. 2023 Apr;27(4):1140-1153.

doi: 10.1007/s10461-022-03851-x. Epub 2022 Nov 11.

Impact of COVID-19 & Response Measures on HIV-HCV Prevention Services and Social Determinants in People Who Inject Drugs in 13 Sites with Recent HIV Outbreaks in Europe, North America and Israel

Lucas Wiessing¹, V Sypsa², A O Abagiu³, A Arble⁴, N Berndt⁵, A Bosch⁶, S Buskin^{7

8}, D Chemtob^{9

10}, B Combs¹¹, C Conyngham¹², J Feelemyer¹³, M Fitzgerald¹⁴, D Goldberg¹⁵, A Hatzakis², R E Patrascu³, E Keenan¹⁴, I Khan¹⁶, S Konrad¹⁶, J Leahy¹⁷, A McAuley^{15

18}, T Menza^{17

19}, S Merrick⁴, R Metcalfe^{18

20}, T Rademaker⁴, S Revivo²¹, P Rosca²², C Seguin-Devaux²³, S Skinner²⁴, C Smith¹², J Tinsley⁸, M Wilberg²⁵, D Des Jarlais¹³

Affiliations

¹ Public Health Unit, European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Praça Europa 1, Cais do Sodré, 1249-289, Lisbon, Portugal. lucas.wiessing@emcdda.europa.eu.
² Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
³ National Institute for Infectious Diseases, Bucharest, Romania.
⁴ Hamilton County Public Health, Cincinnati, OH, USA.
⁵ Luxembourg National Focal Point of the European Monitoring Centre for Drugs and Drug Addiction, Department of Epidemiology and Statistics, Directorate of Health, Luxembourg-Hamm, Luxembourg.
⁶ STD, HIV, and TB Section - Infectious Disease Epidemiology, Prevention and Control, Minnesota Department of Health, St. Paul, MN, USA.
⁷ University of Washington, Seattle, WA, USA.
⁸ Public Health - Seattle & King County, Seattle, WA, USA.
⁹ Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel.
¹⁰ Braun School of Public Health and Community Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel.
¹¹ Scott County Health Department, Scottsburg, IN, USA.
¹² Philadelphia Department of Public Health, Philadelphia, PA, USA.
¹³ School of Global Public Health, New York University, New York, NY, USA.
¹⁴ National Social Inclusion Office, Health Services Executive, Dublin, Ireland.
¹⁵ Public Health Scotland, Glasgow, Scotland, United Kingdom.
¹⁶ First Nations and Inuit Health Branch, Indigenous Services Canada, Regina, Canada.
¹⁷ Oregon Health Authority, Portland, OR, USA.
¹⁸ School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom.
¹⁹ Oregon Health and Science University, Portland, OR, USA.
²⁰ Sandyford Sexual Health Service, Glasgow, Scotland, United Kingdom.
²¹ Izhar Needle and Syringe Programme, Public Health Association, Jerusalem, Israel.
²² Department for the Treatment of Substance Abuse, Ministry of Health, Jerusalem, Israel.
²³ Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
²⁴ University of Saskatchewan, Saskatoon, Canada.
²⁵ Minnesota Department of Human Services, St. Paul, Minnesota, USA.

PMID: 36367613
PMCID: PMC9651099
DOI: 10.1007/s10461-022-03851-x

Impact of COVID-19 & Response Measures on HIV-HCV Prevention Services and Social Determinants in People Who Inject Drugs in 13 Sites with Recent HIV Outbreaks in Europe, North America and Israel

Lucas Wiessing et al. AIDS Behav. 2023 Apr.

. 2023 Apr;27(4):1140-1153.

doi: 10.1007/s10461-022-03851-x. Epub 2022 Nov 11.

Authors

Affiliations

¹ Public Health Unit, European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Praça Europa 1, Cais do Sodré, 1249-289, Lisbon, Portugal. lucas.wiessing@emcdda.europa.eu.
² Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
³ National Institute for Infectious Diseases, Bucharest, Romania.
⁴ Hamilton County Public Health, Cincinnati, OH, USA.
⁵ Luxembourg National Focal Point of the European Monitoring Centre for Drugs and Drug Addiction, Department of Epidemiology and Statistics, Directorate of Health, Luxembourg-Hamm, Luxembourg.
⁶ STD, HIV, and TB Section - Infectious Disease Epidemiology, Prevention and Control, Minnesota Department of Health, St. Paul, MN, USA.
⁷ University of Washington, Seattle, WA, USA.
⁸ Public Health - Seattle & King County, Seattle, WA, USA.
⁹ Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel.
¹⁰ Braun School of Public Health and Community Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel.
¹¹ Scott County Health Department, Scottsburg, IN, USA.
¹² Philadelphia Department of Public Health, Philadelphia, PA, USA.
¹³ School of Global Public Health, New York University, New York, NY, USA.
¹⁴ National Social Inclusion Office, Health Services Executive, Dublin, Ireland.
¹⁵ Public Health Scotland, Glasgow, Scotland, United Kingdom.
¹⁶ First Nations and Inuit Health Branch, Indigenous Services Canada, Regina, Canada.
¹⁷ Oregon Health Authority, Portland, OR, USA.
¹⁸ School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom.
¹⁹ Oregon Health and Science University, Portland, OR, USA.
²⁰ Sandyford Sexual Health Service, Glasgow, Scotland, United Kingdom.
²¹ Izhar Needle and Syringe Programme, Public Health Association, Jerusalem, Israel.
²² Department for the Treatment of Substance Abuse, Ministry of Health, Jerusalem, Israel.
²³ Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
²⁴ University of Saskatchewan, Saskatoon, Canada.
²⁵ Minnesota Department of Human Services, St. Paul, Minnesota, USA.

