Pre-exposure prophylaxis (PrEP) for HIV prevention among people who inject drugs: a global mapping of service delivery
Abstract Background The World Health Organization (WHO) recommends oral pre-exposure prophylaxis (PrEP) for all people at substantial risk of HIV as part of combination prevention. The extent to which this recommendation has been implemented globally for people who inject drugs is unclear. This stud...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12954-023-00729-6 |
| _version_ | 1797865217718222848 |
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| author | Graham Shaw Robin Schaefer Heather-Marie A Schmidt Annie Madden Judy Chang Antons Mozalevskis Busisiwe Msimanga-Radebe Nabeel Mangadan Konath Annette Verster Rachel Baggaley Michelle Rodolph Virginia Macdonald |
| author_facet | Graham Shaw Robin Schaefer Heather-Marie A Schmidt Annie Madden Judy Chang Antons Mozalevskis Busisiwe Msimanga-Radebe Nabeel Mangadan Konath Annette Verster Rachel Baggaley Michelle Rodolph Virginia Macdonald |
| author_sort | Graham Shaw |
| collection | DOAJ |
| description | Abstract Background The World Health Organization (WHO) recommends oral pre-exposure prophylaxis (PrEP) for all people at substantial risk of HIV as part of combination prevention. The extent to which this recommendation has been implemented globally for people who inject drugs is unclear. This study mapped global service delivery of PrEP for people who inject drugs. Methods Between October and December 2021, a desk review was conducted to obtain information on PrEP services for people who inject drugs from drug user-led networks and HIV, harm reduction, and human rights stakeholders. Websites of organizations involved in HIV prevention or services for people who inject drugs were searched. Models of service delivery were described in terms of service location, provider, and package. Results PrEP services were identified in 27 countries (15 high-income). PrEP delivery models varied within and across countries. In most services, PrEP services were implemented in healthcare clinics without direct links to other harm reduction services. In three countries, PrEP services were also provided at methadone clinics. In 14 countries, PrEP services were provided through community-based models (outside of clinic settings) that commonly involved peer-led outreach activities and integration with harm reduction services. Conclusions This study indicates limited PrEP availability for people who inject drugs. There is potential to expand PrEP services for people who inject drugs within harm reduction programs, notably through community-based and peer-led services. PrEP should never be offered instead of evidence-based harm reduction programs for people who inject drugs; however, it could be offered as an additional HIV prevention choice as part of a comprehensive harm reduction program. |
| first_indexed | 2024-04-09T23:04:32Z |
| format | Article |
| id | doaj.art-d188d64438a847d1bf26614c1248a1c0 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-04-09T23:04:32Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-d188d64438a847d1bf26614c1248a1c02023-03-22T10:48:16ZengBMCHarm Reduction Journal1477-75172023-02-012011810.1186/s12954-023-00729-6Pre-exposure prophylaxis (PrEP) for HIV prevention among people who inject drugs: a global mapping of service deliveryGraham Shaw0Robin Schaefer1Heather-Marie A Schmidt2Annie Madden3Judy Chang4Antons Mozalevskis5Busisiwe Msimanga-Radebe6Nabeel Mangadan Konath7Annette Verster8Rachel Baggaley9Michelle Rodolph10Virginia Macdonald11Independent ConsultantGlobal HIV, Hepatitis and STIs Programmes, World Health OrganizationGlobal HIV, Hepatitis and STIs Programmes, World Health OrganizationInternational Network of People who Use DrugsInternational Network of People who Use DrugsGlobal HIV, Hepatitis and STIs Programmes, World Health OrganizationWorld Health OrganizationWorld Health OrganizationGlobal HIV, Hepatitis and STIs Programmes, World Health OrganizationGlobal HIV, Hepatitis and STIs Programmes, World Health OrganizationGlobal HIV, Hepatitis and STIs Programmes, World Health OrganizationGlobal HIV, Hepatitis and STIs Programmes, World Health OrganizationAbstract Background The World Health Organization (WHO) recommends oral pre-exposure prophylaxis (PrEP) for all people at substantial risk of HIV as part of combination prevention. The extent to which this recommendation has been implemented globally for people who inject drugs is unclear. This study mapped global service delivery of PrEP for people who inject drugs. Methods Between October and December 2021, a desk review was conducted to obtain information on PrEP services for people who inject drugs from drug user-led networks and HIV, harm reduction, and human rights stakeholders. Websites of organizations involved in HIV prevention or services for people who inject drugs were searched. Models of service delivery were described in terms of service location, provider, and package. Results PrEP services were identified in 27 countries (15 high-income). PrEP delivery models varied within and across countries. In most services, PrEP services were implemented in healthcare clinics without direct links to other harm reduction services. In three countries, PrEP services were also provided at methadone clinics. In 14 countries, PrEP services were provided through community-based models (outside of clinic settings) that commonly involved peer-led outreach activities and integration with harm reduction services. Conclusions This study indicates limited PrEP availability for people who inject drugs. There is potential to expand PrEP services for people who inject drugs within harm reduction programs, notably through community-based and peer-led services. PrEP should never be offered instead of evidence-based harm reduction programs for people who inject drugs; however, it could be offered as an additional HIV prevention choice as part of a comprehensive harm reduction program.https://doi.org/10.1186/s12954-023-00729-6HIV preventionPre-exposure prophylaxisPeople who inject drugsHarm reduction |
| spellingShingle | Graham Shaw Robin Schaefer Heather-Marie A Schmidt Annie Madden Judy Chang Antons Mozalevskis Busisiwe Msimanga-Radebe Nabeel Mangadan Konath Annette Verster Rachel Baggaley Michelle Rodolph Virginia Macdonald Pre-exposure prophylaxis (PrEP) for HIV prevention among people who inject drugs: a global mapping of service delivery Harm Reduction Journal HIV prevention Pre-exposure prophylaxis People who inject drugs Harm reduction |
| title | Pre-exposure prophylaxis (PrEP) for HIV prevention among people who inject drugs: a global mapping of service delivery |
| title_full | Pre-exposure prophylaxis (PrEP) for HIV prevention among people who inject drugs: a global mapping of service delivery |
| title_fullStr | Pre-exposure prophylaxis (PrEP) for HIV prevention among people who inject drugs: a global mapping of service delivery |
| title_full_unstemmed | Pre-exposure prophylaxis (PrEP) for HIV prevention among people who inject drugs: a global mapping of service delivery |
| title_short | Pre-exposure prophylaxis (PrEP) for HIV prevention among people who inject drugs: a global mapping of service delivery |
| title_sort | pre exposure prophylaxis prep for hiv prevention among people who inject drugs a global mapping of service delivery |
| topic | HIV prevention Pre-exposure prophylaxis People who inject drugs Harm reduction |
| url | https://doi.org/10.1186/s12954-023-00729-6 |
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