Integrating HIV and substance misuse services: a person-centred approach grounded in human rights

Haldane, Victoria; Jung, Andrew; Foo, Chuan De; Shrestha, Pami; Urdaneta, Elena; Turk, Eva; Gaviria, Juan I; Boadas, Jesus; Buse, Kent; Miranda, J. Jaime; Strathdee, Steffanie; Barratt, Ashley; Kazatchkine, Michel D.; McKee, Martin; Legido‐Quigley, Helena

doi:10.1016/s2215-0366(22)00159-6

Cited by 6 publications

(6 citation statements)

References 92 publications

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“…The Health in All Policies and One Health approaches aimed to integrate health across other sectors and domains. 10 The WHO has published guidelines on integrating immunisation services 38,39 and integration is prioritised in the global Immunisation Agenda 2030. 40,41 There are numerous examples of attempts to integrate SSHAP contact -Olivia Tulloch oliviatulloch@anthrologica.com www.socialscienceinaction.org 13 various services within the health sector.…”

Section: Global Integration Efforts Beyond Covid-19mentioning

confidence: 99%

“…45 HIV-related care is a notable example where there have been innovative examples of combining HIV services with other needs of the target groups. As well as integration with ANC, substance misuse services, and mental health programmes, 10,46,47 there are also examples of integration with WASH services, parenting programmes, safe schools programmes, and cash transfers (see Table 5). [46][47][48][49] A review of literature on HIV integration found that conventional approaches failed to consider human rights and the structural factors that determine risk, vulnerability, health seeking, and health equity, and that integration approaches designed with service users at the centre had the potential to address this.…”

Section: Global Integration Efforts Beyond Covid-19mentioning

confidence: 99%

“…[46][47][48][49] A review of literature on HIV integration found that conventional approaches failed to consider human rights and the structural factors that determine risk, vulnerability, health seeking, and health equity, and that integration approaches designed with service users at the centre had the potential to address this. 10 Table 5 (next page) provides some examples of integration efforts, both within the health sector and across sectors, and lists their enablers, challenges, and outcomes where available.…”

Section: Global Integration Efforts Beyond Covid-19mentioning

confidence: 99%

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Key Considerations for Integrating COVID-19 Vaccination Services: Insights from Iraq and Syria for the MENA Region

Butler¹,

Karam²

2022

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With the COVID-19 pandemic well into its third year, governments and response partners are recognising that it no longer makes sense for COVID-19 services, including vaccination, to exist in isolation. There is growing recognition of the potential for integration with other services as the way forward for COVID-19 vaccination. This has recently begun to occur in various countries, but until now, there has been little evidence available as to the success of these initiatives. Service delivery integration occurs where “managerial or operational changes to health systems bring together inputs, delivery, management, and organisation of particular service functions in ways that are contextually appropriate and person-centred with the aim of improving coverage, access, quality, acceptability, effectiveness, and cost-effectiveness” (Haldane et al. 2022) This brief draws on evidence from academic and grey literature and consultations with partners working in the COVID-19 response to review current integration efforts (as of August 2022) and explore potentially effective ways to integrate COVID-19 vaccination into other services in the Middle East and North Africa (MENA) region. Recent guidance on integration from WHO has also been cross-referenced where relevant. Iraq is taken as a detailed case study due to the efforts already made there on integration of COVID-19 and routine immunisation (RI) services. Global integration experiences and a brief discussion of integration efforts in Syria are also included. The brief is part of the Social Science in Humanitarian Action Platform (SSHAP) series on social science considerations relating to COVID-19 vaccines and was written for SSHAP by Nadia Butler supported by Soha Karam (Anthrologica). Verbal consultations and reviews of the draft were provided from response partners in Iraq and other locations within the region (IFRC MENARO, Iraq MoH, UNICEF Iraq, UNICEF MENARO, UNICEF Syria, WHO EMRO). The brief was requested by the UNICEF Middle East and North Africa Regional Office (MENARO) and is the responsibility of SSHAP.

