High-risk behaviors and their association with awareness of HIV status among participants of a prevention intervention

High-risk behaviors and their association with awareness of HIV status among participants of a large-scale prevention intervention in Athens, Greece.

Pavlopoulou, I.D., Dikalioti, S.K., Gountas, I. et al.

BMC Public Health 20, 105 (2020). https://doi.org/10.1186/s12889-020-8178-y

Abstract

Background

Aristotle was a seek-test-treat intervention during an outbreak of human immunodeficiency virus (HIV) infection among people who inject drugs (PWID) in Athens, Greece that started in 2011. The aims of this analysis were: (1) to study changes of drug injection-related and sexual behaviors over the course of Aristotle; and (2) to compare the likelihood of risky behaviors among PWID who were aware and unaware of their HIV status.

Methods

Aristotle (2012–2013) involved five successive respondent-driven sampling rounds of approximately 1400 PWID each; eligible PWID could participate in multiple rounds. Participants were interviewed using a questionnaire, were tested for HIV, and were classified as HIV-positive aware of their status (AHS), HIV-positive unaware of their status (UHS), and HIV-negative. Piecewise linear generalized estimating equation models were used to regress repeatedly measured binary outcomes (high-risk behaviors) against covariates.

Results

Aristotle recruited 3320 PWID (84.5% males, median age 34.2 years). Overall, 7110 interviews and blood samples were collected. The proportion of HIV-positive first-time participants who were aware of their HIV infection increased from 21.8% in round A to 36.4% in the last round. The odds of dividing drugs at least half of the time in the past 12 months with a syringe someone else had already used fell from round A to B by 90% [Odds Ratio (OR) (95% Confidence Interval-CI): 0.10 (0.04, 0.23)] among AHS and by 63% among UHS [OR (95% CI): 0.37 (0.19, 0.72)]. This drop was significantly larger (p = 0.02) among AHS. There were also decreases in frequency of injection and in receptive syringe sharing in the past 12 months but they were not significantly different between AHS (66 and 47%, respectively) and UHS (63 and 33%, respectively). Condom use increased only among male AHS from round B to the last round [OR (95% CI): 1.24 (1.01, 1.52)].

Conclusions

The prevalence of risky behaviors related to drug injection decreased in the context of Aristotle. Knowledge of HIV infection was associated with safer drug injection-related behaviors among PWID. This highlights the need for comprehensive interventions that scale-up HIV testing and help PWID become aware of their HIV status.

Changes to CNP services in SA

SA Health, October 2017

From 1 January 2018, Mission Australia Hindmarsh Centre after-hours Clean Needle Program (CNP) service component (Monday to Friday 5pm to 8pm) will discontinue. However, the daytime CNP service at the Hindmarsh Centre, provided by Hepatitis SA staff will continue Monday to Friday 1.30pm to 5.00pm, with syringe vending machine services available 24 hours per day 7 days per week until 30 June 2018.

The following expanded after-hours CNP service options will become available to clients in the Adelaide metropolitan area in October and November 2017:

  1. NEW  Uniting Communities Hendon CNP service details – opening Monday 9th October 2017:
  • 45-47 Tapleys Hill Rd, Hendon (ph) 8202 5610
  • After-hours CNP service Monday to Sunday 5.00pm to 12.00am (midnight).
  • Daytime CNP service Monday to Sunday 9.00am to 5.00pm.
  • 1 x syringe vending machine available 24 hrs per day 7 days per week from mid-October onwards
  1. NEW Thursday night DASSA Central Stepney after-hours CNP service details – opening Thursday 16th November 2017:
  • 91 Magill Rd, Stepney (ph) 7245 5080
  • After hours CNP service Thursdays only 5.00pm to 9.00pm
  • Daytime CNP service Monday to Friday 9.00am to 5.00pm
  • 2 x syringe vending machines available 24hrs per day 7 days per week.

Syringe vending machines continue to be available 24hr per day 7 days per week at the following locations in SA:

  • NORTH – DASSA Northern Service, 22 Langford Drive, ELIZABETH.
  • SOUTH – Noarlunga Health Village, Alexander Kelly Drive, NOARLUNGA
  • EAST – DASSA Central Service, 91 Magill Rd, STEPNEY
  • WEST – Hindmarsh Centre, 35 Richards St, HINDMARSH.

Free community CNP sites across South Australia:

  • For a complete list of all free community CNP sites across South Australia, type “Clean Needle Program SA” into the Google search bar and then click on the link for “Clean Needle Program Sites List – SA Health”.
  • OR  call  the Alcohol and Drug Information Service (ADIS) on 1300 131 340

For further information:

Please contact the Clean Needle Program by phoning (08) 7425 5080

 

 

The health of Australia’s prisoners 2015

AIHW, released: 27 Nov 2015

The health of Australia’s prisoners 2015 is the fourth report produced by the Australian Institute of Health and Welfare on the health and wellbeing of prisoners. The report explores the conditions and diseases experienced by prisoners; compares, where possible, the health of prisoners to the general Australian community and provides valuable insight into the use of prison health services.

New to the 2015 report are data on the disabilities or long-term health conditions of prisoners entering the prison system (prison entrants), self-assessed mental and physical health status of prisoners and data on smoke-free prisons

Of special note:

Chapter 6 (Communicable diseases) includes:

  • Sexually transmissible infections
  • Bloodborne viruses
  • Surveillance
  • Medication for Hepatitis C

Chapter 12 (Illicit drug use and needle sharing) includes:

  • Drug use prior to prison
  • Drug use in prison
  • Needle sharing
  • Opioid substitution treatment (OST)
  • Tattooing and body piercing

Chapter 14 (Injuries, assaults and unprotected sex) includes:

  • Head injury
  • Accidents or injuries
  • Assault and sexual assault
  • Unprotected sex

See full table of contents & download report (PDF) or read summary here

Union resistance could stymie prison needle exchange program: researcher

Guardian, Monday 19 October 2015

A senior blood-borne diseases researcher, Associate Professor Mark Stoové, says Australia’s first prison needle and syringe program flagged for trial in an ACT jail is most likely doomed because of the influence of a union and its members.

Stoové criticised the Community and Public Sector Union’s resistance to a proposal by the ACT government to trial a needle and syringe program in the Alexander Maconochie Centre, a maximum security prison.

Read more here

 

 

 

Hobart needle exchange program making a difference in community

ABC News, Updated

The program aims to reduce the amount of blood-borne viruses and Heptatitis B and C within the injecting and wider community by supplying sterile needles and other equipment.

As well as supplying sterile needles and a place for needle disposal for injecting drug users, the NSP educates people in harm minimisation and safe needle techniques.

  • Read more here
  • Download the list of Clean Needle Program sites in SA (PDF) here

Brisbane school needlestick injury media reporting criticised

Star Observer, May 30, 2014

Key community and government HIV and AIDS organisations have criticised mainstream media reporting of a Brisbane school student finding and injuring himself with a needlestick as generating “fear”.

Read more