Rapid decline of HIV incidence among people who inject drugs during a fast-track combination prevention programme following an HIV outbreak in Athens

Abstract

Multiple evidence-based interventions delivered through rapid recruitment in a large proportion of the population of PWID are likely to have helped mitigate this HIV outbreak.

A hepatitis C outbreak preceded the HIV outbreak among persons who inject drugs in Athens, Greece: Insights from a mathematical modelling study

“…This could be attributed to public health response to control the HIV outbreak. More specifically, during a high‐coverage community‐based programme (ARISTOTLE), it was observed that injection frequency and sharing used syringes significantly declined in this population, resulting to a 78% decline in HIV incidence from August 2012 to December 2013 . As HCV and HIV share a common transmission route in this population, intervention to reduce HIV incidence affected indirectly also the incidence of HCV .…”

“…The second change that model showed (ie, the significant decrease in the NUI in 2013 compared to 2012) has also been highlighted from observational studies. Sypsa et al showed that HIV interventions launched in Athens in 2012 significantly reduced the HIV incidence and the rates of risky injection post‐2013. For example, a statistically significant reduction in the proportion of PWID reporting injecting drug use at least once per day, sharing syringes in the past 12 months or receipt of used syringes in the last month from ≥2 different persons has been observed …”

“…Soon after the recognition of the outbreak, significant public health interventions were implemented including increase in needle and syringe provision, expansion of the opioid substitution programmes and the implementation of a high‐coverage seek‐test‐and‐treat programme (ARISTOTLE). Those significant public health responses managed to significantly decrease the HIV incidence from 7.8/100 person‐years in 2012 to 1.7/100 person‐years in 2013 …”

FAST TRACK rehabilitation in patients after laparoscopic repair of hiatal hernia

“…Снижение осложнений от медицинского вмешательства достигается за счет отказа от инвазивных медицинских манипуляций, не имеющих, безусловно, показаний к применению у конкретного пациента [5][6][7]. Максимально применяются малоинвазивные хирургические технологии, имеются особенности в анестезиологическом обеспечении, послеоперационном обезболивании, что в целом снижает периоперационный стресс и улучшает репаративные функции организма [6][7][8].…”

“…В итоге подавляющее большинство авторов, применяющих принципы ускоренной реабилитации пациентов в своей повседневной работе, отмечают снижение количества осложнений, повышение качества лечения и уменьшение сроков пребывания пациентов в стационаре, что, в конечном результате, уменьшает накладные расходы медицинского учреждения и увеличивает доступность медицинской помощи [5][6][7][8][9].…”