Can counseling, links to services cut death rates in half among people with HIV who inject drugs?

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A study across three countries where HIV incidence is fueled by substance use found that a little support went a long way for people living with the virus and injecting drugs — helping them to stay on antiretroviral treatment and opioid substitution therapy, and keep their viral levels suppressed. The study, at health centers in Ukraine, Vietnam and Indonesia,  linked participants with either the standard interventions of referrals to HIV treatment and methadone clinics, as well as services for substance use treatment programs, syringe services and risk counseling as well as screening, testing and treatment for other infections, or all of that plus a  “systems navigator” to help them overcome hurdles to accessing the services as well as two brief counseling sessions.

Not only did those who received the additional guidance have increased adherence to both HIV and substance use treatment, but death rates were lower among both them, and partners with whom they injected drugs than among those who received only standard interventions. And while new HIV infections among the injecting partners of those assigned either set of interventions were few, they were entirely among those receiving only standard services, without the additional guidance.

The study, led by Dr. William C. Miller of Ohio State University and reported in the Sept. 1 Lancet was intended to set the stage for a larger study, exploring the range of benefits that might be gained from measures to help people living with HIV who inject drugs overcome obstacles they face accessing services.

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