Evaluation of the scale-up of HIV testing among people who inject drugs in Scotland in the context of an ongoing HIV outbreak

Trayner, Kirsten M A; Palmateer, Norah; McAuley, Andrew; Metcalfe, Rebecca; Goldberg, David J.; Peters, Erica J.; Craik, Julie; Gunson, Rory; Thain, Donna; Carter, Daniel; Hutchinson, Sharon

doi:10.1016/j.drugpo.2021.103304

Cited by 6 publications

(16 citation statements)

References 33 publications

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“…However, increasing BBV testing rates in Scotland is paramount in the context of the ongoing HIV outbreak in Glasgow. Significant gains made pre-COVID-19 in relation to increased HIV test uptake among PWID in response to the outbreak could be in danger of being reversed ( Trayner et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…Modelling research estimated that delaying HCV prevention programmes (testing, diagnosis and treatment) by one year could result in 44,800 excess hepatocellular carcinoma cases and 72,300 excess liver-related deaths globally ( Blach et al, 2021 ). The continued monitoring of intervention coverage and injecting risk behaviours is fundamental in the context of subsequent waves of COVID-19 and to ensure that gains made in relation to the control of the HIV outbreak and significant progress towards HCV elimination in Scotland are not eroded ( Metcalfe et al, 2020 , Palmateer et al, 2021 , Trayner et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…Pre-pandemic, the coverage of BBV prevention services in Scotland was good (with ‘moderate’ OAT and ‘high’ NSP coverage), compared to other regions globally where less than 1% of PWID live in countries with a high coverage of both NSP and OAT ( Larney et al, 2017 , Wiessing et al, 2017 ). However, despite relatively good access to services, Glasgow, Scotland’s largest city, is currently experiencing an ongoing outbreak of HIV that represents the largest community-based outbreak in the UK since the 1980s ( McAuley et al, 2019 , Trayner et al, 2021 , Trayner et al, 2020 ). The prevalence of hepatitis C virus (HCV) among PWID has also historically been high; however, significant progress in reducing the prevalence of chronic HCV infection (from 39% in 2015/16–19% in 2019/20) has been made as a result of the scale up of direct-acting antivirals ( Health Protection Scotland, 2019a , Palmateer et al, 2021 , Public Health England, 2020a ).…”

Section: Introductionmentioning

confidence: 99%

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Examining the impact of the first wave of COVID-19 and associated control measures on interventions to prevent blood-borne viruses among people who inject drugs in Scotland: an interrupted time series study

Trayner

McAuley

Palmateer

et al. 2022

Drug and Alcohol Dependence

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Background COVID-19 has likely affected the delivery of interventions to prevent blood-borne viruses (BBVs) among people who inject drugs (PWID). We examined the impact of the first wave of COVID-19 in Scotland on: 1) needle and syringe provision (NSP), 2) opioid agonist therapy (OAT) and 3) BBV testing. Methods An interrupted time series study design; 23rd March 2020 (date of the first ‘lockdown’) was chosen as the key date. Results The number of HIV tests and HCV tests in drug services/prisons, and the number of needles/syringes (N/S) distributed decreased by 94% (RR=0.062, 95% CI 0.041–0.094, p < 0.001), 95% (RR=0.049, 95% CI 0.034–0.069, p < 0.001) and 18% (RR = 0.816, 95% CI 0.750–0.887, p < 0.001), respectively, immediately after lockdown. Post-lockdown, an increasing trend was observed relating to the number of N/S distributed (0.6%; RR = 1.006, 95% CI 1.001–1.012, p = 0.015), HIV tests (12.1%; RR = 1.121, 95% CI 1.092–1.152, p < 0.001) and HCV tests (13.2%; RR = 1.132, 95 CI 1.106–1.158, p < 0.001). Trends relating to the total amount of methadone prescribed remained stable, but a decreasing trend in the number of prescriptions (2.4%; RR = 0.976, 95% CI 0.959–0.993, p = 0.006) and an increasing trend in the quantity prescribed per prescription (2.8%; RR = 1.028, 95% CI 1.013–1.042, p < 0.001) was observed post-lockdown. Conclusions COVID-19 impacted the delivery of BBV prevention services for PWID in Scotland. While there is evidence of service recovery; further effort is likely required to return some intervention coverage to pre-pandemic levels in the context of subsequent waves of COVID-19.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Examining the impact of the first wave of COVID-19 and associated control measures on interventions to prevent blood-borne viruses among people who inject drugs in Scotland: an interrupted time series study

Trayner

McAuley

Palmateer

et al. 2022

Drug and Alcohol Dependence

Self Cite

View full text Add to dashboard Cite

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“…An expansion of testing across multiple settings in response to an ongoing HIV outbreak in Scotland increased testing from 33% to 67% among PWID. 50 This increase in targeted testing is likely to have contributed to low levels of late diagnosis reported in Scotland in recent years ( Figure 1 ).…”

Section: Prevalence Of Late Hiv Diagnosis In the Uk And Patient Chara...mentioning

confidence: 99%

Tackling late HIV diagnosis: Lessons from the UK in the COVID-19 era

Boardman,

Boffito,

Chadwick

et al. 2023

Int J STD AIDS

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Introduction Late diagnosis of HIV is associated with increased morbidity and mortality, and an increased risk of non-infectious comorbidities. On a societal level, late diagnosis leads to higher treatment and healthcare costs and is a major driver of HIV transmission. Despite improvements in other areas of the HIV care pathway, late diagnosis remains an individual and public health concern globally. Objective To examine the barriers to HIV testing and highlight successful strategies to improve prompt diagnosis. This review describes the prevalence of late diagnosis in the UK and discusses key factors that contribute to late diagnosis, including the effect of the COVID-19 pandemic. Late HIV diagnosis is lower in the UK than in most other European countries. In this review, pilot projects and ongoing initiatives that have reduced late diagnosis in the UK are highlighted; moreover, further strategies for improving prompt diagnosis are suggested. Conclusions Insufficient testing is the fundamental reason for late HIV diagnosis, with societal, systemic, and individual factors all contributing to inadequate testing. Improving access to testing, removing barriers to health-seeking behaviour, and ensuring all people with HIV indicator conditions are promptly tested are key to reducing the rates of late diagnosis globally.

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“…HIV testing is the cornerstone of the public health response among this population. We know from experience that increasing HIV test uptake is achievable through community‐based testing including opt‐out testing in prisons and testing in drug treatment services [9]. Facilitating accessible regular universal testing ensures clusters of HIV are rapidly detected and individuals are linked to HIV treatment services.…”

mentioning

confidence: 99%

Editorial on ‘Epidemiology of HIV infection and associated behaviours among people who inject drugs in England, Wales, and Northern Ireland: nearly 40 years on’

Grimshaw

Trayner

2022

HIV Medicine

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Evaluation of the scale-up of HIV testing among people who inject drugs in Scotland in the context of an ongoing HIV outbreak

Cited by 6 publications

References 33 publications

Examining the impact of the first wave of COVID-19 and associated control measures on interventions to prevent blood-borne viruses among people who inject drugs in Scotland: an interrupted time series study

Examining the impact of the first wave of COVID-19 and associated control measures on interventions to prevent blood-borne viruses among people who inject drugs in Scotland: an interrupted time series study

Tackling late HIV diagnosis: Lessons from the UK in the COVID-19 era

Editorial on ‘Epidemiology of HIV infection and associated behaviours among people who inject drugs in England, Wales, and Northern Ireland: nearly 40 years on’

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