Scaling Up Opioid Agonist Therapies to Prevent HIV in Central Asia Using NIATx Implementation Strategy

What this Trial Is About

Central Asia is experiencing the fastest growing HIV epidemic globally, mainly affecting people who inject drugs PWID and their sexual partners. This research focuses on expanding opioid agonist therapies OAT in Kazakhstan, Kyrgyzstan, and Tajikistan, as scaling up OAT combined with antiretroviral therapy ART is considered the most cost-effective way to prevent new HIV infections. The study uses the NIATx implementation strategy guided by the Exploration-Planning-Implementation-Sustainment EPIS framework to understand and improve OAT delivery in this challenging healthcare context. The study involves training and coaching national experts and Chief Narcologists in these countries using NIATx tools and quality improvement techniques. This includes initial training sessions, ongoing coaching, and collaborative learning to overcome barriers and improve OAT entry and retention. The researchers will also conduct formative research to assess facilitators and barriers at client, program, and structural levels, aiming to create sustainable and locally adapted OAT models integrated with primary and HIV care. Participants include PWID meeting opioid dependence criteria, OAT delivery staff, and Chief Narcologists involved in OAT programs. Assessments include surveys, organizational evaluations, and focus groups, with ongoing monitoring of OAT census, new patient numbers, and dropout rates over 36 months. Stakeholder meetings will help guide implementation and policy changes to support sustainability. The total study duration includes long-term follow-up to assess implementation trajectories and outcomes.

Expanding Medication-Assisted Therapies in Central Asia