Harm Reduction Journal最新文献

{"title":"Australian general practitioners' knowledge, attitudes and prescribing intentions for e-cigarettes as a smoking cessation aid: a nationwide baseline and 12-month follow up survey.","authors":"Melis Selamoglu, Sowmya Malamardi, Bircan Erbas, Hester Wilson, Jamie Brown, Chris Barton","doi":"10.1186/s12954-025-01175-2","DOIUrl":"10.1186/s12954-025-01175-2","url":null,"abstract":"<p><strong>Background: </strong>The Australian Government introduced a major policy change tightening regulations regarding the access to nicotine containing e-cigarettes in October 2021. We assessed general practitioners' (GPs) knowledge, attitudes, beliefs and intentions to prescribe nicotine containing e-cigarettes for smoking cessation. We compared baseline data near the time of policy change with data collected from these GPs 12-months later.</p><p><strong>Methods: </strong>GPs were invited to complete a repeated cross-sectional survey based on the Theory of Planned Behaviour between December 2021 and March 2022 (T1) and again, between January and April 2023 (T2). Survey questions assessed knowledge, attitudes, beliefs and intention to prescribe e-cigarettes for smoking cessation.</p><p><strong>Results: </strong>A total of 264 GPs completed the baseline (T1) survey and 94 provided responses at follow-up (T2). Over half of responders were female (T1 n = 170, 64.4%, T2 n = 57, 60.6%) and roughly one third were aged between 30 and 39 years (T1 n = 80, 37.2%, T2 n = 28, 29.8%). Participants who agreed e-cigarettes were suitable smoking cessation aids were more willing to recommend e-cigarettes to patients at T1 and T2 (T1 n = 29, 87.9%, vs. T2 n = 20, 100%). Knowledge about e-cigarettes was limited and did not change between T1 and T2. Participants who had greater confidence in their ability to talk to and answer patient questions about e-cigarettes were more likely to recommend them for smoking cessation at both T1 and T2 (T1 n = 24, 70.6% vs. T2 n = 17, 85.0%).</p><p><strong>Conclusion: </strong>Since tightening the regulation of nicotine containing e-cigarettes, there has been little change in Australian GPs' perceptions of e-cigarettes as smoking cessation aids. Australian GPs are poorly educated about vaping and knowledge about e-cigarettes remained limited, however, GPs at follow-up were more confident in their ability to discuss e-cigarettes with their patients. The findings from this survey may help guide policy and develop strategies to support the implementation of smoking cessation guidelines that incorporate the use of e-cigarettes as smoking cessation aids in Australia.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"35"},"PeriodicalIF":4.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive drug policies increase trust in local government: an analysis of authorities' and residents' perspectives in rural US Appalachian and Midwestern counties.","authors":"Xi Liu, Man-Pui Sally Chan, Dolores Albarracín","doi":"10.1186/s12954-024-01148-x","DOIUrl":"10.1186/s12954-024-01148-x","url":null,"abstract":"<p><strong>Background: </strong>In many rural US Appalachian and Midwestern counties, stigma surrounding harm reduction interventions has led health professionals and policymakers to approach drug policy implementation with caution, fearing potential backlash from politically conservative communities. One concern is that the public's disapproval of harm-reduction policies may erode the public's trust in its government.</p><p><strong>Methods: </strong>This study examined how the public's trust in the local government-as both self-reported and authority-assessed-is influenced by the perceived governmental support of comprehensive drug policies (i.e., inclusive of both drug treatment and harm reduction). Survey data gathered from 138 community authorities and 6,609 community residents from 13 Appalachian and Midwestern states between 2019 and 2023 were analyzed using a multiple regression approach. Furthermore, in an online experiment conducted in 2024, we experimentally simulated the role of authority vs. resident and manipulated the level of perceived governmental support for comprehensive drug policies (high vs. low) to assess their effects on trust and perceived governmental effort and feelings of optimism as possible mediators.</p><p><strong>Results and conclusion: </strong>In both the field surveys and the experiment, trust was positively associated with perceptions of governmental support for comprehensive drug policies. In addition, authorities (both real and experimentally simulated roles) consistently assessed the public's trust in them to be higher than did residents. Both effects were mediated by participants' beliefs in the government's effort to reduce drug use problems and optimism that drug use issues could be improved.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"34"},"PeriodicalIF":4.