title: Select barriers to harm-reduction services for IDUs in eastern Europe.
abstract: BACKGROUND
  In eastern Europe, the high prevalence rates of HIV and the hepatitis C virus (HCV) are concentrated among injecting drug users (IDUs). Harm reduction programmes such as needle and syringe programmes and opioid substitution therapy (OST) have been shown to be effective in preventing these infections. However, structural barriers can limit their effectiveness by hindering access.
  
  
  METHODS
  Through use of a semi-structured online survey sent to 65 professionals in the region, this study explores the prevalences of age restrictions, user fees or a lack of confidentiality for these programmes as well as HIV/HCV testing programmes.
  
  
  RESULTS
  Twenty respondents reported that age restrictions were not widespread in the 11 reporting countries, apart from for OST. User fees were found to be very common in HCV testing and varied for other services. It was stated to be common to inform parents of young IDUs who receive HIV services, but not to inform public authorities when IDUs enter harm reduction programmes.
  
  
  CONCLUSIONS
  Where access to services is limited or confidentiality is compromised, as reported in this pilot study, it is crucial that health-care guidelines and national legislation are reformed to ensure access to these evidence-based interventions.
authors.affiliation: Department of Public Health, Copenhagen University, Denmark.
authors.forename: Nadja Kehler
authors.initials: NK
authors.lastname: Curth
authors.forename: Liv Nanna
authors.initials: LN
authors.lastname: Hansson
authors.forename: Frederikke
authors.initials: F
authors.lastname: Storm
authors.forename: Jeffrey V
authors.initials: JV
authors.lastname: Lazarus
mesh_terms: D000367:Age Factors; D003219:Confidentiality; D005061:Europe, Eastern / Q000453:epidemiology; D005249:Fees and Charges; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D040261:Harm Reduction; D006297:Health Services Accessibility / Q000458:organization & administration*; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008691:Methadone / Q000627:therapeutic use*; D018671:Needle-Exchange Programs / Q000458:organization & administration*; D010865:Pilot Projects; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000517:prevention & control* / Q000628:therapy
chemical_list: D008691:Methadone