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Section: Global Integration Efforts Beyond Covid-19mentioning

confidence: 99%

Section: Global Integration Efforts Beyond Covid-19mentioning

confidence: 99%

Section: Global Integration Efforts Beyond Covid-19mentioning

confidence: 99%

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Key Considerations for Integrating COVID-19 Vaccination Services: Insights from Iraq and Syria for the MENA Region

Butler¹,

Karam²

2022

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“…Opioid use disorder is associated with physiological, behavioural, and social consequences such as premature mortality, criminality, violence, and suicide [ 1 , 2 ]. Additionally, injecting drug use is associated with an increased occurrence of drug overdose, risk of HIV and Hepatitis C infections and a key driver of the HIV epidemic [ 1 , 3 – 5 ]. Further, people who inject drugs (PWID) experience stigma and social exclusion that hinder them from accessing social services and healthcare [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Further, people who inject drugs (PWID) experience stigma and social exclusion that hinder them from accessing social services and healthcare [ 6 , 7 ]. The use of opioid agonists such as methadone and buprenorphine as a long-term maintenance treatment is effective in reducing drug use and its HIV-related risk among people who inject drugs (PWIDs) [ 3 , 8 – 10 ]. Medication for Opioid use disorder (MOUD) is recommended by the World Health Organization (WHO), the United Nations Office of Drug Control (UNODC), and the Joint United Nations Programme on HIV/AIDS (UNAIDS) as an essential harm-reduction intervention for PWID [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Retention of people who inject drugs enrolled in a ‘medications for opioid use disorder’ (MOUD) programme in Uganda

Mudiope,

Mutamba,

Komuhangi

et al. 2024

Addict Sci Clin Pract

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Background Injection Drug use is associated with increased HIV risk behaviour that may result in the transmission of HIV and poor access to HIV prevention and treatment. In 2020, Uganda introduced the ‘medication for opioid use disorder (MOUD) treatment’ for People who inject drugs (PWID). We analysed the 12-month retention and associated factors among PWID enrolled on MOUD treatment in Kampala, Uganda. Methods We conducted a retrospective analysis of 343 PWID with OUD who completed 14 days of methadone induction from September 2020 to July 2022. Retention was defined as the number of individuals still in the programme divided by the total number enrolled, computed at 3-, 6-, 9-, and 12 months using lifetable and Kaplan-Meier survival analyses. Cox proportional regression analyses were conducted to assess factors associated with retention in the programme in the first 12 months. Results Overall, 243 (71%) of 343 participants stabilized at a methadone dose of 60 mg or more. The majority of participants were males (n = 284, 82.8%), and the median (interquartile range, IQR) age was 31 (26–38) years. Most participants (n = 276, 80.5%) lived 5 km or more away from the MOUD clinic. Thirty (8.8%) were HIV-positive, 52 (15.7%) had a major mental illness and 96 (27.9%) had a history of taking alcohol three months before enrollment. The cumulative retention significantly declined from 83.4% (95%CI = 79.0–87.0) at 3months to 71.9% (95%CI = 67.2–76.6) at 6months, 64% 95%CI = 58.7–68.9) at 9months, and 55.2%; 95% CI (49.8–60.3% at 12months. The 12-month retention was significantly higher for participants on methadone doses of 60 mg or more (adj.HR = 2.1, 95%CI = 1.41–3.22), while participants resident within 5 km of the MOUD clinic were 4.9 times more likely to be retained at 12 months, compared to those residing 5 km or more, (adj. HR = 4.81, 95%CI = 1.54-15). Other factors, including predisposing, need, and enabling factors, were not associated with retention. Conclusion Our study demonstrates acceptable 12-month retention rates for people who inject drugs, comparable to previous studies done in both developing and developed countries. Sustaining and improving retention may require enhanced scaling up of MOUD dose to an optimal level in the first 14 days and reducing the distance between participant locale and MOUD clinics.

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Depression mediates the relationship between exposure to stigma and medication adherence among people living with HIV in low-resource setting: a structural equation modeling approach

Sulaiman,

Musa,

Tsiga-Ahmed

et al. 2024

J Behav Med

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Integrating HIV and substance misuse services: a person-centred approach grounded in human rights

Cited by 6 publications

References 92 publications

Key Considerations for Integrating COVID-19 Vaccination Services: Insights from Iraq and Syria for the MENA Region

Key Considerations for Integrating COVID-19 Vaccination Services: Insights from Iraq and Syria for the MENA Region

Retention of people who inject drugs enrolled in a ‘medications for opioid use disorder’ (MOUD) programme in Uganda

Depression mediates the relationship between exposure to stigma and medication adherence among people living with HIV in low-resource setting: a structural equation modeling approach

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