Global, regional, and country-level coverage of testing and treatment for HIV and hepatitis C infection among people who inject drugs: a systematic review
Year: 2023
Type: review
Abstract: Background People who inject drugs are disproportionately affected by HIV and hepatitis C virus (HCV) infections, while there is little global data on HIV and HCV testing and treatment coverage of this population. We conducted a systematic review to evaluate country-level, regional, and global coverage of HIV and HCV testing and treatment among people who inject drugs. Methods We did a systematic review, and searched bibliographic databases (MEDLINE, Embase, and PsycINFO) and grey literature for studies published between Jan 1, 2017, and April 30, 2022, that evaluated the proportion of people who inject drugs who received testing or treatment for HIV or HCV. For each country, we estimated the proportion of people who inject drugs tested for HIV antibodies in the past 12 months (recent), people who inject drugs ever tested for HCV antibodies and HCV RNA, people who inject drugs with HIV currently receiving antiretroviral therapy, and people who inject drugs with HCV ever receiving HCV antiviral treatment. Regional and global estimates, weighted by the population size of people who inject drugs, were generated where sufficient data were available. This study is registered with PROSPERO (CRD42020173974). Findings 512 documents reported data eligible for analyses, including 337 peer-reviewed articles, 27 conference abstracts or presentations, and 148 documents from grey literature or supplementary searches. Data of recent HIV antibody testing were available for 67 countries and ever having had HCV antibody testing were available for 49 countries. Globally, an estimated 48·8% of people who inject drugs were recently tested for HIV antibodies (95% uncertainty interval [UI] 43·3–54·2%; range 0·9–86·0%), and 47·1% had ever been tested for HCV antibodies (95% UI 43·4–51·0%; range 0·0–93·3%). HCV RNA testing data were available from three countries. Coverage of HIV antibody testing was high (>75%) in four countries and for HCV antibody testing in 15 countries. The estimated uptake of current HIV treatment (18 countries) ranged from 2·6% to 81·9%, and the estimated uptake of ever having HCV treatment (23 countries) ranged from 1·8% to 88·6% across countries. Uptake of HIV treatment was high in two countries, and of HCV treatment in one country. Interpretation HIV and HCV testing and treatment uptake among people who inject drugs was highly variable, and suboptimal in most countries. Strategies to improve access to HIV and HCV care among people who inject drugs and the availability of public health surveillance are urgently required. Funding Australian National Health and Medical Research Council and UK National Institute for Health and Care Research Health Protection Research Unit in Behavioural Science and Evaluation.
Source: The Lancet Global Health
Authors: Behzad Hajarizadeh, Abe Kairouz, Sophie Ottaviano, Jeremy Ireland, Alex Willing, Evan Cunningham, Paige Webb, Samantha Colledge-Frisby, Alice Wheeler, Janni Leung, Lucy T Tran, Olivia Price, Peter Vickerman, Michael Farrell, Matthew Hickman, Gregory J Dore, Anne Bergenström, Louisa Degenhardt, Jason Grebely
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $5,780
Funders: Social Trends Institute, Australian Government, National Institute for Health Research Health Protection Research Unit, National Institute for Health and Care Research, European Centre for Disease Prevention and Control, University of Pretoria, University of New South Wales, Department of Health and Aged Care, Australian Government, National Drug Research Institute, Medical Research Council, National Health and Medical Research Council, National Drug and Alcohol Research Centre, National Institute on Drug Abuse, National Institute of Allergy and Infectious Diseases
Awards: Improving the health of people with problematic drug use: hepatitis C and drug dependence, G1513324279, Strategies to facilitate elimination of hepatitis C infection among people who inject drugs, NIHR Senior Investigator Award, The MRC Addiction Research Clinical Training programme: MARC, G6016042862, G6502652893, Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modeling, G7607370995, Increasing knowledge about substance use, mental health and harms, and interventions to prevent and reduce harm, Evaluating the Population Impact of Hepatitis C Direct Acting Antivral Treatment as Prevention for People Who Inject Drugs (EPIToPe), Improving Knowledge and Interventions to reduce and prevent substance use related harms, Modeling Structural HIV Determinants in Substance Users and related populations
OpenAlex ID: W4388661267