Theme: Models of Care Year: 2021
Background: People who use drugs (PWUD) are highly affected by HIV infection, various comorbidities, and risks such as overdose. HIV and drug use have had a profound impact on the population of Mozambique. MSF collaborated with local stakeholders and the authorities to implement a community center and outreach program for PWUD in Maputo, with direct link with health facilities. Description of model of care/intervention: The complete package of harm reduction, recommended by WHO, was progressively implemented with a patient centered approach over 2 years. In the community center and outreach, different activities were implemented: harm reduction education, counselling and screening for HIV, viral hepatitis and tuberculosis, vaccination for HBV, condom distribution, prevention/treatment of STIs, needle and syringe program and naloxone distribution. Methadone treatment and HIV, viral hepatitis and tuberculosis treatment were implemented as a one-stop shop at the heath facility. Activities monitoring was set up in order to tailor the intervention. Effectiveness: Over 2 years, 2,200 PWUD, including 15% of people who inject drugs, were screened for HIV, viral hepatitis and tuberculosis. Since February 2020, 154 PWUD initiated methadone treatment, and from August, 60 people were trained to naloxone use. In 2020, more than 120,000 syringes were distributed and collected. The community, police and authorities were sensitized. The project has empowered many local collaborating partners and influenced the drafting of national harm reduction guidelines and drug policy. Conclusion and next steps: The project has demonstrated the feasibility of a full harm reduction package in low resource settings. Decentralization of the activities and collaboration with peer-workers were key to access the beneficiaries. We continue working on the barriers to care, especially engaging with female PWUD and the impact of law enforcement on syringe possession. This pilot built local evidence to support the Global Fund 2021-2023 grant application which will allow the scale-up in 3 more provinces. Disclosure of Interest Statement: See example below: MSF fund the pilot project in Maputo, Mozambique. For all the authors, no conflict of interest has been identified.
Download abstract Watch video