Cross-sectional assessments of participants' characteristics and loss to follow-up in the first Opioid Substitution Therapy Pilot Program in Kabul, Afghanistan.
BACKGROUND
Kabul has over 12,000 people who inject drugs (PWID), most of them heroin users, and opioid substitution therapy has recently been introduced as an effective method to reduce opioid use. We aimed to evaluate a pilot Opioid Substitution Therapy Pilot Program (OSTPP) in Kabul, Afghanistan, particularly to (1) describe characteristics of the participants enrolled in the program and (2) identify factors associated with client retention in the OSTPP.


RESULTS
Two cross-sectional surveys evaluated participants attending the OSTPP at baseline (n = 83) and 18 months after (n = 57). Questionnaires assessed socio-demographic, drug use behavior, and general and mental health factors. After 18 months, 57 participants remained in the OSTPP. Participants lost to follow-up were younger (p < 0.01) and married (p < 0.01) and had no family contact (p < 0.01). Participants at 18 months reported no criminal activity in the last month and only two (3.5 %) reported heroin use in the last month, constituting significant decreases from baseline.


CONCLUSIONS
While preliminary results are promising, further evaluation is needed to determine the feasibility of implementing OSTPP in this setting and effectiveness in reducing injection risk behaviors in Afghanistan.
Department of Psychiatry, Michigan State University, College of Ostheopathic Medicine, 965 E Fee Hall Suite A227, Lansing, MI, 48824, USA. ruiseore@msu.edu.|Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA. ruiseore@msu.edu.
Horacio
H
Ruiseñor-Escudero
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA.|Department of Emergency Medicine, Johns Hopkins University, School of Medicine, 5801 Smith Avenue, Suite 3220, Baltimore, MD, 21205, USA.
Alexander
A
Vu
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Center for Public Health and Human Rights, 615 N Wolfe Street, Baltimore, MD, 21205, USA.
Andrea L
AL
Wirtz
Department of Psychiatry, Michigan State University, College of Ostheopathic Medicine, 965 E Fee Hall Suite A227, Lansing, MI, 48824, USA.
Itziar
I
Familiar-Lopez
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA.
Mark
M
Berry
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA.
Iliassou
I
Mfochive
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA.|Department of Interprofessional Health Studies, Towson University, Baltimore, MD, 21252, USA.
Cyrus
C
Engineer
Medecins du Monde, Kabul, Afghanistan.
Ahmad
A
Farhad
Medecins du Monde, Kabul, Afghanistan.
Senop
S
Tschakarjan
Medecins du Monde, Kabul, Afghanistan.|Medecins du Monde, 63 rue de Marcadet, Paris, 75018, France.
Ernst
E
Wisse
National AIDS Control Program, Kabul, Afghanistan.
Feda M
FM
Paikan
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA.
Gilbert
G
Burnham
D000293:Adolescent; D000328:Adult; D000346:Afghanistan; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D010865:Pilot Projects; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D055815:Young Adult