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Access and coverage of needle and syringe programmes (NSP) in Central and Eastern Europe and Central Asia*

Authors

  • Carmen Aceijas,

    Corresponding author
    1. Centre for Research on Drugs and Health Behaviour (CRDHB), London School of Hygiene and Tropical Medicine (LSHTM), Department of Public Health and Policy, London, UK,
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    • On behalf of the Reference Group on HIV/AIDS Prevention and Care among IDU in Developing and Transitional Countries.

  • Matthew Hickman,

    1. Centre for Research on Drugs and Health Behaviour (CRDHB), London School of Hygiene and Tropical Medicine (LSHTM), Department of Public Health and Policy, London, UK,
    2. Department of Social Medicine, University of Bristol, Bristol, UK
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  • Martin C. Donoghoe,

    1. WHO Regional Office for Europe, Copenhagen, Denmark,
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  • Dave Burrows,

    1. AIDS Projects Management Group, Sydney, Australia,
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  • Raminta Stuikyte

    1. Central and Eastern European Harm Reduction Network (CEEHRN), Vilnius, Lithuania and
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  • *

    The contents of this paper, including data, analysis, interpretation and presentation are the responsibility of the authors and not of the United Nations.

Carmen Aceijas, Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine, Department of Public Health and Policy, Keppel Street, London WC1E 7HT, UK. E-mail: carmen.aceijas@lshtm.ac.uk

ABSTRACT

Objective  To estimate access, activity and coverage of needle and syringe programmes (NSP) in Central and Eastern Europe and Central Asia.

Methods  Two data sets (‘regional’ and ‘high-coverage sites’) were used to estimate NSP provision (availability/number of sites), NSP utilization (syringes distributed/year), needle and syringe distribution (needles/syringes distributed/IDU/year), IDU reached (number/percentage of IDU contacted/year), regular reach (five or more contacts/month) and syringe coverage (percentage of injections/IDU/year administrable with new injecting equipment).

Results  Regional data set: results from 213 sites in 25 countries suggested that Czech Republic, Poland, Russia and Ukraine had > 10 NSP during 2001/2. Czech Republic, Kazakhstan, Latvia, Russia, Slovakia and Ukraine had ≥ 10 000 IDU in contact with NSP. Ten countries reached ≥ 10% of the estimated IDU population. The 25 countries distributed ∼ 17 million syringes/needles. Eight countries distributed > 0.5 million syringes/year. Syringe coverage (assuming 400 injections/IDU/year) was < 5% in 19 countries, 5–15% in five and > 15% in Macedonia. Overall syringe coverage was 1.2% and when assuming 700 injections/IDU/year it decreased to 0.7%. Syringe coverage for the IDU population in contact with NSP was ≤ 15% in 10 countries, 15–60% in 11 and > 60% in Croatia, Macedonia, Moldova and Tajikistan. Overall syringe coverage for the population in contact with NSP was 9.8%. High-coverage data set: Soligorsk, Pskov and Sumy's NSP reached 92.3%, 92.2% and 73.3% of their estimated IDU population, respectively (regular reach: 0.2%, 1.8% and 22.7%). The distribution levels were 47.2, 51.7 and 94.2 syringes/IDU/year, respectively.

Conclusion  The evidence suggests suboptimal levels of NSP implementation, programme activity and coverage. This paper provides a baseline for development of indicators that could be used to monitor NSP. Strategies to increase coverage that may go beyond NSP are urgently required, as is research into understanding how NSP can contribute to better syringe coverage among IDU.

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