Author/Authors :
Noroozi Alireza نويسنده , Noroozi Mehdi نويسنده Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran , Mirzazadeh Ali نويسنده Department of Epidemiology and Biostatistics, Health Faculty, Tehran University of Medical Sciences, Tehran , Soori Hamid نويسنده School of Public Health, Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences , Hajebi Ahmad نويسنده Tehran Institute of Psychiatry-Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran , Sharifi Hamid نويسنده , Mehrabi Yadoallah نويسنده Department of Epidemiology, Safety Promotion and Injury
Prevention Research Center, Shahid Beheshti University of Medical
Sciences, IR Iran , Hashemi Sayed Saeed نويسنده Department of Epidemiology, Safety Promotion and Injury
Prevention Research Center, Shahid Beheshti University of Medical
Sciences, IR Iran , Ghoddousi Seyed Ebrahim نويسنده Mental Health, Social Health and Addiction Department
(MeHSHAD), Substance Abuse Prevention and Treatment Office (SAPTO),
Ministry of Health and Medical Education, Tehran, IR
Iran , Etemad Korosh نويسنده Department of Epidemiology, Safety Promotion and Injury
Prevention Research Center, Shahid Beheshti University of Medical
Sciences, IR Iran
Abstract :
Background The sharing of syringes by people who inject drugs
(PWID) is an important factor for the transmission of HIV. Needle and
syringe programs (NSP) are widely used to reduce any harm associated
with drug injection, however since the impact of these programs have not
been systematically studied our objective is to model the impact of NSPs
on HIV incidences for PWID in Kermanshah, Iran. Objectives The aim of
this study was to determine the effectiveness of NSP coverage in
prevention of HIV incidence among PWIDs. Patients and Methods We used
Wilson et al.’s mathematical model to predict the occurrence of HIV
amongst PWID with sufficient and insufficient client-level coverage of
NSPs. We parameterized and calibrated the model using behavioral and
epidemiological data collected in an empirical study of 470 active PWID
and recruited them through two Drop-In Centers (DIC) in Kermanshah, Iran
from April to September, 2014. Other parameters such as risk of HIV
transmission through injection with a shared injection, and
effectiveness of syringe cleaning were obtained from the literature. We
applied Monte Carlo simulation (10,000 runs) to capture the uncertainty
(simulation interval – SI) in the model’s output. Results Given the
output of the model, we found that among the PWID with sufficient
coverage of NSPs the HIV rate is 1.02%, while those with insufficient
coverage is increased to 4.04% (risk different = 3%, SI 95% 2.7 - 3.4%).
By reducing the percentage of sharing from 18% (in patients with
insufficient NSPs coverage) to 10%, the HIV incidence will be Dropped to
0.9% (SI 95%, 0.4 - 1.3%). Conclusions We found a large impact due to
NSPs for reducing the occurance of HIV among active drug injectors who
have been provided sufficient needles and syringes. The coverage of NSPs
needs to be increased to observe such significant impact.