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The implementation of safer drug consumption facilities in Scotland: a mixed methods needs assessment and feasibility study for the city of Edinburgh.","authors":"James Nicholls, Wendy Masterton, Danilo Falzon, Andrew McAuley, Hannah Carver, Kathryn Skivington, Josh Dumbrell, Andy Perkins, Samantha Steele, Kirsten Trayner, Tessa Parkes","doi":"10.1186/s12954-025-01187-y","DOIUrl":"10.1186/s12954-025-01187-y","url":null,"abstract":"","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"33"},"PeriodicalIF":4.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent HIV testing and self-reported HIV prevalence among men who inject drugs in Afghanistan: a nationwide survey in 2019-2020.","authors":"Ajmal Sabawoon, Sima Naderi, Said Iftekhar Sadaat, Abdul Rasheed, Alim Atarud, Fatemeh Tavakoli, Hamid Sahrifi, Ali Mirzazadeh","doi":"10.1186/s12954-025-01183-2","DOIUrl":"10.1186/s12954-025-01183-2","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs (PWID) remain at high risk for HIV in many countries, including Afghanistan. Previous reports on HIV testing and prevalence in Afghanistan were published in 2012. This study assessed recent HIV testing and self-reported HIV prevalence among male PWID in Afghanistan from 2019 to 2020.</p><p><strong>Method: </strong>We visited 374 public venues and hotpots where PWID used to gather and meet their peers across 8 cities in Afghanistan to enroll eligible participants in our study. Using interviews and a survey, our trained interviewers collected data on the demographics, types of drugs, HIV testing history, and self-reported HIV status of the participants. We analyzed the data using the venues and hotpots as clusters to report the percentages of recent HIV tests and self-reported HIV prevalence overall and in subgroups defined by demographic characteristics and locations.</p><p><strong>Results: </strong>Among the 1385 participants, most were from Kabul city (28.9%), spoke Dari (67.4%), were aged 25-34 years (42.1%), and were married (52.4%). Overall, 70.7% (95% CI 67.6-73.6) (ranging from 20.0% in Kandahar to 99.3% in Mazar-i-Sharif) were tested for HIV within the past 12 months. Among those who had ever been tested for HIV, 20.7% (95% CI 17.8-24.0) (ranging from 0% in Zarang to 63.2% in Kabul) reported being positive for HIV.</p><p><strong>Conclusion: </strong>Compared with the results of a similar study in 2012, we found a significant improvement in HIV testing coverage among PWID in Afghanistan. The high self-reported HIV prevalence among this group also highlights the need for targeted screening and treatment programs for PWID in Afghanistan, particularly in the cities of Kabul and Jalalabad.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"31"},"PeriodicalIF":4.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social support and HIV management among people who inject drugs: in-depth interviews in Delhi, India.","authors":"Rose P Kaptchuk, Aastha Kant, Surendra S Shekhawat, Jiban Baishya, Archit Sinha, Ashwini Kedar, Saisha Khanna, Allison M McFall, Sunil S Solomon, Shruti H Mehta, Gregory M Lucas","doi":"10.1186/s12954-025-01185-0","DOIUrl":"10.1186/s12954-025-01185-0","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs (PWID) experience a higher burden of HIV compared to general populations. Social support has been shown to improve disease management and combat stigma for PWID yet remains unexplored among PWID in low- and middle-income countries.</p><p><strong>Methods: </strong>We conducted qualitative in-depth interviews to understand social ties and health management among PWID living with HIV in Delhi, India. The research was nested in a factorial randomized controlled trial comparing same-day treatment and community-based care with standard-of-care. Interviews were conducted in Hindi in a private room, audio recorded, transcribed in English, and analyzed inductively using Dedoose.</p><p><strong>Results: </strong>We conducted 22 interviews (30 min-two hours) with PWID living with HIV in Delhi (all men, ages 21-38 years). 10 slept in houses, 11 on public streets, and one in a shelter. Participants often experienced isolation in their lives but identified avenues of positive social support from healthcare staff, families, peers (friends or injecting partners), and authority figures/public contacts. Healthcare staff provided information and respectful encouragement to manage health. Outreach workers provided support to remind and accompany participants to clinic visits. Family members offered financial support, medicine reminders, and trust. Authority figures/public contacts included employers, shopkeepers, and vendors who provided a safe place to sleep or store belongings, which proved crucial to consistently store and take pills. In some cases, specific social connections created barriers to health by enabling injecting drug use and carrying out harmful behaviors such as physical attacks, disrespect, and theft.