Scaling-Up Coverage & Quality Of Hiv & Viral Hepatitis Prevention Targeted To Most-At-Risk Population

Author: GURUNG Binod

Theme: Epidemiology & Public Health Research Year: 2017

Background: There are total 93,534 people who use drugs (PUD) in Nepal (IBBS-2015). According to one national survey carried out in 2012, HIV and Hepatitis C (HCV) prevalence ratio among injecting drug user (IDU) was 20.36% and 92% respectively.
The major objectives of this project are:
1. Reduce HIV & HCV prevalence among IDUs
2. Provide quality treatment, care and support services to people living with HIV (PLHIV)
Method: Since February 2009 SATHI SAMUHA (S.S) has initiated the Global Fund HIV & AIDS project in Kathmandu district under the principal recipient Save the Children. S.S established 5 drop-in-centers (DIC) in various parts of Kathmandu with an aim to deliver harm reduction services like needle/syringe exchange program (NSEP), regular outreach, peer education, primary healthcare, condom distribution and voluntary testing for HIV and HCV for IDUs.
Likewise S.S established 1 Community Care Center (CCC) to deliver treatment, care and support services for PLHIV & positive PUDs.
Result: Till the end of 2016, S.S has:
• Contributed for overall reduction of HIV and HCV prevalence among IDUs from 20.36% and 92% in 2012 to 6.23% and 76% respectively in 2015 (CB survey)
• Reached and enrolled 3472 IDUs in NSEP
• Tested for HIV- 1850, HCV-950 IDUs
• Enrolled 20 HCV positive IDUs on treatment through pilot program
• Total distribution of condoms to most-at-risk population- 32,945.
• Enrolled 53 HIV positive IDUs on anti-retro viral therapy.
Conclusion: S.S is able to contribute a larger share in reduction of HIV and HCV prevalence among IDUs in the country. Similarly we found that HCV is the major cause of death among IDUs with HIV co-infection. Therefore funding agencies and Government should immediately start “Test, Treat & Retain” program particularly for IDUs with co-infection, in order to meet various global AIDS targets like 90,90,90, ending AIDS epidemic by 2030 etc.

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