Background:
In Kyrgyzstan, a country in Central Asia, injecting drug use is a key driver of HCV transmission. The estimated number of people who inject drugs (PWID) is 25,000 with 8,226 of them officially registered with the state drug addiction service. HCV prevalence among PWID is 65.2%. Opioid agonist therapy (OAT) has been available in Kyrgyzstan since 2002, as of January 2025 there were 716 OAT patients at 25 OAT sites countrywide. The prevalence of HCV among OAT patients is 39.0%.
Description of intervention:
In 2023, Kyrgyzstan started implementation of the cohort study within the Unitaid-funded Innovate, Involve, Inspire Project to introduce long-acting depot buprenorphine (LADB) for 100 PWID either switching from methadone or those from illicit opioids. Within the study, the patients will receive monthly LADB injections and followed up for 24 months. The aim of the study is to assess and describe barriers and facilitators for introducing LADB treatment within routine OAT services, including considerations of requirements for scale-up. Qualitative and quantitative data collection will take place at baseline, 3,6 and 12-month into LADB.
Effectiveness:
LADB will be introduced at 2 OAT sites in Bishkek. The study will measure patient outcomes over 48 weeks of follow-up among a cohort of PWID who initiate LADB as well as assess the values and preferences for LADB among PWID including facilitators and barriers to initiate and continue LADB.
Conclusion and next steps:
The country has already included LADB into National OAT Guidelines, LADB has been included into the National List of Essential Medicines, study protocol has been approved by both WHO and National Ethical Review Boards. First patients will be enrolled in April 2025 accompanied by baseline in-depth interviews and surveys and followed up for 24 months. |