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Background:
PWID estimated number in Kyrgyzstan is 25,000. HIV prevalence among PWID – 16.2%, Hepatitis C – 62.2%. Due to lack of funds, stigma and discrimination, PWID cannot receive treatment.
With support of UNITAID, FrontlainAids and Alliance for Public Health, a model of community-based HCV diagnostics and treatment is introduced in the form of WHO and local Ethics Committee approved operational study. 2,200 PWID will receive treatment on the basis of NGOs. Study results will allow scaling-up the community-based treatment model.
Description of care/intervention model:
1.Legislation was revised and included the possibility of community-based HCV testing, diagnostics and treatment.
2.Treatment services require conditions for providing services and obtaining medical license, which was fulfilled.
3.NGOs conduct HCV express-tests among PWID and refer them to us for diagnostics and treatment.
4.Innovativeness of the model is that PWID may undergo diagnostics and start treatment in three visits. We confirm HCV (PCR), companion diagnostics (hepatitis B, HIV, pregnancy, fibrosis degree etc.) and PWID receive drugs. In case of HIV, HBV and other diseases, patients referred to relevant organizations.
Effectiveness:
8000 PWID will be tested for hepatitis C, 2,200 people will be treated. HCV prevalence among PWID will be reduced twice. PWID note that they prefer this model because of reduced number of visits and expenses, no queues and stigma.
Conclusion and subsequent steps:
The model allows extending coverage of HCV PWID treatment, provide services with low costs and exclude discrimination. The model can be scaled-up to other countries and used for treating HIV, STDs.
We will present an algorithm of how communities are integrated into healthcare system, obtain permission documents, provide diagnostics and treatment means logistics. Using WHO recommendations and national protocols, we will explain the arrangement of drug users simplified inclusion process into treatment. By the moment of the conference holding, results of community-based treatment and effectiveness will be available.
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