Abstract
Reaching hard-to-reach and high-risk injecting drug users (IDUs) is one of the most important challenges for contemporary needle syringe programs (NSPs). The aim of this review is to examine, based upon the available international experience, the effectiveness of syringe vending machines and mobile van/bus based NSPs in making services more accessible to these hard-to-reach and high-risk groups of IDUs. A literature search revealed 40 papers/reports, of which 18 were on dispensing machines (including vending and exchange machines) and 22 on mobile vans. The findings demonstrate that syringe dispensing machines and mobile vans are promising modalities of NSPs, which can make services more accessible to the target group and in particular to the harder-to-reach and higher-risk groups of IDUs. Their anonymous and confidential approaches make services attractive, accessible and acceptable to these groups. These two outlets were found to be complementary to each other and to other modes of NSPs. Services through dispensing machines and mobile vans in strategically important sites are crucial elements in continuing efforts in reducing the spread of HIV and other blood borne viruses among IDUs.
Highlights
HIV transmission associated with sharing of contaminated injecting equipment is a global problem, with more than 110 countries having reported HIV transmission in this context [1]
The aim of this review is to examine the available evidence for the effectiveness of syringe dispensing machines and mobile van or bus based needle syringe programs (NSPs) in making services accessible to hard-to-reach and high-risk groups of injecting drug users (IDUs)
Conference presentations and proceedings, evaluation reports, and other relevant organizational reports relating to supply of sterile injecting equipment through dispensing machines and/or mobile vans were identified by a comprehensive search of electronic databases such as Medline, Medscape, Current Contents, HealthSTAR, CAB Abstracts, Aidsline, Sociological Abstracts and CINAHL
Summary
HIV transmission associated with sharing of contaminated injecting equipment is a global problem, with more than 110 countries having reported HIV transmission in this context [1]. World Health Organisation (WHO) estimates approximately 10% of all new HIV infections globally can be attributed to the sharing of contaminated injecting equipment [2]. In many parts of the world injecting drug users (IDUs) comprise a far higher proportion of new HIV infections, for example 72% of new HIV infections in Ukraine [3]. An injecting drug user infected with HIV can cause a cascade of new infections in other individuals, through sharing of contaminated injecting equipment and through sexual and perinatal transmission. Having experienced the limited outcomes of efforts to significantly eliminate supply and demand for illicit drugs by law enforcement, and in the face of rising prevalence of HIV and other blood-borne viruses, there has been a growing urgency to implement more effective prevention responses to prevent transmission of blood-borne viruses among IDUs. authorities have adopted a more (page number not for citation purposes)
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