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ID: HR23-8
Presenting author: Shatyam Issur

Presenting author biography:

A human rights advocate whose career focuses on harm reduction, social & mental well-being, and HIV prevention & treatment for priority populations (People who use/inject drugs, sex workers, LGBTQIA+ community, and people living with HIV) in Mauritius.

A holistic approach to harm reduction services - From prevention, HIV, HCV and STIs testing to the retainment in the continuum of care.

Shatyam Issur
Background: In Mauritius, out of the estimated 14,000 people living with HIV in 2020, only 67% have been tested and knew their status. Out of the 67%, only 25% was on antiretroviral treatment (ART), among which 17% were undetectable. Among people who inject drugs (PWIDs), the prevalence rate for HIV was at 21%, 89% for HCV and 10% of syphilis, with only 37% of PWIDs (N=6600) registered on the needle syringe program (NSP), and few on the methadone substitution therapy (MST). Through funding from ViiV Healthcare, the program’s overall objective is to link and retain PWIDs to the NSP, MST and/or HIV treatment without structural barriers.

Description: Combing the NSP with referral and accompaniment to the MST and ART, the project starts with a ‘backpack’ strategy where peer educators walk around two selected regions with a backpack and discreetly provide NSP Materials to PWIDs. During interventions, PWIDs are identified for the MST, testing, treatment, and care and are referred to a partner organization for immediate psychological support and accompaniment to care.

Lessons: Over an implementation period of 12 months, 1356 PWIDs were reached with the NSP. 22066 Syringes and needles, 723 Condoms, 6975 alcohol swabs and 88 gels were distributed. 606 persons tested for HIV, HCV, and Syphilis testing which 182 were tested for the first time. 22 HIV, 227 HCV and 51 syphilis positive cases were detected. Among the 606 PWIDs tested, 515 were referred for MST and 353 for HIV care and 111 for HCV care. The discretion of the NSP strategy and the immediate accompaniment to care were cited as primary reasons for PWIDs' engagement.

Conclusions: Through this approach, more PWIDs are being accompanied to MST and retained in the continuum of care. As such, such concept can only move Mauritius closer to the “95-95-95” UNAIDS target.