Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programs

Harm Reduction Journal

Research

Mehdi Ghorbanian¹  Nasim Nasiri Moghadam²  Willi Mcfarland³  Mohammad Mehdi Gouya⁴  Ali Akbar Haghdoost⁵  Fatemeh Tavakoli⁵  Nima Ghalekhani⁵  Hamid Sharifi⁵  Mehrdad Khezri⁶  Marzieh Mahboobi⁷  Ali Komasi⁸  Ali Mohammad Hosseionpour⁹  Maryam Taghipour^1,10 

[1] Alborz University of Medical Sciences, Alborz, Iran;Center for HIV/STI Control and Prevention, Kerman University of Medical Sciences, Kerman, Iran;Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA;Department of Infectious Disease and Tropical Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran;HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran;HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran;Department of Epidemiology, School of Global Public Health, New York University, New York, NY, USA;Iranian Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran;Kermanshah University of Medical Sciences, Kermanshah, Iran;Mashhad University of Medical Sciences, Mashhad, Iran;Shiraz University of Medical Sciences, Shiraz, Iran;

关键词: Harm reduction;    Double counting;    HIV;    Drug use;    Iran;   

DOI  :  10.1186/s12954-023-00851-5

 received in 2023-02-17, accepted in 2023-08-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMany 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.MethodsBetween 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.ResultsSynthesizing 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).ConclusionDouble 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.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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