Barriers to HIV and Hepatitis C care for people who inject drugs in Colombia

Borda, Juan P.; Friedman, Hannah; Castaño, Guillermo A.; Rodríguez, Henry Alberto; Muñoz, Carlos F.; Tofighi, Babak

doi:10.1080/09540121.2021.1889952

Cited by 4 publications

(6 citation statements)

References 16 publications

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“…Barriers to HIV treatment among PWID in Colombia include lack of transportation (OR 0.23 95% CI 0.05-0.99, p 0.034) [38]. In the same study past poor treatment at a clinic or lack of trust in doctor were associated barriers to HCV testing [38].…”

Section: Harm Reduction Drug Treatment and Hiv/hcv Testing And Treatmentmentioning

confidence: 82%

“…In relation to HIV testing, being married, less frequent injecting, not engaging in poly-drug use were associated with seeking HIV testing among PWID in Lashio, Myanmar, while being female, completing higher education, living with a sex partner, using methamphetamines or having an STI was associated with increased testing among PWUD in Muse, Myanmar [47,50]. In Colombia lack of awareness of testing sites and not wanting to know results were barriers to HIV and HCV testing [38].…”

Section: Harm Reduction Drug Treatment and Hiv/hcv Testing And Treatmentmentioning

confidence: 98%

“…A study in Medellin, a city in Colombia, reported that 63.4% of the sample sold drugs [35]. Between 50 and 60% of Afghanistan populations reported a history of imprisonment [41,45,57] between 4 and 20% were homeless or unstably housed across the three countries [38,42,59,62] and between 15 and 52.4% were unable to read or write in Myanmar and Afghanistan [44,46,51]. In all studies except one, the majority of the sample were male (82-100%).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…Three studies in Myanmar and Afghanistan looked at retention into opioid substitution therapy and two focused on receipt of needle/syringes at harm reduction programmes [30,42,43,45,57]. One study in Colombia and three in Myanmar focused on use of HIV testing and treatment [38,39,47,50].…”

Section: Harm Reduction Drug Treatment and Hiv/hcv Testing And Treatmentmentioning

confidence: 99%

“…Two studies in Kabul found that prior incarceration was associated with greater likelihood of using harm reduction services (AOR 1.57 95% CI 1.06-2.32) or drug treatment services (AOR 1.81 95% CI 1.04-3.13) [53,57]. Barriers to HIV treatment among PWID in Colombia include lack of transportation (OR 0.23 95% CI 0.05-0.99, p 0.034) [38]. In the same study past poor treatment at a clinic or lack of trust in doctor were associated barriers to HCV testing [38].…”

Section: Harm Reduction Drug Treatment and Hiv/hcv Testing And Treatmentmentioning

confidence: 99%

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Determinants of health among people who use illicit drugs in the conflict-affected countries of Afghanistan, Colombia and Myanmar: a systematic review of epidemiological evidence

O’Brien

Jaramillo²,

Roberts³

et al. 2022

Confl Health

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Background Afghanistan, Colombia and Myanmar are the world’s leading heroin and cocaine producers and have also experienced prolonged periods of armed conflict. The link between armed conflict and drug markets is well established but how conflict impacts on the health and social determinants of people who use drugs is less clear. The aim was to investigate health outcomes and associated factors among people who use illicit drugs in Afghanistan, Colombia and Myanmar. Methods We conducted a systematic review searching Medline, EMBASE, PsychINFO and Global Health databases using terms relating to Afghanistan, Colombia and Myanmar; illicit drug use (all modes of drug administration); health and influencing factors. Quality assessment was assessed with the Newcastle–Ottawa-Scale and papers were analysed narratively. Results 35 studies were included in Afghanistan (n = 15), Colombia (n = 9) and Myanmar (n = 11). Health outcomes focused predominantly on HIV, Hepatitis C (HCV), Hepatitis B and sexually transmitted infections (STIs), with one study looking at human rights violations (defined as maltreatment, abuse and gender inequality). Drug use was predominantly injection of heroin, often alongside use of amphetamines (Myanmar), cocaine and cocaine-based derivatives (Colombia). Only one study measured the effect of a period of conflict suggesting this was linked to increased reporting of symptoms of STIs and sharing of needles/syringes among people who inject drugs. Findings show high levels of external and internal migration, alongside low-income and unemployment across the samples. External displacement was linked to injecting drugs and reduced access to needle/syringe programmes in Afghanistan, while initiation into injecting abroad was associated with increased risk of HCV infection. Few studies focused on gender-based differences or recruited women. Living in more impoverished rural areas was associated with increased risk of HIV infection. Conclusions More research is needed to understand the impact of armed-conflict and drug production on the health of people who use drugs. The immediate scale-up of harm reduction services in these countries is imperative to minimize transmission of HIV/HCV and address harms associated with amphetamine use and other linked health and social care needs that people who use drugs may face.

