Key harm reduction interventions and their impact on the reduction of risky behavior and HIV incidence among people who inject drugs in low-income and middle-income countries.

摘要: PURPOSE OF REVIEW: HIV infection rates continue to rise among people who inject drugs (PWID) in many lower- and middle-income countries (LMICs). Although progress is being made prevention care for PWID some settings coverage of essential services remains low. This article reviews the evidence benefits scaling up key interventions as a combination treatment package PWID. RECENT FINDINGS: WHO defined comprehensive nine which following four have effectiveness reducing incidence: needle syringe programs (NSP) medication-assisted therapy (MAT) antiretroviral (ART) counseling testing (HCT). Coverage these LMICs varies from low ( 20-60%). At least 60% likely be required reduce incidence. Evidence LMIC contexts suggests that NSP MAT can high-risk injecting behavior HCT risky sexual ART plausibly preventive benefit onward parenteral transmission with clearer (ARV) prevent transmission. Modeling analysis compared current scale-up would beneficial cost-effective approach. SUMMARY: The continuation significant incidence avoidable implementation immediate harm reduction ARV interventions. Policymakers should address structural resource allocation barriers allow this occur.