Evaluating a Low Dead-space Syringe and Needle Distribution Program for People Who Inject Drugs in Low- and Middle-income Countries

What This Trial Is About

Researchers are evaluating the implementation and impact of a distribution program for low dead-space syringes and needles LDSSN in multiple low- and middle-income countries including Armenia, Georgia, Tanzania, Egypt, Nigeria, Vietnam, India, Ukraine, and South Africa. The study aims to identify best practices for LDSSN distribution to improve acceptance and maintain high usage rates among people who inject drugs PWID. This observational research also explores community preferences and barriers related to LDSSN access and usage. The study involves three phases Phase 1 includes focus group discussions FGDs with PWID to present and discuss various LDSSN products and gather feedback to inform selection. Phase 2 consists of a 6-week pilot where participants can access selected LDSSN products alongside usual needle and syringe program NSP services, followed by a second round of FGDs to reflect on experiences. In Phase 3, a selection of LDSSN products will be made available at NSP sites, while routine programmatic data and a cohort study with 240 participants per country 480 in Nigeria collect information on LDSSN uptake, HIV and HCV testing, and behavioral surveys over 18 months. Participants will be involved in surveys, HIV and HCV antibody testing at baseline, 6, 12, and 18 months, and ongoing access to usual services and LDSSN products. Data collection also includes routine program data on needle use and focus groups to assess acceptability and impact. Key informant interviews will evaluate feasibility and effectiveness, while mathematical modeling will estimate public health impact and cost-effectiveness of scaling up LDSSN distribution among PWID. The primary outcome measures the effectiveness of the community-informed LDSSN distribution program on increasing uptake over 18 months.

Low Dead-space Injecting Equipment Distribution Program for People Who Inject Drugs in Low- and Middle-income Countries