Methadone within prison and linkage to and retention in treatment upon community release for people with opioid use disorder in Kyrgyzstan: Evaluation of a national program

Implementation opportunities for scaling up methadone maintenance treatment in Kyrgyzstan: Methadone dosage and retention on treatment over two years

“…Multivariable Cox regression incorporated time-to-event covariates such as methadone dosage (low, medium, high), previous experience of OAT, type of site, HIV status, and region. Since people released from prison are at increased risk of treatment discontinuation ( Bachireddy et al, 2022 ; Chandra et al, 2019 ), the estimates were controlled for the additional variable reflecting loss-to-follow-up after release. Hazard ratios were adjusted for the year of enrollment to minimize temporal change biases in treatment, political and secular trends.…”

Costs and impact on HIV transmission of a switch from a criminalisation to a public health approach to injecting drug use in eastern Europe and central Asia: a modelling analysis

“…The proportion of PWID that have injected for <1 year and have ever been incarcerated (11%, 8/74) from the 2016 IBBS among PWID (56) was used as an upper bound for the proportion of PWID that started injecting with a history of incarceration. There were two estimates for the median duration of prison sentence, 16 months (IQR 15-19 mths) from IBBS among prisoners 2016 (57) and 4.6 years (IQR 3.2-6.3 years) from Rick Altice's prison IBBS 2017-2020 (just to be released prisoners) (58). We used a range based on these different estimates from 16 months to 4.6 years.…”

“…Incarceration sub-model 3 A third sub-model was also used in Kyrgyzstan to calculate the proportion of prisoners who started injecting in prison (either on this incarceration or previously). We don't have data on the proportion of PWID that started injecting in prison, although we do know that 11% of PWID with injecting duration <1 year had been incarcerated before(56), and Rick Altice's prison survey in 2017 found that 37% (41/122) of prisoners had started injecting in prison (58). Therefore, we assumed that between 60% and 96% of PWID start as never incarcerated and fit to the proportion of prisoners that started injecting in prison as 37%.…”

“…. LTFU data for OAT came from these data sets (55) as well as a study on linkage to OAT on being incarcerated and released (58). A population size estimate for 2013 was also used with data on the number of PWID on OAT and ART to then derive coverage estimates for these interventions.…”

“…In terms of LTFU from OAT (community or in prison), data suggested the yearly LTFU (not including deaths and immigration) was 16.4% in 2017(55); we sampled between half and double this value. On release, Rick Altice's data suggests that 28% were linked to OAT in 30 days of release and 30% in 90 days(58), which we used directly as the linkage rate for OAT from prison to the community by sampling the linkage rate uniformly between 0.25 and 0.35. We assumed scale up of OAT occurred in 2006 and 2013, with the rate of recruitment on to OAT changing at those two time points to reflect the obvious increase in numbers on OAT in those years.…”