Opioid agonist therapy and needle and syringe programs are effective in reducing the transmission of HIV, HCV, and injecting risk behavior, according to a recent review.
The prevalence of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is associated with injecting risk behavior in people who inject drugs (PWID). This systematic review updated an existing review with recent evidence pertaining to the effectiveness of interventions, including opioid agonist therapy (OAT) and needle and syringe programs (NSPs), in preventing the transmission of HIV and HCV among PWID. A total of 13 reviews and 61 studies were considered eligible for the current study. The findings are published in the International Journal on Drug Policy.
Opioid Agonist Therapy Is Effective in Preventing HCV Infection
There is sufficient evidence to support the role of OAT in preventing primary HCV infection and HCV reinfection and in reducing injecting risk behavior and injection frequency. However, there is not enough evidence regarding the role of OAT in preventing the transmission of HCV in criminal justice settings.
Heroin-Assisted Treatment and Pharmacological Treatment for Stimulant Dependence
The reviews included in this study did not provide evidence regarding the role of heroin-assisted or pharmacological treatment in stimulant dependence in preventing injecting risk behavior, injection frequency, HIV, or HCV transmission.
Strong Evidence Supports Psychosocial Interventions to Reduce Injection Frequency
There is insufficient evidence to conclude the role of psychosocial interventions in preventing the transmission of HIV and HCV. However, adequate evidence supports the role of psychosocial interventions in reducing injection frequency and injecting risk behavior. There is no or insufficient evidence for the efficacy of these interventions in contingency management and prison settings.
Reduced Injection Frequency With Psychosocial Interventions
The updated evidence is tentative regarding the effectiveness of NSPs for HCV transmission; however, the evidence regarding the role of NSPs in preventing HIV transmission is sufficient. There is no or insufficient evidence underlying the role of NSPs in reducing injecting risk behavior and preventing HIV and HCV transmission in criminal justice settings. A reduction in injecting risk behavior is supported by sufficient evidence in the context of pharmacy settings. Sterile drug preparation equipment has sufficient evidence to support its effect on injecting risk behavior.
Combined OAT and NSP Approach for Preventing HCV Transmission
The combined administration of OAT and NSPs is supported by sufficient evidence related to its role in preventing HCV transmission; however, the evidence is insufficient and tentative in the case of HIV transmission and injecting risk behavior, respectively.
Source:
Palmateer, N., Hamill, V., Bergenström, A., Bloomfield, H., Gordon, L., Stone, J., Fraser, H., Seyler, T., Duan, Y., Tran, R., Trayner, K. M. A., Biggam, C., Smith, S., Vickerman, P., Hickman, M., & Hutchinson, S. (2022). Interventions to prevent HIV and Hepatitis C among people who inject drugs: Latest evidence of effectiveness from a systematic review (2011 to 2020). International Journal of Drug Policy, 109, 103872. https://doi.org/10.1016/j.drugpo.2022.103872
