Modeling the impact of a supervised consumption site on HIV and HCV transmission among people who inject drugs in three counties in California, USA

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2024-08-29 DOI:10.1016/j.drugpo.2024.104557

J.A. Killion , O.S. Jegede , D. Werb , P.J. Davidson , L.R. Smith , T. Gaines , J. Graff Zivin , M.L. Zúñiga , H.A. Pines , R.S. Garfein , S.A. Strathdee , C. Rivera Saldana , N.K. Martin

{"title":"Modeling the impact of a supervised consumption site on HIV and HCV transmission among people who inject drugs in three counties in California, USA","authors":"J.A. Killion , O.S. Jegede , D. Werb , P.J. Davidson , L.R. Smith , T. Gaines , J. Graff Zivin , M.L. Zúñiga , H.A. Pines , R.S. Garfein , S.A. Strathdee , C. Rivera Saldana , N.K. Martin","doi":"10.1016/j.drugpo.2024.104557","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Supervised consumption sites (SCS) have been shown to reduce receptive syringe sharing among people who inject drugs (PWID) in the United States and elsewhere, which can prevent HIV and hepatitis C virus (HCV) transmission. PWID are at risk of disease transmission and may benefit from SCS, however legislation has yet to support their implementation. This study aims to determine the potential impact of SCS implementation on HIV and HCV incidence among PWID in three California counties.</p></div><div><h3>Methods</h3><p>A dynamic HIV and HCV joint transmission model among PWID (sexual and injecting transmission of HIV, injecting transmission of HCV) was calibrated to epidemiological data for three counties: San Francisco, Los Angeles, and San Diego. The model incorporated HIV and HCV disease stages and HIV and HCV treatment. Based on United States data, we assumed access to SCS reduced receptive syringe sharing by a relative risk of 0.17 (95 % CI: 0.04–1.03). This model examined scaling-up SCS coverage from 0 % to 20 % of the PWID population within the respective counties and assessed its impact on HIV and HCV incidence rates after 10 years.</p></div><div><h3>Results</h3><p>By increasing SCS from 0 % to 20 % coverage among PWID, 21.8 % (95 % CI: −1.2–32.9 %) of new HIV infections and 28.3 % (95 % CI: −2.0–34.5 %) of new HCV infections among PWID in San Francisco County, 17.7 % (95 % CI: −1.0–30.8 %) of new HIV infections and 29.8 % (95 % CI: −2.1–36.1 %) of new HCV infections in Los Angeles County, and 32.1 % (95 % CI: −2.8–41.5 %) of new HIV infections and 24.3 % (95 % CI: −1.6–29.0 %) of new HCV infections in San Diego County could be prevented over ten years.</p></div><div><h3>Conclusion</h3><p>Our models suggest that SCS is an important intervention to enable HCV elimination and could help end the HIV epidemic among PWID in California. It could also have additional benefits such facilitating pathways into drug treatment programs and preventing fatal overdose.</p></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"132 ","pages":"Article 104557"},"PeriodicalIF":4.4000,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S095539592400241X/pdfft?md5=bbc6661d69dc245629a6f9646bd14b33&pid=1-s2.0-S095539592400241X-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Drug Policy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S095539592400241X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SUBSTANCE ABUSE","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Supervised consumption sites (SCS) have been shown to reduce receptive syringe sharing among people who inject drugs (PWID) in the United States and elsewhere, which can prevent HIV and hepatitis C virus (HCV) transmission. PWID are at risk of disease transmission and may benefit from SCS, however legislation has yet to support their implementation. This study aims to determine the potential impact of SCS implementation on HIV and HCV incidence among PWID in three California counties.

Methods

A dynamic HIV and HCV joint transmission model among PWID (sexual and injecting transmission of HIV, injecting transmission of HCV) was calibrated to epidemiological data for three counties: San Francisco, Los Angeles, and San Diego. The model incorporated HIV and HCV disease stages and HIV and HCV treatment. Based on United States data, we assumed access to SCS reduced receptive syringe sharing by a relative risk of 0.17 (95 % CI: 0.04–1.03). This model examined scaling-up SCS coverage from 0 % to 20 % of the PWID population within the respective counties and assessed its impact on HIV and HCV incidence rates after 10 years.

Results

By increasing SCS from 0 % to 20 % coverage among PWID, 21.8 % (95 % CI: −1.2–32.9 %) of new HIV infections and 28.3 % (95 % CI: −2.0–34.5 %) of new HCV infections among PWID in San Francisco County, 17.7 % (95 % CI: −1.0–30.8 %) of new HIV infections and 29.8 % (95 % CI: −2.1–36.1 %) of new HCV infections in Los Angeles County, and 32.1 % (95 % CI: −2.8–41.5 %) of new HIV infections and 24.3 % (95 % CI: −1.6–29.0 %) of new HCV infections in San Diego County could be prevented over ten years.

Conclusion

Our models suggest that SCS is an important intervention to enable HCV elimination and could help end the HIV epidemic among PWID in California. It could also have additional benefits such facilitating pathways into drug treatment programs and preventing fatal overdose.

查看原文本刊更多论文

模拟监督消费场所对美国加利福尼亚州三个县注射毒品人群中艾滋病毒和丙肝病毒传播的影响

背景在美国和其他地方，监督消费场所（SCS）已被证明可以减少注射吸毒者（PWID）之间共用注射器的现象，从而预防艾滋病毒和丙型肝炎病毒（HCV）的传播。注射吸毒者面临着疾病传播的风险，可能会受益于 "注射器分离系统"，但立法尚未支持其实施。本研究旨在确定在加利福尼亚州三个县的吸毒者中实施 "性伴侣策略 "对 HIV 和 HCV 感染率的潜在影响。方法根据三个县的流行病学数据校准了吸毒者中 HIV 和 HCV 联合传播动态模型（HIV 的性传播和注射传播、HCV 的注射传播）：旧金山、洛杉矶和圣地亚哥。该模型包含 HIV 和 HCV 疾病分期以及 HIV 和 HCV 治疗。根据美国的数据，我们假定使用 SCS 可将接受性共用注射器的相对风险降低 0.17（95 % CI：0.04-1.03）。该模型研究了在各县的吸毒者中将 SCS 的覆盖率从 0% 提高到 20%，并评估了 10 年后其对 HIV 和 HCV 感染率的影响。结果通过将 SCS 在吸毒者中的覆盖率从 0% 提高到 20%，旧金山县的吸毒者中新增 HIV 感染率为 21.8%（95% CI：-1.2-32.9%），新增 HCV 感染率为 28.3%（95% CI：-2.0-34.5%），旧金山县的吸毒者中新增 HIV 感染率为 17.7%（95% CI：-1.0-30.8%），新增 HCV 感染率为 28.3%（95% CI：-2.0-34.5%），旧金山县的吸毒者中新增 HCV 感染率为 17.7%（95% CI：-1.0-30.8%）。结论我们的模型表明，SCS 是消除丙型肝炎病毒的一项重要干预措施，有助于结束艾滋病毒在加利福尼亚州吸毒者中的流行。它还能带来更多益处，如促进进入戒毒治疗计划的途径和预防致命的用药过量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.