</p><p><strong>Conclusion: </strong>Social connections can offer PWID positive emotional and logistical support to access health services and help them persevere through societal and structural stigmas. However, in some cases they may also contribute negatively to health management challenges. As a harm reduction strategy, public health services can work with PWID to consider untapped opportunities to build positive support and resilience through social ties, as well as how to contend with social connections harmful to health management.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"32"},"PeriodicalIF":4.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"City-level drug policies in Portugal: the COVID-19 pandemic as an analyzer of harm reduction responsiveness in Porto and Lisbon.","authors":"Cristiana Vale Pires, Adriana Curado, Ricardo Fuertes, Maria Carmo Carvalho, Helena Valente","doi":"10.1186/s12954-025-01179-y","DOIUrl":"10.1186/s12954-025-01179-y","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic health crisis and its potential implications for people who use drugs (PWUD) created permissive conditions toward social innovation and experimentation. Still, it also exposed gaps in harm reduction approaches. Harm reduction responsiveness was informed by the priorities defined at the local level, so it was not applied uniformly in different regions. This paper intends to contribute to the analysis of harm reduction responsiveness during the COVID-19 outbreak by comparing the adaptations and implementation of harm reduction and municipal services to support street-involved (SI) PWUD in two Portuguese cities- Porto and Lisbon. This study aims to shed light on the city-level implementation of drug policies in Portugal.</p><p><strong>Methods: </strong>This study is based on a comparative qualitative analysis based on the experiences of PWUD and Harm Reduction (HR) professionals regarding the implementation of harm reduction responses during the COVID-19 pandemic in Porto and Lisbon. The study is based on interviews with SI PWUD (n = 22, 12 in Porto and 10 in Lisbon) and online focus groups with harm reduction professionals (N = 12, 6 in Porto and 6 in Lisbon).</p><p><strong>Results: </strong>Harm reduction teams in Porto and Lisbon implemented contingency plans and proactive adaptations to respond to the pandemic-related emerging needs. However, the study revealed contrasting experiences in the city-level support to harm reduction and responsiveness to the impacts of COVID-19 among SI PWUD in Porto and Lisbon. There were relevant differences in the support they received from the City Council and the city-level responses implemented to support SI PWUD. While the approach in Porto was described as restrictive and zero-tolerance towards drug use, Lisbon´s strategy was harm reduction-focused and inclusive. The study participants revealed better results in Lisbon regarding the harm reduction responsiveness to the pandemic health crisis and the accessibility and adherence of SI PWUD to services.</p><p><strong>Conclusion: </strong>The pandemic constraints and adaptations must be contextualized in the ongoing city-level debates regarding drug policies and harm reduction in Portugal. Moreover, city-level drug policies and local support are crucial to map the opportunities and challenges of implementing the Portuguese Drug Decriminalization Model in different contexts.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"29"},"PeriodicalIF":4.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anonymous Opt-Out HIV and hepatitis C screening at a syringe services program in Florida.","authors":"Heather Henderson, Jason Wilson, Bernice McCoy, Megan Sarmento, Asa Oxner","doi":"10.1186/s12954-025-01182-3","DOIUrl":"10.1186/s12954-025-01182-3","url":null,"abstract":"<p><p>This paper outlines the implementation of opt-out HIV and Hepatitis C (HCV) screening at a syringe services program (SSP) in Florida, highlighting its effectiveness in reducing the transmission of these infectious diseases. Historically, many SSPs have utilized opt-in testing models, which require participants to actively choose testing and often result in low participation rates. Recognizing the need for a more effective approach and to comply with Florida's regulatory requirements under the Infectious Disease Elimination Act, we transitioned to an opt-out testing model at our SSP. This model integrates routine, anonymous, and voluntary testing into standard care, normalizing the process and reducing stigma associated with infectious disease screening. Initially, our policy tied testing to access to specific services, including syringe exchange, to meet compliance with Florida Department of Health mandates. However, after feedback from participants, staff, and community members, we revised our approach to allow all participants to access all services, regardless of their decision to participate in testing. Importantly, this