Theme: Social Science and Policy Research Year: 2021
Background: The COVID-19 pandemic had a significant impact on HIV and harm reduction (HR) services. For people who use drugs, COVID-19 has added to an already difficult situation of violations of human rights, criminalization, stigma, discrimination, HIV and viral hepatitis, and overdose. In late 2020, a collaboration between Harm Reduction International and the International AIDS Society sought to identify the role of integrated and community-led services in responding to the needs of people who use drugs during the pandemic, and to identify best practices. Methods: We utilized semi-structured key informant interviews with researchers, service providers and advocates. Participants were selected through purposive stratified sampling. Data collection took place between 16th November and 18th December 2020. We used inductive thematic analysis to analyse the data. Interview data was supplemented by a systematized review of academic, governmental and nongovernmental literature. Results: Integrated HR services were crucial in providing linkage to COVID-19 care for people who use drugs during the pandemic. Familiarity with clients’ and their needs, and trusting relationships between service providers and clients were central to this success. In some cases, integrating COVID-19 testing and care also brought people into contact with HR services for the first time. The role of community-led services was vital in the continuity of access to HR services during the pandemic. Community groups were quick to adapt, and were uniquely capable of anticipating clients’ needs and maintaining contact with clients. Conclusions: Integrating HR with other health and social services, and involving the community in the planning, design and delivery of services, were essential in maintaining coverage and accessibility during the COVID-19 pandemic. Such services were able to maintain contact with their clients in the face of restrictions that impacted their normal operating procedures. The integration of COVID-19 services with HIV and HR services had a mutually enhancing effect on accessibility. Disclosure of interest statement: The authors have no disclosures.
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