Geographic Disparities in Access to Syringe Services Programs Among Young Persons With Hepatitis C Virus Infection in the United States

Canary, Lauren; Hariri, Susan; Campbell, Cecily; Young, Randall; Whitcomb, Jeannette M.; Kaufman, Harvey W.; Vellozzi, Claudia

doi:10.1093/cid/cix333

Cited by 61 publications

(41 citation statements)

References 9 publications

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“…The USA, Brazil and Canada share the challenge of providing equitable access to health across extensive, varied geographical regions, with rural populations often living long distances from heath care services. In the USA, this creates a particular problem in tackling the rural opioid epidemic, with an estimated 80% of all HCV-infected people aged less than 30 years living more than 10 miles from a syringe service program 258 . This situation underscores the importance of combating the rural opioid epidemic using diverse strategies, including integration of HCV testing and treatment services into syringe services programs, and designating pharmacies as sources of safe injection equipment.…”

Section: Barriers To Eliminationmentioning

confidence: 99%

Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

Cooke

Andrieux-Meyer

Applegate

et al. 2019

The Lancet Gastroenterology & Hepatology

428

391

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investments to support countries with greatest burden of viral hepatitis All heavily burdened countries to have fully funded elimination plans by 2019 Recognition of need to focus on high burden countries and support for national policy development (All) Funding for national elimination plans Creation of fiscal space for new programmes with costed investment programmes Adopt domestic innovative finance tools where appropriate Support national policy makers in their activity (WHO, UNITAID, NGOs) Provide international support for financing measures (UNITAID, GFATM, bilaterial donors) Prevention Ensure all WHO elimination targets addressed in plans Address operational challenges in delivery of birth dose HBV vaccine Ensure provision of harm reduction services and engage with marginalised group (e.g. prisoners, PWIDs). Ensure clear public health messages to encourage testing and treatment Support countries to decriminalise injecting drug use and ensure equitable access to services for all (NGOs, WHO, civil society) Ensure appropriate funding for HBV vaccine, including birth dose (GAVI, WHO) Support R&D into HCV vaccine development (Research funders and pharma) Testing and Models of Care Focus on substantially scaling up testing for HBV and HCV Create and evaluate simplified care pathways relevant to local setting, integrating with existing services. Promote task sharing and decentralisation of care through capacity building, training and removal of Support operational research into simplified pathways (Research funders, UNITAID) requirements for specialised prescribing Diagnostics Ensure testing is integrated into the wider healthcare system, rather than centralised facilties Ensure access to quality diagnostics through Essential Diagnostic List and prequalification (WHO, funders) Support implementation science for models of care and R&D into novel diagnostics suitable for decentralised settings. (Research funders, FIND, industry) Access to treatment Ensure all Essential Medicines for viral hepatitis are included in national programmes, with an emphasis on pan-genotypic regimens Apply comprehensive policy approach to promoting access, including compulsory licensing Ensure all essential medicines are pre-qualified and either available through voluntary licensing or Medicines Patent Pool (WHO, NGOs, civil society, funders) Support shared procurement mechanisms for treatment (PAHO) Monitor Progress National plans need clearly defined, measurable objectives Develop new indices of national progress Progress of individual countries needs to be closely monitored towards elimination goals (Polaris, WHO, Creation of Elimination Index) Develop greater capacity for advocacy in high burden regions (all) Viral hepatitis is one of the leading causes of death in the world. 96% of those deaths are due to hepatitis B and C, which are the focus of this commission. Unlike many other major diseases, the tools exist to eliminate viral hepatitis. A highly effective vaccine is available to prevent hepatitis B, and a revolution in HCV treat...

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Section: Barriers To Eliminationmentioning

confidence: 99%

Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

Cooke

Andrieux-Meyer

Applegate

et al. 2019

The Lancet Gastroenterology & Hepatology

428

391

View full text Add to dashboard Cite

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“…This high cost is due, in part, to the success of other harm reduction strategies suppressing the rate of HIV transmission. However, many PWID in the rural areas at risk for HIV outbreaks do not have access to other prevention efforts, such as SSPs (Canary et al, 2017; Des Jarlais et al, 2015). In these settings, PrEP may be the only option for preventing HIV among many PWID.…”

Section: Introductionmentioning

confidence: 99%

PrEP awareness, eligibility, and interest among people who inject drugs in Baltimore, Maryland

Sherman

Schneider

Park

et al. 2019

Drug and Alcohol Dependence

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Background: Limited research has examined pre-exposure prophylaxis (PrEP) interest among people who inject drugs (PWID). To date, few studies have examined the relationship between PrEP eligibility and PrEP interest among PWID. Methods: Data were from an anonymous, cross-sectional survey of Baltimore Syringe Services Program (SSP) clients and non-client peers, restricted to HIV-uninfected participants (N=265). Participants were classified as PrEP eligible/ineligible based on injection related criteria outlined in the CDC’s PrEP guidelines. Participants were asked if they were previously aware of PrEP, would be interested in taking PrEP, and the ease of taking PrEP daily. Participants self-reported their sociodemographic characteristics, health diagnoses, and recent drug use, overdose, and drug treatment history. We estimated bivariate and multivariate logistic regression models to test for significant predictors of interest in PrEP. Results: One-quarter of PWID had previously heard of PrEP and 63% of the sample was interested in taking PrEP. Only two respondents were currently taking PrEP. The majority (89%) thought taking PrEP every day would be easy. In the presence of other variables, PrEP interest was associated with PrEP eligibility (adjusted odds ratio [aOR]=2.46; 95% Confidence Interval [CI]:1.34,4.50) and the number of medical diagnoses (aOR=1.16; 95% CI:1.01,1.33) Conclusions: Most PWID were unaware of PrEP but interested in taking it. PWID who were eligible for PrEP are more likely to be interested in taking it. Having co-morbid conditions was an important correlate of PrEP interest. These results underscore the importance of providers across the healthcare sector engaging PWID in discussions about PrEP.

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“…Without clear evidence of success, NEP implementation expanded in an attempt to curtail the spread of HCV. To date, there has been no direct evidence demonstrating that NEPs reduce HCV transmission in the United States . In fact, there are no randomized control trials directly evaluating the effectiveness of NEPs and HCV transmission.…”

mentioning

confidence: 99%

CON: Needle Exchange Programs Should Not Be Instituted to Reduce Hepatitis C Virus Transmission

O’Riordan

Khan

Mazulis

2018

Clinical Liver Disease

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Geographic Disparities in Access to Syringe Services Programs Among Young Persons With Hepatitis C Virus Infection in the United States

Cited by 61 publications

References 9 publications

Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

PrEP awareness, eligibility, and interest among people who inject drugs in Baltimore, Maryland

CON: Needle Exchange Programs Should Not Be Instituted to Reduce Hepatitis C Virus Transmission

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