policy change did not decrease testing rates, with only 6 out of 226 new enrollments (3%) opting out since the implementation of opt-out screening. By fostering a trusting, non-coercive environment and normalizing screening as part of routine care, we achieved high rates of participation while maintaining participant autonomy. Since transitioning to an opt-out model, we have conducted nearly 3,000 HIV and HCV tests, with seropositivity rates of 3.8% and 54%, respectively. These efforts have facilitated early detection, rapid linkage to care, and reduced transmission within the community. Our findings underscore the importance of comprehensive, repeat testing in high-risk populations and demonstrate the potential for opt-out models to serve as a scalable framework for SSPs nationwide. This approach not only fulfills regulatory and public health objectives but also strengthens the role of SSPs as critical interventions in combating HIV and HCV transmission.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"30"},"PeriodicalIF":4.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is fentanyl in everything? Examining the unexpected occurrence of illicit opioids in British Columbia's drug supply.","authors":"Bruce Wallace, Irene Shkolnikov, Collin Kielty, Derek Robinson, Lea Gozdzialski, Jai Joshua, Ava Margolese, Pablo Gonzalez-Nieto, Armin Saatchi, Lucas Abruzzi, Taelor Zarkovic, Chris Gill, Dennis Hore","doi":"10.1186/s12954-025-01189-w","DOIUrl":"10.1186/s12954-025-01189-w","url":null,"abstract":"<p><strong>Background: </strong>Illicit opioids, including fentanyl, are linked to unprecedented levels of overdose in Canada and elsewhere. The risks associated with illicit opioids can include high potency, unpredictable concentration and the unexpected presence in other drugs. Within this context, we examine drug checking data to better understand the presence of illicit opioids such as fentanyl in other drugs and possible ways to interpret these results.</p><p><strong>Methods: </strong>Three years (2021-2023) of data (18,474 samples) from Substance Drug Checking in British Columbia, Canada were examined to investigate the risks associated with the detection of opioids in other drugs such as cocaine and methamphetamine, as well as in other drug categories. Samples were tested by paper spray mass spectrometry (PS-MS), fentanyl test strips and Fourier-Transform infrared spectroscopy (FTIR). We examine the 8889 samples not expected to include fentanyl to confirm; if the expected drug was detected, if unexpected opioids were detected, and when the unexpected opioids are in trace concentration.</p><p><strong>Results: </strong>Unexpected opioids were rarely detected (2%) in other drugs (189 of 8889 samples) with most (61.4%) detected at trace concentration levels. Unexpected opioids are far more likely to be found in samples that did not contain the expected drug than in samples that were confirmed to contain the expected drug. The least common scenario (below 1%) were substances that included the expected drug plus unexpected opioid above trace concentration. These findings raise questions on how to interpret and communicate the detection of fentanyl and related opioids in other drugs. We present three potential interpretations: (1) mistaken and misrepresented samples where the expected drug was never detected, (2) cross contamination when opioids were at trace concentration levels, or (3) adulteration as the least frequent scenario where opioids were detected above trace concentrations in combination with the expected drug.</p><p><strong>Conclusions: </strong>In a region where fentanyl is associated with extreme rates of overdose, it remains rare to find such opioids in other drugs. However, the risk of fentanyl in other drugs remains an ongoing threat that warrants responses by individuals and public health. We provide possible interpretations to inform such responses. Our data raises questions on how to interpret and communicate the detection of fentanyl and other opioids in other drugs.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"28"},"PeriodicalIF":4.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking the vicious cycle of delayed healthcare seeking for people who use drugs.","authors":"Zoi Papalamprakopoulou, Elisavet Ntagianta, Vasiliki Triantafyllou, George Kalamitsis, Arpan Dharia, Suzanne S Dickerson, Angelos Hatzakis, Andrew H Talal","doi":"10.1186/s12954-025-01166-3","DOIUrl":"10.1186/s12954-025-01166-3","url":null,"abstract":"<p><strong>Background: </strong>People who use drugs (PWUD) are at increased mortality risk, yet they typically avoid healthcare settings due to stigma and shunning. Understanding the healthcare journey from the viewpoint of PWUD has been understudied, although it is essential for informing solutions to increase healthcare access to improve their healthcare outcomes. We aimed to understand the process of accessing healthcare for PWUD, including perceived barriers and facilitators, by exploring their experiences, attitudes, and beliefs.