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Section: Harm Reduction Drug Treatment and Hiv/hcv Testing And Treatmentmentioning

confidence: 82%

Section: Harm Reduction Drug Treatment and Hiv/hcv Testing And Treatmentmentioning

confidence: 98%

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Harm Reduction Drug Treatment and Hiv/hcv Testing And Treatmentmentioning

confidence: 99%

Section: Harm Reduction Drug Treatment and Hiv/hcv Testing And Treatmentmentioning

confidence: 99%

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Determinants of health among people who use illicit drugs in the conflict-affected countries of Afghanistan, Colombia and Myanmar: a systematic review of epidemiological evidence

O’Brien

Jaramillo²,

Roberts³

et al. 2022

Confl Health

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HIV knowledge and risk behaviors among people who inject heroin in Colombia

Borda

Arango

Herrera

et al. 2021

Drugs: Education, Prevention and Policy

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Perspectives on Adherence From the ACTG 5360 MINMON Trial: A Minimum Monitoring Approach With 12 Weeks of Sofosbuvir/Velpatasvir in Chronic Hepatitis C Treatment

Sowah

Smeaton

Brates

et al. 2023

Clinical Infectious Diseases

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Background With the advent of efficacious oral Direct-acting antivirals (DAAs) for hepatitis C virus(HCV), identification of characteristics associated with adherence is critical to treatment success. We examined correlates of sub-optimal adherence to HCV therapy in a single-arm, multinational, clinical trial. Methods ACTG A5360 enrolled HCV treatment-naïve persons without decompensated cirrhosis from 5 countries. All participants received a 12-weeks course of sofosbuvir/velpatasvir at entry. In-person visits occurred at initiation and week 24, sustained virologic response (SVR) assessment. Adherence at week 4 was collected remotely and was dichotomized optimal (100%, no missed doses) versus sub-optimal (<100%). Correlates of sub-optimal adherence were explored using logistic regression. Results 400 participants enrolled; 399 initiated treatment; 395/397 (99%) reported completing at week 24.. Median age was 47 years with 35% female. Among the 368 reporting optimal adherence at week 4 SVR was 96.5% (95% CI [94.1%, 97.9%]) vs. 77.8% (95% CI [59.2%, 89.4%]) p-value < 0.001. In the multivariate model age < 30 years and being a US participant were independently associated with early sub-optimal adherence. Participants < 30 years were 7.1 times more likely to have early sub-optimal adherence compared to their older counterparts. Conclusion Self-reported optimal adherence at week 4 was associated with SVR. Early self-reported adherence could be used to identify those at higher risk of treatment failure and may benefit from additional support. Younger individuals < 30 years may also be prioritized for additional adherence support.

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Barriers to HIV and Hepatitis C care for people who inject drugs in Colombia

Cited by 4 publications

References 16 publications

Determinants of health among people who use illicit drugs in the conflict-affected countries of Afghanistan, Colombia and Myanmar: a systematic review of epidemiological evidence

Determinants of health among people who use illicit drugs in the conflict-affected countries of Afghanistan, Colombia and Myanmar: a systematic review of epidemiological evidence

HIV knowledge and risk behaviors among people who inject heroin in Colombia

Perspectives on Adherence From the ACTG 5360 MINMON Trial: A Minimum Monitoring Approach With 12 Weeks of Sofosbuvir/Velpatasvir in Chronic Hepatitis C Treatment

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