Pre-exposure prophylaxis (PrEP) for HIV prevention among people who inject drugs: a global mapping of service delivery

Harm Reduction Journal

Perspective

Antons Mozalevskis¹  Michelle Rodolph¹  Virginia Macdonald¹  Robin Schaefer¹  Annette Verster¹  Rachel Baggaley¹  Heather-Marie A Schmidt²  Graham Shaw³  Judy Chang⁴  Annie Madden⁴  Busisiwe Msimanga-Radebe⁵  Nabeel Mangadan Konath⁶ 

[1] Global HIV, Hepatitis and STIs Programmes, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland;Global HIV, Hepatitis and STIs Programmes, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland;UNAIDS Regional Office for Asia and the Pacific, Bangkok, Thailand;Independent Consultant, Cambridge, UK;International Network of People who Use Drugs, London, UK;World Health Organization, Pretoria, South Africa;World Health Organization, Yangon, Myanmar;

关键词: HIV prevention;    Pre-exposure prophylaxis;    People who inject drugs;    Harm reduction;   

DOI  :  10.1186/s12954-023-00729-6

 received in 2022-11-11, accepted in 2023-01-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsBetween 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.ResultsPrEP 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.ConclusionsThis 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.

【 授权许可】

CC BY   
© World Health Organization 2023

【 图 表 】

Fig. 1