Interventions to prevent HIV and Hepatitis C in people who inject drugs: A review of reviews to assess evidence of effectiveness

Uso de reducción de daños y gravedad psicopatológica y médica en pacientes en programa de mantenimiento con metadona

“…Con respecto a la vía de consumo ya es sabido que los pacientes que utilizan los recursos REDAN tienden a tener más consumo por vía intravenosa independientemente de la droga de consumo (MacArthur et al, 2014), por eso el intercambio de jeringuillas y las salas de consumo supervisado por vía intravenosa fueron los programas iniciales y fundadores de REDAN (IHRA, 2010). Nuestros hallazgos corroboran este hecho al identificarse mayor uso de la vía intravenosa (5.9 % vs 70.3 %, .017) en el grupo PMM-RE-DAN, mientras que el grupo PMM-NO REDAN presenta mayor uso de la vía fumada (24.3 % vs 5.4 %, .011).…”

“…Los programas sustitutivos con agonistas opiáceos han demostrado elevada eficacia, siendo en la actualidad los más utilizados en pacientes con dependencia de opiáceos, así como para reducir la prevalencia de infección por el VIH (Amato, Davoli, Perucci, Ferri, Faggiano y Mattick, 2005;Fernandez-Miranda, García-Portilla, Sáiz, Gutiérrez y Bobes, 2001;MacArthur et al, 2014). Existen estudios observacionales que demuestran la utilidad en relación a la capacidad de retención en tratamiento de los PMM, disminución del consumo de drogas ilegales, de las prácticas de riesgo, de la comorbilidad y morbi-mortalidad (VIH, hepatitis víricas) y criminalidad asociadas, así como la mejoría en el empleo y calidad de vida del adicto (Fernández-Miranda et al, 2001; Havinga, van der Velden, de Gee y van der Poel, 2014; Salamina et al, 2010).…”

Is the recent emergence of mephedrone injecting in the United Kingdom associated with elevated risk behaviours and blood borne virus infection?

“…Responses should first look at ways to improve injection practice and hygiene, as well as promoting awareness among PWID of the risks and harms that are associated with injecting mephedrone [9,18,19]. However, to date, the UKs response to the injection of psychoactive drugs has had a strong focus on the traditional predominant drug, heroin, with an emphasis on a combination of high coverage NSPs and easy to access OST, which have been shown to be effective for reducing infections [36]. Although stimulant injection is not a new phenomenon in the UK, this has predominantly been in the form of crack cocaine injection alongside heroin (both need to be dissolved in acidic solutions), whereas the injection of amphetamines has been comparatively rare but may have increased in recent years [31].…”

Hepatitis C Virus seroconversion among persons who inject drugs in relation to primary care physician visiting: The potential role of primary healthcare in a combined approach to Hepatitis C prevention

“…Broad access to needle exchange programs (NEP) is considered, by and large, a cornerstone measure to an effective HCV prevention response. Sterile syringe provision has been shown to play an important role in altering high-risk injection practices, thereby potentially reducing the risk of HCV infection (MacArthur, et al, 2014). Access to substance use treatment is also considered key in harm reduction.…”

“…Access to substance use treatment is also considered key in harm reduction. For opiate users, receipt of opiate substitution treatment (OST) has been demonstrated to have positive impacts on risky injection behaviours (MacArthur, et al, 2014) and more recently, on HCV seroconversion (Nolan, et al, 2014;Tsui, Evans, Lum, Hahn, & Page, 2014), though limited evidence exists in support of other addiction treatment interventions (e.g., outpatient drug-free programs) (Hagan, Pouget, & Des Jarlais, 2011). In parallel, timely HCV screening, counseling and testing constitute essential actions for prevention (Centers for Disease Control and Prevention, 2012), as they have the potential to impact HCV acquisition and transmission rates by reducing high-risk drug use practices Bruneau, et al, 2014).…”