The state of harm reduction in the Middle East and North Africa: A focus on Iran and Morocco

Himmich, Hakima; Madani, Navid

doi:10.1016/j.drugpo.2016.02.013

Cited by 39 publications

(23 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 Indeed, only three countries (ie, Djibouti, Iran, and Morocco) in the MENA have been reported to have a relatively stable and functioning HIV surveillance system. 4,8,9 Moreover, no country has managed to have more than three rounds of integrated bio-behavioral surveillance surveys (IBBS) among key populations. Egypt, Lebanon, and Tunisia are the only three countries to have conducted IBBS in all three key populations (ie, FSWs, MSM, PWID).…”

Section: Limited Hiv Data For Key Populations At Risk Of Hivmentioning

confidence: 99%

“…Moreover, needle and syringe programs (NSPs) have helped increase safe injection practices to 70% among PWID in Iran, Lebanon, Morocco, and Tunisia. 6,9,19,31,32 Interventions aimed at improving the sexual health of MSM have also shown promise where services take on a rights-based approach to HIV prevention and when civil society is enabled to provide support for the community. For example, 75% of MSM in Lebanon have reported consistent condom use and knowledge of their HIV status.…”

Section: Lessons Learned and Path Forwardmentioning

confidence: 99%

See 1 more Smart Citation

Improving the Quality and Quantity of HIV Data in the Middle East and North Africa: Key Challenges and Ways Forward

Karamouzian

Madani

Doroudi

et al. 2016

Int J Health Policy Manag

Self Cite

View full text Add to dashboard Cite

Although the HIV pandemic is witnessing a decline in the number of new infections in most regions of the world, the Middle East and North Africa (MENA) has a rapidly growing HIV problem. While generating HIV data has been consistently increasing since 2005, MENA’s contribution to the global HIV literature is just over 1% and the existing evidence often falls behind the academic standards. Several factors could be at play that contribute to the limited quantity and quality of HIV data in MENA. This editorial tries to explore and explain the barriers to collecting high-quality HIV data and generating precise estimates in MENA. These barriers include a number of logistic and socio-political challenges faced by researchers, public health officials, and policy-makers. Looking at successful regional HIV programs, we explore examples were policies have shifted and lessons could be learned in developing appropriate responses to HIV across the region.

show abstract

Section: Limited Hiv Data For Key Populations At Risk Of Hivmentioning

confidence: 99%

Section: Lessons Learned and Path Forwardmentioning

confidence: 99%

Improving the Quality and Quantity of HIV Data in the Middle East and North Africa: Key Challenges and Ways Forward

Karamouzian

Madani

Doroudi

et al. 2016

Int J Health Policy Manag

Self Cite

View full text Add to dashboard Cite

show abstract

“…Prospective follow-up is feasible, molecular phylogeny is obtainable and interpretable for understanding transmission dynamics and surveillance can guide improved policies. [21][22][23][24][25][26] History teaches time and time again that epidemics ignored are epidemics unleashed. A dearth of relevant data will simply misrepresent the true epidemic profile, misleading public health and clinical practitioners and policy-makers.…”

Section: Resultsmentioning

confidence: 99%

Ensuring HIV Data Availability, Transparency and Integrity in the MENA Region Comment on "Improving the Quality and Quantity of HIV Data in the Middle East and North Africa: Key Challenges and Ways Forward"

Modjarrad

Vermund

2017

Int J Health Policy Manag

View full text Add to dashboard Cite

In this commentary, we elaborate on the main points that Karamouzian and colleagues have made about HIV data scarcity in Middle Eastern and North African (MENA) countries. Without accessible and reliable data, no epidemic can be managed effectively or efficiently. Clearly, increased investments are needed to bolster capabilities to capture and interpret HIV surveillance data. We believe that this enhanced capacity can be achieved, in part, by leveraging and repurposing existing data platforms, technologies and patient cohorts. An immediate modest investment that capitalizes on available infrastructure can generate data on the HIV burden and spread that can be persuasive for MENA policy-makers to intensify efforts to track and contain the growing HIV epidemic in this region. A focus on key populations will yield the most valuable data, including among men who have sex with men (MSM), transgender women and men, persons who inject drugs (PWIDs), female partners of high risk men and female sex workers.

show abstract

“…name and address) is required in order to assure a proper record linkage and an active follow-up (37,38). This issue, strongly emphasized by women in our study, can be considered a structural barrier potentially resulting from the existing punitive laws and high levels of stigma and discrimination around injecting drug use in Iran (39). Although the recent shifts from hard-line drug laws in Iran have succeeded in approaching and engaging PWID in harm reduction services to a large extent (40) and therefore has made them more accessible for research, it appears that further efforts are required to close the trust gap between this marginalized population and the healthcare researchers.…”

Section: Logistics Needed For Cohort Studiesmentioning

confidence: 86%

Barriers and motivators to participation and retention in HIV/HCV cohort studies among people who inject drugs; A community consultation in Iran

Mirzazadeh

Hooshyar²,

Shahesmaeili

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The lack of robust estimates of HIV/HCV incidence among people who inject drugs (PWID) in Iran calls for well-designed prospective cohort studies. Successful recruitment and follow-up of PWID in cohort studies may require formative assessment of barriers PWID are faced with in participation and retention in cohort studies and factors they think may facilitate their engagement in such studies. Using a focus group discussion (FGD) format, we conducted a consultation with PWID in southeast Iran to recognize those barriers and motivators. Methods Using targeted sampling, we recruited PWID (aged≥18, injected in last 6 months) from community-based drop-in centers (DICs), homeless shelters, and through outreach efforts to participate in four FGDs (one women-only). Socio-demographic characteristics, injection behaviors and self-reported HCV/HIV testing and diagnosis history were obtained. Then, a semi-structured FGD guide was applied to explore barriers and motivators to participation and retention in cohort studies among study participants. All FGD sessions were recorded and transcribed verbatim, removing any identifying information. The content of FGDs were analyzed by thematic analysis using an inductive approach. Results In total, 30 individuals (10 women) participated in the study. The mean age of participants was 35.4 years (SD 7.6), with majority (73.3%) reporting injecting drug use within the last month. Only 40.0% reported ever being tested for HCV whereas a larger proportion (63.4%) reported ever being tested for HIV. While the majority were willing to participate in cohort studies, breach of confidentiality, fear of positive test results, perceived required commitment, and marginalization were reported as barriers to participation and retention in such studies. Monetary incentive, the thought of a better life, protection from police interventions and trust between health workers and PWID were addressed as motivators of engagement in cohort studies among PWID.Conclusions Strategies to enhance data security and reduce stigma associated with injecting drug use along with involving peer workers in research, providing pre and post-test counselling and education and addressing the needs of more marginalized groups potentially through integrated healthcare programs and housing support are among few approaches that may help address barriers and strengthen the motivators for successful cohort studies among this population.

show abstract

The state of harm reduction in the Middle East and North Africa: A focus on Iran and Morocco

Cited by 39 publications

References 13 publications

Improving the Quality and Quantity of HIV Data in the Middle East and North Africa: Key Challenges and Ways Forward

Improving the Quality and Quantity of HIV Data in the Middle East and North Africa: Key Challenges and Ways Forward

Ensuring HIV Data Availability, Transparency and Integrity in the MENA Region Comment on "Improving the Quality and Quantity of HIV Data in the Middle East and North Africa: Key Challenges and Ways Forward"

Barriers and motivators to participation and retention in HIV/HCV cohort studies among people who inject drugs; A community consultation in Iran

Contact Info

Product

Resources

About