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ID: HR23-63
Presenting author: Samantha Colledge-Frisby

Presenting author biography:

Dr Samantha Colledge-Frisby is a Research Fellow at the National Drug Research Institute, an honorary Research Fellow at the Burnet Institute and National Drug and Alcohol Research Centre. She completed her PhD in early 2022 and her work focuses on injecting-related infections, overdose, and other harms impacting people who inject.

The global coverage of interventions to prevent and manage drug-related harms among people who inject drugs: a systematic review of the evidence

Samantha Colledge-Frisby, Sophie Ottaviano, Paige Webb, Jason Grebely, Alice Wheeler, Evan Cunningham, Behzad Hajarizadeh, Janni Leung, Amy Peacock, Peter Vickerman, Michael Farrell, Greg Dore, Matthew Hickman, Louisa Degenhardt
Background Harm reduction and treatment programs are essential for reducing harms experienced by people who inject drugs (PWID). In a previous global review, we estimated that there were approximately 33 needles distributed per PWID annually, and 16 opioid agonist treatment recipients per 100 PWID. We aimed to update these estimates and include availability of other harm reduction services that target PWID (take-home naloxone [THN] programs, supervised consumption facilities, and drug checking services).

Methods We searched the peer-reviewed and grey literature for programmatic data on the availability of services. National estimates of coverage of OAT (i.e., number of people accessing OAT per 100 PWID) and NSP (i.e., number of needle-syringes distributed per PWID per year) were generated where available using the most recent data. Regional and global estimates were derived and compared to the World Health Organization indicators of low-, medium-, and high-coverage.

Results We included 195 studies and identified 89 countries implementing OAT and 91 countries implementing NSP. Only five countries, with 2% of the PWID population, are providing high coverage of both services. Far fewer countries were found to be implementing THN programs, supervised consumption facilities, and drug checking services, with only nine countries implementing all five services. Globally, we estimated that 18 (95% uncertainty intervals [UI]=12-27) people accessed OAT per 100 PWID, and 35 (UI=24-52) needle-syringes were distributed per person who injects drugs annually. More countries reported high (OAT 24; NSP 10), moderate (OAT 8; NSP 15), and low (OAT 37; NSP 46) coverage of services compared to the previous review.

Conclusion Global coverage of OAT and NSP has increased modestly in the five years since the previous review but remains low for majority of PWID in majority of countries.