Tytuł prezentacji - Lisbon addictions 2017

Tytuł prezentacji - Lisbon addictions 2017

Program
Prevention of HCV infections
The main objective of the Program is to provide a basis for planning a longterm strategy for preventing HCV and combating hepatitis C in Poland.
PROGRAM SUPPORTED BY A GRANT FROM SWITZERLAND TROUGH THE SWISS
CONTRIBUTION TO THE ENLARGEMENT EUROPEAN UNION AND BY MINISTRY OF
HEALTH OF REPUBLIC OF POLAND
Narodowy Instytut
Zdrowia Publicznego –
Państwowy Zakład
Higieny w Warszawie
www.hcv.pzh.gov.pl
Instytut
Psychiatrii
I Neurologii
w Warszawie
Uniwersytet
Medyczny
w Lublinie
Główny
Inspektorat
Sanitarny
Main partner:
Narodowy Instytut Zdrowia
Publicznego – Państwowy
Zakład Higieny w Warszawie
Partners:
Instytut
Psychiatrii
I Neurologii
w Warszawie
www.hcv.pzh.gov.pl
Uniwersytet
Medyczny
w Lublinie
Główny
Inspektorat
Sanitarny
Janusz Sierosławski
Institute of Psychiatry and Neurology
Estimation of prevalence of HCV among IDUs in Poland and identification of risk factors
Addiction Conference
Lisbon, 23‐25 September 2015 www.hcv.pzh.gov.pl
Introduction
• Objectives of the project
– to cover IDUs population by evidence based HCV prevention measures
– to increase institutional capacity to response HCV problem among IDUs
• Outputs of the project
– Model HCV prevention program targeting IDUs
– Proposals for National HCV Prevention and Control Strategy • HCV prevalence study:
– initial assessment for developing HCV prevention program
– baseline for evaluation of prevention program
• First preliminary results as a subject of presentation
www.hcv.pzh.gov.pl
Method
• Population under study – drug users using regularly illicit substances and experience problems
• Inclusion criteria: – daily or almost daily drug use during at least 1 month in the last 3 years, or
– lifetime injecting drug use • Snowball sampling in 15 localization around Poland • Testing saliva samples (anti‐HCV antibodies) and collecting standardized interviews • Sample size – 1219 (average per localization – 81)
• Data collected in March‐June 2014 www.hcv.pzh.gov.pl
HCV antibodies and injecting drug use
Lifetime injecting and non‐
injecting drug use (numbers)
HCV antibodies among IDUs and non IDUs (percentages)
General populatio
n ‐ about 1%
Statistically significant p 0,01 www.hcv.pzh.gov.pl
HCV antibodies among IDUs
Lifetime use of needles or syringes used by others
www.hcv.pzh.gov.pl
HCV antibodies and use of used needles or syringes Statistically significant p 0,01 Risk of HCV antibodies among IDUs –
logistic regression model
Variables (reference category)
Age
Odds CI CI Variables not included ratio lower higher in the model:
1.130 1.103 1.158
Sharing needles or syringes 4.393 3.112 6.202
(no)
Imprisonment (no)
Education (secondary and higher)
www.hcv.pzh.gov.pl
1.458 1.010 2.104
• Gender
• Homelessness
• Number of years since first injection
• Interaction between age and number of years since first injection
Model fitting:
1.937 1.314 2.854
• 76,8% correctly classified • R2 Nagelkerke = 0,39 Risk of use of used needles or syringes in last 30 days – logistic regression model
Variables (reference category)
N = 424
Odds CI CI Variables not ratio lower higher included in the model:
Homelessness (no)
2,359
1,435
3,879
Risky places of injections (no)
1,986
1,133
3,483
Injection every day (once a week or less frequently)
3,430
1,746
6,737
Injection 2‐6 times per week
(once a week or less frequently)
1,694 0,852
3,367
Tested HCV+ (no tested)
0,656
0,387
1,109
Tested HCV‐ (no tested)
0,299
0,131
0,685
www.hcv.pzh.gov.pl
Gender
Age
Education Number of years since first injection
• Imprisonment experiences
•
•
•
•
Model fitting:
• 78,1% correctly classified • R2 Nagelkerke = 0,19 Conclusions ‐1
• Prevalence of HCV antibodies among problem drug users without any injecting experiences six times higher than in the general population – prevention program should be addressed also to non injecting drug users • Prevalence of HCV antibodies among lifetime IDUs ten times higher than among other problem drug users • Rick factors for HCV antibodies among IDUs: • Increasing age
• Needles or syringes sharing
• Low education • Experience in imprisonment • Prevention measures should be different for different groups of problem drug users
www.hcv.pzh.gov.pl
Conclusions ‐2
• The study results suggest that use of used injecting equipment is related to two „environmental” factors :
• Homelessness
• Injecting in risky places
• Response should include intervention focused not only on injectors but also on environment
• Injection rooms should be the best offer for homeless and IDUs who inject in risky places
www.hcv.pzh.gov.pl
Project webpage (English): http://www.hcv.pzh.gov.pl/en/Page/project‐2‐
1
PROGRAM SUPPORTED BY A GRANT FROM SWITZERLAND TROUGH THE SWISS
CONTRIBUTION TO THE ENLARGEMENT EUROPEAN UNION AND BY MINISTRY OF HEALTH OF
REPUBLIC OF POLAND
Narodowy Instytut
Zdrowia Publicznego –
Państwowy Zakład
Higieny w Warszawie
www.hcv.pzh.gov.pl
Instytut
Psychiatrii
I Neurologii
w Warszawie
Uniwersytet
Medyczny
w Lublinie
Główny
Inspektorat
Sanitarny