Nima Ghalekhani2Mehrdad Khezri3Ali Akbar Haghdoost4Mohammad Mehdi Gouya5Marzieh Mahboobi6Ali Mohammad Hosseionpour7Ali Komasi8Mehdi Ghorbanian9Nasim Nasiri Moghadam10Maryam Taghipour11Hamid Sharifi12HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical SciencesDepartment of Epidemiology and Biostatistics, University of California San FranciscoHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical SciencesHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical SciencesHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical SciencesDepartment of Infectious Disease and Tropical Medicine, School of Medicine, Iran University of Medical SciencesIranian Center for Communicable Diseases Control, Ministry of Health and Medical EducationMashhad University of Medical SciencesKermanshah University of Medical SciencesAlborz University of Medical SciencesCenter for HIV/STI Control and Prevention, Kerman University of Medical SciencesShiraz University of Medical SciencesHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical SciencesAbstract Background Many people with high-risk sexual or injection behaviors use harm reduction services with different identities and are therefore counted more than once in client databases. This practice results in inaccurate statistics on the number of clients served and the effective reach of these services. This study aimed to determine the levels of double counting of clients of harm reduction services, including needle and syringe programs, condom distribution, HIV testing and counseling, and methadone maintenance in five cities in Iran. Methods Between September and March 2020, our study included 1630 clients, 115 staff of harm reduction centers, and 30 experts in the field of harm reduction in five cities in Iran. Clients of harm reduction services were asked about using harm reduction services multiple times at the same center or at different centers in the last year using different identities. Estimates of double counting derived from client responses were validated by panels of center staff and experts in harm reduction. Results Synthesizing data from clients, staff, and experts, the final estimates of double counting of clients using harm reduction services were: HIV testing 10% (95% confidence interval [CI] 0–15), needle and syringe programs 17% (95% CI 8.5–20), condom distribution programs 13% (95% CI 3–19), HIV/STI counseling 10% (95% CI 0–16), and methadone maintenance 7% (95% CI 2–10). Conclusion Double counting of clients in harm reduction services in Iran is substantial. Data on clients reach by harm reduction services need to be corrected for double counting to improve program planning, client population size estimation, and efficient resource allocation.https://doi.org/10.1186/s12954-023-00851-5Harm reductionDouble countingHIVDrug useIran |
| spellingShingle | Fatemeh Tavakoli Willi Mcfarland Nima Ghalekhani Mehrdad Khezri Ali Akbar Haghdoost Mohammad Mehdi Gouya Marzieh Mahboobi Ali Mohammad Hosseionpour Ali Komasi Mehdi Ghorbanian Nasim Nasiri Moghadam Maryam Taghipour Hamid Sharifi Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programs Harm Reduction Journal Harm reduction Double counting HIV Drug use Iran |
| title | Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programs |
| title_full | Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programs |
| title_fullStr | Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programs |
| title_full_unstemmed | Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programs |
| title_short | Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programs |
| title_sort | double counting of clients using services in iran implications for assessing the reach of harm reduction programs |
| topic | Harm reduction Double counting HIV Drug use Iran |
| url | https://doi.org/10.1186/s12954-023-00851-5 |
| work_keys_str_mv | AT fatemehtavakoli doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT willimcfarland doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT nimaghalekhani doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT mehrdadkhezri doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT aliakbarhaghdoost doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT mohammadmehdigouya doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT marziehmahboobi doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT alimohammadhosseionpour doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT alikomasi doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT mehdighorbanian doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT nasimnasirimoghadam doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT maryamtaghipour doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms AT hamidsharifi doublecountingofclientsusingservicesiniranimplicationsforassessingthereachofharmreductionprograms |