DOI: https://doi.org/10.22263/2312-4156.2021.3.63
Shylava M.A.1, Abramovich A.V.2
Epidemiological characteristics of HIV-infected drug users at the stage of becoming a member of the opioid substitution therapy program in the city of Minsk
1Belarusian State Medical University, Minsk, Republic of Belarus
2City Clinical Narcological Dispensary, Minsk, Republic of Belarus
Vestnik VGMU. 2021;20(3):63-70.
Abstract.
Objectives. To identify the medico-social and epidemiological peculiarities of HIV-infected people injecting drugs (PWID) at the stage of joining the opioid substitution therapy (OST) program, who adopted it in 2019 in the city of Minsk.
Material and methods. The data of the primary accounting documentation of the Health Care Institution «City Clinical Narcological Dispensary» and the Health Care Institution «City Clinical Infectious Diseases Hospital» of PWID HIV-infected patients were analyzed on joining the opioid substitution therapy program who adopted it in 2019 in the city of Minsk (n=91).
Results. It has been found that the largest proportion of the OST program participants constituted males (73.63%) aged 36 years and older (73.62%); 64.84% of them were convicted more than 3 times, 83.52% were not officially married, 64.84% were officially unemployed. The median experience of using opioid drugs made up 21 (19-24) years. Almost ½ (46.15%) of HIV-infected drug users were members of OST program for 3 (1-5) years in 2019.
Most of the OST program participants (83.52%) had up to 3 periods without drug use, while in 54.95% of them these breaks were due to serving a sentence, and in 21.98% because of undergoing rehabilitation.
Lifestyle changes and socialization in society were authentically the most significant reasons and motives for the participation of PWID HIV-infected persons in the OST program in Minsk (p<0.05).
The analysis of the comorbidity rate showed that all the participants in the studied group were infected with viral hepatitis C, 6.59% – with hepatitis B against the background of hepatitis C virus (HCV), and 1.01% – with hepatitis D.
Conclusions. The revealed medical, social and epidemiological features of HIV-infected PWID persons at the stage of joining the opioid substitution therapy program will make it possible to increase the efficiency of providing medical care to opioid drug users with HIV infection and parenteral viral hepatites and extend the coverage of the studied contingent by this program.
Key words: methadone maintenance treatment, HIV, PWID, IDUs, drug users, HCV, HBV, HDV.
References
1. World drug report 2019: summary, conclusions, and policy implications. Available from: https://wdr.unodc.org/wdr2019/prelaunch/WDR2019_B1_R.pdf. [Accessed 08th Jun 2021]. (In Russ.)
2. Zhuang X, Liang Y, Chow EPF, Wang Y, Wilson DP, Zhang L. HIV and HCV prevalence among entrants to methadone maintenance treatment clinics in China: a systematic review and meta-analysis. BMC Infect Dis. 2012 Jun;12:130. doi: http://dx.doi.org/10.1186/1471-2334-12-130
3. Health, Rights and Drugs: Harm Reduction, Decriminalization and Zero Discrimination for People Who Use Drugs. Available from: https://www.unaids.org/sites/default/files/media_asset/JC2954_UNAIDS_drugs_report_2019_ru.pdf. [Accessed 08th Jun 2021]. (In Russ.)
4. World Health Organization, United Nations Office on Drugs and Crime, UNAIDS. Substitution maintenance therapy in the management of opioid dependence and HIV/AIDS prevention: WHO/UNODC/UNAIDS position paper. Geneva, Switzerland; 2004. 36 p.
5. Karki P, Shrestha R, Huedo-Medina TB, Copenhaver M. The Impact of Methadone Maintenance Treatment on HIV Risk Behaviors among High-Risk Injection Drug Users: A Systematic Review. Evid Based Med Public Health. 2016;2:e1229.
6. Pikirenia VI, Kopytov AV. Factors affecting the effectiveness of methadone substitution therapy. Med Zhurn. 2018;(1):30-4. (In Russ.)
