The Effect of Harm-reducing Programs in Drop-in Centers on the Frequency of High-Risk Behaviors Among Injecting Drug Users in Hamadan

Abstract

Background: It is necessary to study high-risk behaviors among intravenous drug users, as well as the effectiveness of the syringe-needle program to help health officials adopt appropriate health policies in order to promote public health services. Therefore, it is necessary to gather and present up-to-date evidence on the effectiveness of these interventions. Methods: The study aimed to evaluate a harm-reducing program using a self-report tool before and after implementing an interventional program, consisting of training on low-risk injection methods, sterilization methods for injection devices, reducing the risks of drug abuse and sexual behaviors, HIV and hepatitis B counseling and testing, apportioning sterile syringes, needles, cotton, alcohol, and condoms, offering methadone maintenance treatment, collecting and discarding contaminated needles, and referral of patients to specialized medical centers. These procedures were performed in two drop-in centers (DIC) in Hamadan. Participants were recruited by the census, including 188 volunteers from the DICs. Descriptive statistics for quantitative variables were mean and standard deviation. Absolute and relative frequencies were used for ranked and categorized variables. Analytical analysis for high-risk behaviors before and after the intervention was performed using the tests related to paired data and, if necessary, regression models (P ≤ 0.05). STATA version 12 was used to analyze the data. Results: A total of 188 people participated in this study, of whom 112 (59.6%) were male, and 76 (40.4%) were female. The mean ± standard deviation of the age of the participants was 47.72 ± 10.88. The results showed that the proportions of non-injecting drug users (P = 0.03), injecting drug users (P = 0.008), and co-injection users (P < 0.001) were significantly different compared before admission to the DICs and two months after discharge (P = 0.03). Conclusions: Programs of DICs, especially educational programs and distributing syringes and needles, play a significant role in reducing high-risk behaviors, at least in the short term. As a result, this practice may help reduce the incidence of HIV and other diseases transmitted through joint injections among drug users.