Select barriers to harm-reduction services for IDUs in eastern Europe

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Harm Reduction Strategies

Background:

• High prevalence of HIV and HCV among injecting drug users (IDUs) in Eastern Europe.
• Harm reduction programs, including needle/syringe programs and opioid substitution therapy (OST), are effective in preventing HIV/HCV.
• Structural barriers can impede access to and effectiveness of these essential public health interventions.

Purpose of the Study:

• To explore the prevalence of structural barriers to harm reduction services for IDUs in Eastern Europe.
• To investigate age restrictions, user fees, and confidentiality issues in HIV/HCV testing and harm reduction programs.

Main Methods:

• A semi-structured online survey was distributed to 65 professionals in Eastern Europe.
• The survey focused on identifying barriers within needle/syringe programs, OST, and HIV/HCV testing services.

Main Results:

• Age restrictions were uncommon, except for OST.
• User fees were prevalent for HCV testing and varied for other services.
• Confidentiality was a concern, with parental notification common for young IDUs receiving HIV services, but not typically involving public authorities for harm reduction program entry.

Conclusions:

• Limited access and compromised confidentiality in harm reduction services were reported.
• Reforming healthcare guidelines and national legislation is crucial to ensure access to evidence-based interventions for IDUs.
• Addressing structural barriers is essential for effective HIV and HCV prevention in Eastern Europe.