Gori

Researchers are evaluating a distribution program for low dead-space syringes and needles (LDSS/N) among people who inject drugs in several low- and middle-income countries, including Armenia, Georgia, Tanzania, Egypt, Nigeria, Vietnam, India, Ukraine, and South Africa. This study aims to identify the best ways to implement and sustain high use of LDSS/N by understanding community preferences and program feasibility. It also seeks to assess the impact of LDSS/N on blood borne virus transmission risks such as HIV and Hepatitis C. The study includes multiple phases. Initially, focus group discussions (FGDs) with people who inject drugs will help select LDSS/N products based on their preferences. Then, a 6-week pilot distribution phase will allow participants to try these products alongside usual services at needle and syringe programs (NSPs). Afterward, a scaled-up distribution of selected LDSS/N products will occur while collecting routine program data and running an observational cohort study with approximately 240 participants per country (480 in Nigeria). Participants will undergo HIV and Hepatitis C testing and complete surveys at baseline, 6, 12, and 18 months. Additional FGDs and interviews with staff and stakeholders will explore program acceptability and feasibility. Participants will attend NSP sites or outreach services to access LDSS/N and answer questions about their use. Researchers will monitor LDSS/N uptake through routine data and cohort surveys. The primary outcome is how well the community-informed LDSS/N distribution increases LDSS/N use over 18 months. Mathematical modeling will estimate the public health impact and cost-effectiveness of scaling up LDSS/N distribution. The total participant involvement includes baseline and follow-up testing and surveys over an 18-month period, alongside qualitative feedback sessions.