7. Aye NS, Oo MM, Harries AD, Mon MM, Hone S, Oo HN, et al. HIV, HBV and HCV in people who inject drugs and are placed on methadone maintenance therapy. Public Health Action. 2018 Dec;8(4):202-210. doi: http://dx.doi.org/10.5588/pha.18.0050
8. Vlahov D, Robertson AM, Strathdee SA. Prevention of HIV Infection among Injection Drug Users in Resource-Limited Settings. Clin Infect Dis. 2010 May;50(Suppl 3):S114-21. doi: http://dx.doi.org/10.1086/651482
9. On the Use of Substitution Therapy in Opioid Dependent Individuals: prikaz M-va zdravookhraneniia Resp Belarus', 16 noiab 2010 g, № 1233. OOO «Professional'nye pravovye sistemy». Biznes-Info [Elektronnyi resurs]. Minsk, RB; 2021. (In Russ.)
10. About the clinical protocol of medical care for patients with mental and behavioral disorders: prikaz M-va zdravookhraneniia Resp Belarus', 31 dek 2010 g, № 1387. Ministerstvo zdravookhraneniia Respubliki Belarus': [sait]. Available from: http://minzdrav.gov.by/ru/dlya-spetsialistov/standarty-obsledovaniya-i-lecheniya/2010-god.php. [Accessed 08th Jun 2021]. (In Russ.)
11. Zapata MA, Giraldo LF. Methadone Substitution Therapy for Heroin Addiction: A Treatment Program Assessment in Colombia. Adicciones. 2012;24(1):69-75.
12. Moran L, Keenan E, Elmusharaf K. Barriers to progressing through a methadone maintenance treatment programme: perspectives of the clients in the Mid-West of Ireland’s drug and alcohol services. BMC Health Serv Res. 2018 Nov;18(1):911. doi: http://dx.doi.org/10.1186/s12913-018-3717-2
13. Clinical Protocol "Diagnosis and Treatment of Patients with HIV Infection: postanovlenie M-va zdravookhraneniia Resp Belarus', 01 iiunia 2017 g, № 41. Available from: http://minzdrav.gov.by/upload/dadvfiles/001077_878477_41_vich.pdf. [Accessed 08th Jun 2021]. (In Russ.)
14. On approval of sanitary norms and rules "Requirements for organization and carrying out sanitary and anti-epidemic measures aimed at preventing the emergence and spread of viral hepatitis" and invalidation of Decree of the Ministry of Health of the Republic of Belarus of November 14, 2011 № 112: postanovlenie M-va zdravookhraneniia Resp Belarus', 06 fevr 2013 g, № 11. ByMed: [sait]. Available from: https://bymed.top/docs/by-regulatory/%D0%BF%D1%80%D0%BE%D1%84%D0%B8%D0%BB%D0%B0%D0%BA%D1%82%D0%B8%D0%BA%D0%B0-%D0%B2%D0%B8%D1%80%D1%83%D1%81%D0%BD%D1%8B%D1%85-%D0%B3%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82%D0%BE%D0%B2-11-1015. [Accessed 08th Jun 2021]. (In Russ.)
15. About preventive vaccinations: postanovlenie M-va zdravookhraneniia Resp Belarus', 17 maia 2018 g, № 42. Ministerstvo zdravookhraneniia Respubliki Belarus': [sait]. Available from: http://minzdrav.gov.by/ru/dlya-belorusskikh-grazhdan/vaktsinatsiya/natsionalnyy-kalendar-privivok.php. [Accessed 08th Jun 2021]. (In Russ.)
Information about authors:
Shylava M.A. – senior lecturer of the Chair of Epidemiology, Belarusian State Medical University,
ORCID: https://orcid.org/0000-0002-2365-2138
Abramovich A.V. – psychiatrist-narcologist, City Clinical Narcological Dispensary.
Correspondence address: Republic of Belarus, 220116, Minsk, 83 Dzerzhinskogo ave., Belarusian State Medical University, Chair of Epidemiology. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Marharyta A. Shylava.