</p><p><strong>Methods: </strong>We employed purposive sampling to recruit PWUD to participate in nine focus group discussions (FGDs) (N = 57) in Athens, Greece. Inclusion criteria required a history of injection drug use, internet access, and Greek verbal fluency. The FGDs were audio-recorded, transcribed, translated into English, and de-identified. We analyzed FGD transcripts using modified grounded theory.</p><p><strong>Results: </strong>Participants' mean (standard deviation) age was 47.9 (8.9) years, 89.5% (51/57) were male, 91.2% (52/57) were of Greek origin, and 61.4% (35/57) had attended at least 10 years of school. We identified three key themes from the FGD transcript analysis: (1) seeking care after an individual's rapid health decline, (2) facing barriers in accessing healthcare, and (3) building trust to improve access to healthcare for PWUD. Participants disclosed that they tended to seek healthcare after a rapid deterioration in their health. They experienced multiple barriers to healthcare access such as stigma, healthcare system mistrust, unresponsive emergency medical services and competing priorities such as homelessness, mental health challenges, and ongoing manifestations of substance use disorder (SUD). Participants' recommendations to build patient-provider trust and improve healthcare access include stigma minimization, promotion of empathy in the patient-provider relationship, and engaging community organizations that serve PWUD to build bridges with healthcare providers and institutions.</p><p><strong>Conclusions: </strong>PWUD in Athens, Greece demonstrate delayed health-seeking behaviors and report multifaceted healthcare access barriers including stigma, delays in emergency care, poor mental health, homelessness, and SUD manifestations. Key trust-building processes to expand healthcare access include minimizing stigma and promoting empathy in healthcare encounters, enhancing healthcare staff education on SUD, improving the responsiveness of emergency medical services, engaging community organizations, and exploring telehealth's role in improving healthcare access for PWUD.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"27"},"PeriodicalIF":4.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of HIV and Hepatitis C and access to opioid substitution treatment among people who inject drugs in three cities in Croatia: findings from the second wave of respondent-driven sampling surveys.","authors":"Sandra Šević, Goran Koletić, Tatjana Nemeth Blažić, Mirjana Lana Kosanović Ličina, Josipa-Lovorka Andreić, Senad Handanagić, Magda Pletikosa Pavić, Ivana Božičević","doi":"10.1186/s12954-025-01174-3","DOIUrl":"10.1186/s12954-025-01174-3","url":null,"abstract":"<p><strong>Background: </strong>The second wave of integrated bio-behavioural surveys was conducted among people who inject drugs (PWID) in the cities of Zagreb, Split, and Rijeka in Croatia to estimate the prevalence of HIV and hepatitis C virus (HCV) antibodies and sexual and injecting risk behaviours.</p><p><strong>Methods: </strong>Respondent-driven sampling (RDS) was used to recruit a total of 301 PWID in Split, 130 in Rijeka, and 86 in Zagreb from March to July 2022. Participants provided biological specimens for HIV and HCV testing and completed a behavioural questionnaire. RDS-Analyst software was used to calculate weighted population estimates with 95% confidence intervals (95% CI).</p><p><strong>Results: </strong>Approximately one in four PWID were women (range from 24.3% in Zagreb to 29.9% in Rijeka). Overall, HIV prevalence was low, with no cases identified in Zagreb, and 0.6% and 0.8% in Split and Rijeka, respectively. HCV antibody prevalence was 37.2% among PWID in Zagreb and Rijeka, and as high as 59.5% in Split. Testing for HIV and HCV in the 12 months before the survey was reported by 11.3-19.8% and 17.3-21.6% of PWID across the cities, respectively. Use of needles and syringes in the past 30 days that had already been used by someone else was reported by 8.9-26.5% across the cities. A large proportion of PWID-54.0% in Zagreb, 31.0% in Rijeka and 29.9% in Split-never used needle and syringe exchange programmes. Being in drug addiction treatment at the time of the survey was reported by 50.8% in Split, 57.3% in Rijeka and 73.3% in Zagreb. Injecting cocaine in 30 days before the survey was common, ranging from 12.7 to 32.1% across the cities.</p><p><strong>Conclusion: </strong>HIV prevalence continues to be low among PWID in Croatia, whereas HCV prevalence is substantial. Due to low coverage of HIV and HCV testing and insufficient use of harm reduction services, there is a potential for further spread of drug-related infectious diseases in this population.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"26"},"PeriodicalIF":4.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}