Measuring individual-level needle and syringe coverage among people who inject drugs in Myanmar

Myanmar has prioritised people who inject drugs (PWID) as a key population for HIV mitigation efforts, with targets for needle and syringe distribution set at a population level. However, individual-level coverage, defined as the percentage of an individual’s injecting episodes covered by a sterile...

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Veröffentlicht in:The International journal of drug policy Jg. 58; S. 22 - 30
Hauptverfasser: O’Keefe, Daniel, Aung, Soe Moe, Pasricha, Naanki, Wun, Thu, Linn, Soe Khaing, Lin, Nay, Aitken, Campbell, Hughes, Chad, Dietze, Paul
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Netherlands Elsevier B.V 01.08.2018
Elsevier Science Ltd
Schlagworte:
Adult
Demography
Drop-in centers
Drug abuse
Drug policy
Drug use
Drugs
Facilities and Services Utilization - statistics & numerical data
Female
Harm reduction
Heroin
HIV
Human immunodeficiency virus
Humans
Hypodermic needles
Individual differences
Injecting drug use
Injections
Intervention
Low and middle income
Male
Mitigation
Myanmar - epidemiology
Needle and syringe coverage
Needles - statistics & numerical data
Pharmacies
Quantitative analysis
Questionnaires
Risk
Risk behavior
Risk-Taking
Services
Substance Abuse, Intravenous - epidemiology
Substance Abuse, Intravenous - psychology
Syringes - statistics & numerical data
Urban Population - statistics & numerical data
Young Adult
Myanmar
Myanmar (Burma)
Harm reduction
Injecting drug use
Needle and syringe coverage
Low and middle income
ISSN:0955-3959, 1873-4758, 1873-4758
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Zusammenfassung:Myanmar has prioritised people who inject drugs (PWID) as a key population for HIV mitigation efforts, with targets for needle and syringe distribution set at a population level. However, individual-level coverage, defined as the percentage of an individual’s injecting episodes covered by a sterile syringe, is a more sensitive measure of intervention coverage. We sought to examine individual-level coverage in a sample of PWID in Myanmar. We recruited 512 PWID through urban drop-in-centres in Yangon, Mandalay and Pyin Oo Lwin. Participants were administered a quantitative questionnaire covering five domains: demographics, drug use, treatment and coverage, and injecting risk behaviour. We calculated past fortnight individual-level syringe coverage, estimating levels of sufficient (≥100% of injecting episodes covered by a sterile syringe) and insufficient (<100%) coverage, and examined associations between key variables and insufficient coverage via logistic regression. Our sample was predominately male (97%), employed (76%), and living in stable accommodation (96%), with a median age of 27. All participants reported heroin as the drug most frequently injected, and injected a median of 27 times in the past two weeks. Nineteen per cent of participants had insufficient coverage in the two weeks before interview. Insufficient coverage was positively associated with syringe re-use (AOR: 5.19, 95% CIs: 2.57, 10.48) and acquiring sterile syringes from a location other than a formal drop-in-centre (AOR: 2.04, 95% CIs: 1.08, 3.82). Participants recruited in Mandalay (AOR: 0.30, 95% CIs: 0.11, 0.80) and Pyin Oo Lwin (AOR: 0.39, 95% CIs: 0.18, 0.87) had lower odds of insufficient coverage than those recruited in Yangon. Our study shows coverage in selected areas of Myanmar was comparable with studies in other countries. Our results inform the delivery of harm reduction services for PWID, specifically by encouraging the use of formal drop-in-centres, over other sources of syringe distribution, such as pharmacies.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0955-3959
1873-4758
1873-4758
DOI:10.1016/j.drugpo.2018.04.010