Select barriers to harm-reduction services for IDUs in eastern Europe.
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.
Curth
Nadja Kehler
NK
Department of Public Health, Copenhagen University, Denmark.
Hansson
Liv Nanna
LN
Storm
Frederikke
F
Lazarus
Jeffrey V
JV
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
D008691:Methadone