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Peer-delivered HIV testing and counseling among people who inject drugs in Bangkok, Thailand

Peer-delivered HIV testing and counseling among people who inject drugs in Bangkok, Thailand. Lianping Ti 1 Kanna Hayashi 1,2 Karyn Kaplan 3 Paisan Suwannawong 3 Evan Wood 1,4 Julio Montaner 1,4 Thomas Kerr 1,4

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Peer-delivered HIV testing and counseling among people who inject drugs in Bangkok, Thailand

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  1. Peer-delivered HIV testing and counseling among people who inject drugs in Bangkok, Thailand Lianping Ti 1 Kanna Hayashi 1,2 Karyn Kaplan 3 PaisanSuwannawong3 Evan Wood 1,4 Julio Montaner1,4 Thomas Kerr 1,4 1British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, BC, Canada 2Interdisciplinary Graduate Studies Program, University of British Columbia, Vancouver, BC, Canada 3Thai AIDS Treatment Action Group, Bangkok, Thailand 4Department of Medicine, University of British Columbia, Vancouver, BC, Canada

  2. HIV EPIDEMIC IN THAILAND Source: MOPH Thailand

  3. HIV TESTING • Reduce HIV-related morbidity and mortality • May minimize high-risk behaviour • Provide linkages to HIV treatment and care services Wood et al. (2006). Impact of HIV testing on uptake of HIV therapy among antiretroviral naïve HIV-infected injection drug users. Drug and Alcohol Review, 25, 451-454.

  4. BARRIERS TO HIV TESTING IN THAILAND • Uptake of HIV testing <20% among IDU in Asia-Pacific • 2003 “War on Drugs” campaign • Fear of HIV-positive test result • Stigma and discrimination • Breaches of patient confidentiality

  5. OBJECTIVES • Seek – Test – Treat - Retain • Explore acceptability of novel methods of testing and counselling (VCT)

  6. MITSAMPAN COMMUNITY RESEARCH PROJECT • A collaborative research effort involving: • Peer researchers involved in all stages of the project • Former/active drug users trained as peer researchers • Interviewers • Outreach workers • Three completed cycles to date (2008, 2009, 2011)

  7. MITSAMPAN HARM REDUCTION CENTER (MSHRC) Photo by Rico Gustav

  8. METHODS • Recruited IDU through peer outreach and word-of-mouth • Completed interviewer-administered questionnaire • Eligibility criteria: • Injection drug use in the previous six months • Reside in Bangkok or adjacent provinces • Informed consent • Data collected in 2011 • Restricted sample to HIV-negative IDU or IDU of unknown HIV serostatus

  9. RESULTS

  10. RESULTS AOR: adjusted odds ratio, CI: confidence interval, MSHRC: Mitsampan Harm Reduction Center *Activities in the previous six months

  11. RESULTS AOR: adjusted odds ratio, CI: confidence interval, MSHRC: Mitsampan Harm Reduction Center *Activities in the previous six months

  12. DISCUSSION • Substantial proportion willing to get peer-delivered VCT at a drug user-run drop-in centre • Peer-delivered VCT could reach key groups who may be missed through traditional public health methods • IDU who were previously incarcerated • IDU engaged in high intensity drug use • Need for HIV prevention education efforts for IDU • Increase awareness of HIV risks and transmission • Target IDU with lower education and those who avoid HIV tests

  13. CONCLUSION • Current HIV testing approaches in Thailand are limited • Need for ongoing HIV prevention education efforts • Potential of novel approaches to VCT for IDU Photo by BC-CfE

  14. ACKNOWLEDGEMENTS • MSCRPparticipants • MSHRC, TTAG, & O-Zone House staff and volunteers • Chulalongkorn University: Dr. NiyadaKitaying-Angsulee • BC-CfE staff: Tricia Collingham, Deborah Graham, Caitlin Johnston, Calvin Lai, Peter Vann • MSCRP staff: PrempreedaPramoj Na Ayutthaya, ArphatsapornChaimongkon, SattaraHattirat

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