Sebastian, M.P., Dasgupta, A., Saraswati, L.R., et al. Harm Reduction Journal (June 2017), 14:38, doi:10.1186/s12954-017-0165-y.
This article described service uptake during a study of 3,774 people who inject drugs (PWID), and the costs associated with a comprehensive package of HIV prevention, care, and treatment services. The comprehensive package, implemented between 2011 and 2014 in Delhi, India, included HIV and hepatitis B and C virus (HBV, HCV) counseling and testing, treatment of sexually transmitted infections, clean needles and syringes, condoms, wound care, bathing facilities, and education. Referrals for HIV and TB treatment, opioid substitution therapy, and substance rehabilitation also were provided. The program provided 7,334 HIV tests. Nutrition services were provided for 3,494 participants and wound care to 1,219; however, only 692 continued care until wound healing was complete. Of 2,331 PWID receiving HBV testing, 1,875 returned for their result. HBV vaccination was provided to 1,706 PWID, but only 492 completed all three doses. The needle/syringe exchange and condom distribution services were provided to 2,508 and 2,392 participants, respectively. Education and awareness activities reached 2,840 PWID. At the study's end, 82 PWID were on antiretroviral treatment. Over the three-year implementation period, costs were USD$1,067,629.88. HIV prevention and care services accounted for around 50 percent of the cost. The authors concluded that providing comprehensive services for PWID is challenging, and requires significant efforts to address uptake and retention of services.