Continued high prevalence of HIV, HBV and HCV among injecting and noninjecting drug users in Italy

Abstract

We estimated the prevalence of HIV, HBV and HCV infections among injecting and noninjecting drug users treated within public drug-treatment centres in Italy to determine the correlates of infection. In the sample of 1330 drug users, the prevalence of HIV was 14.4% among drug injectors and 1.6% among non-injectors; the prevalence of HBV was 70.4% among injecting drug users and 22.8% among non-injectors and of HCV was 83.2% among injecting drug users and 22.0% among non-injectors. Old age, unemployment, and intravenous drug use were significantly correlated with each of the infections, as well as a longer history of injecting drug use. The results indicate that these infections continue to circulate among drug users, highlighting the need for monitoring of this group in Italy.

HIV Epidemics in the European Region: Vulnerability and Response

“…Broader structural interventions to reduce violence among women as a whole are needed as well as targeted interventions for SWs. Policies are needed that address the social welfare of SWs and social determinants of health such as disparities in employment opportunities, wage, access to welfare, and domestic violence [87][88][89]. The inclusion of these kinds of structural interventions often have an indirect benefit of reducing harms among peripheral members of key population groups who may not identify themselves as SWs.…”

“…As with PWID (see above), recruiting SWs at their places of work and in the community overcomes potential bias linked to recruiting those in contact with STI clinics and helping services. Especially vulnerable SWs, such as migrant SWs, for instance, are less likely to be in contact with clinics [87][88][89]. An HIV-related behavioral survey of SWs was identified in three-fifths (30) of the countries: two-fifths (8) in the Western subregion, three-fifths (9) These surveillance data have influenced policy and responses, and have reflected their impacts.…”

“…Studies outside Europe have also reported stimulant use as a correlate for HIV risk and seroconversion [85,88,89], though there are exceptions, and in Estonia, amphetamine users were less likely to have ever shared a needle than fentanyl users (24% as opposed to 34%) [21]. Source: PWID publications as per tables C.4-C.6.…”

“…As noted in "Methods" section a crude index of enabling policy environment for HIV prevention among PWID may include, but is not restricted to, the following domains: (a) the meaningful engagement of key stakeholders (including PWID) in policy formation and programming; (b) a coordinated multisectoral national HIVprevention strategy emphasizing an evidence-based public health and rightsoriented approach; (c) the generation of research and surveillance on HIV epidemic spread and response; and (d) the development and scale-up of a package of evidence-based interventions, including the removal of structural obstacles limiting their implementation [2,85]. Accordingly, there have been increasing calls to de-emphasize the criminalization of PWID by developing public policies emphasizing public health above law enforcement dominated approaches, and for the rapid scaling-up of HIV prevention along with community action and social support interventions [2,[85][86][87][88].…”

“…Proposals for HIV related surveillance studies need to be conducted with full consultation with affected populations and with appropriate rights protections in place [86]. There are some useful lessons in good surveillance practice in Europe, including, for instance, the European Men Who Have Sex with Men Internet Survey, the sentinel surveillance of HIV and risk among PWID in Italy, Spain, and the United Kingdom; and sentinel surveillance among SWs in Central Asia [50,[87][88][89][90].…”