PMID: 36367613
PMCID: PMC9651099
DOI: 10.1007/s10461-022-03851-x

Abstract
in English, Spanish

HIV/HCV prevention among people who inject drugs (PWID) is of key public health importance. We aimed to assess the impact of COVID-19 and associated response measures on HIV/HCV prevention services and socio-economic status of PWID in high-HIV-risk sites. Sites with recent (2011-2019) HIV outbreaks among PWID in Europe North America and Israel, that had been previously identified, were contacted early May 2020. Out of 17 sites invited to participate, 13 accepted. Semi-structured qualitative site reports were prepared covering data from March to May 2020, analyzed/coded and confirmed with a structured questionnaire, in which all sites explicitly responded to all 103 issues reported in the qualitative reports. Opioid maintenance treatment, needle/syringe programs and antiretroviral treatment /hepatitis C treatment continued, but with important reductions and operational changes. Increases in overdoses, widespread difficulties with food and hygiene needs, disruptions in drug supply, and increased homelessness were reported. Service programs rapidly reformed long established, and politically entrenched, restrictive service delivery policies. Future epidemic control measures should include mitigation of negative side-effects on service provision and socio-economic determinants in PWID.

La prevención del VIH/VHC entre las personas que se inyectan drogas (PWID) es de vital importancia para la salud pública. Nuestro objetivo fue evaluar el impacto de COVID-19 y las medidas de respuesta asociadas en los servicios de prevención del VIH/VHC y el estado socioeconómico de las PWID en sitios de alto riesgo de VIH. Se contactó con sitios con brotes recientes (2011–2019) de VIH entre PWID en Europa, América del Norte e Israel, que habían sido previamente identificados, a principios de mayo de 2020. De los 17 sitios invitados a participar, 13 aceptaron. Se prepararon informes cualitativos semiestructurados del sitio que cubrían los datos de marzo a mayo de 2020, analizados/codificados y confirmados con un cuestionario estructurado, en el que todos los sitios respondieron explícitamente a los 103 asuntos reportados en los informes cualitativos. El tratamiento de mantenimiento con opiáceos, los programas de agujas/jeringas y el tratamiento antirretroviral/tratamiento de la hepatitis C continuaron, pero con importantes reducciones y cambios operativos. Se reportaron aumentos en las sobredosis, dificultades generalizadas con las necesidades alimentarias y de higiene, interrupciones en el suministro de medicamentos y aumento de personas sin hogar. Los programas de servicios reformaron rápidamente las políticas restrictivas de prestación de servicios, establecidas desde hace mucho tiempo y políticamente arraigadas. Las futuras medidas de control de epidemias deben incluir la mitigación de los efectos secundarios negativos en la prestación de servicios y los determinantes socioeconómicos en las PWID.

Keywords: COVID-19; Epidemiology; HIV; Hepatitis C; Homelessness; Outbreaks; Overdose; People who inject drugs (PWID); Prevention; Services; Social determinants; Treatment.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

**Fig. 1**
Impact of COVID-19/response measures on HIV-HCV services and social determinants in people who inject drugs, in sites with recent HIV outbreaks in Europe, North America and Israel

See this image and copyright information in PMC

References

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1. WHO. 14.9 million excess deaths associated with the COVID-19 pandemic in 2020 and 2021. Geneva; 2022. Available from: https://www.who.int/news/item/05-05-2022-14.9-million-excess-deaths-were...
1. United Nations. A UN framework for the immediate socio-economic response to COVID-19. April 2020. New York; 2020. Available from: https://unsdg.un.org/sites/default/files/2020-04/UN-framework-for-the-im...
1. Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P, et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. Lancet Glob Health. 2017;5(12):e1192-e207. doi: 10.1016/S2214-109X(17)30375-3. - DOI - PMC - PubMed
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Impact of COVID-19 & Response Measures on HIV-HCV Prevention Services and Social Determinants in People Who Inject Drugs in 13 Sites with Recent HIV Outbreaks in Europe, North America and Israel

Affiliations

Impact of COVID-19 & Response Measures on HIV-HCV Prevention Services and Social Determinants in People Who Inject Drugs in 13 Sites with Recent HIV Outbreaks in Europe, North America and Israel

Authors

Affiliations

Abstract
in English, Spanish

Conflict of interest statement

Figures

References

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Abstract in English, Spanish

Conflict of interest statement

Figures

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MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Abstract
in English, Spanish