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Reaching the 90–90–90 UNAIDS treatment target for people who inject drugs receiving integrated clinical care at a drug-use outpatient treatment facility

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Abstract

Background

People who inject drugs (PWID) experience more gaps at each stage of the HIV care continuum than others living with HIV. The study aimed to describe the effectiveness of an integrated care model to reach the UNAIDS 90–90–90 target.

Methods

This cross-sectional study included PWID who met the criteria for DSM-5 substance use disorder. They received a multidisciplinary comprehensive program, including medical HIV care, substance use treatment, and psychosocial support, at a drug-use treatment outpatient facility during 2019. The percentage of patients reaching the 90–90–90 UNAIDS target was the main study variable.

Results

Two hundred and twenty-one PWID were monitored at the facility during a median follow-up of 98 months (IQR: 61–143). Current HIV status was established in all PWID, of whom 84/221 (38.0%) tested HIV-positive. All the 84 patients (100%) received antiretroviral therapy, and 76(90.5%) had RNA HIV-1 < 20 copies/ml during a median of 74 months (IQR: 36–115). The UNAIDS goals were: 84/84 (100%) for the HIV testing, 84/84 (100%) for patients on antiretroviral therapy, and 76/84 (90.5%) for viral suppression.

Conclusions

Integrated clinical care provided at a drug-use treatment facility is a useful strategy to sustain a long-term HIV care continuum among PWID.

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Acknowledgements

Thanks to Stephanie Lonsdale for manuscript editing and editorial assistance.

Funding

Instituto de Salud Carlos III–FEDER-Red de Trastornos Adictivos UE-FEDER 2016 (RD16/0017/0010); AGAUR-Suport Grups de Recerca (2017 SGR530) and Acció instrumental d’Intensificació de Professionals de la Salut – Facultatius especialistes (PERIS: SLT006/17/00014).

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Authors and Affiliations

  1. Institut de Neuropsiquiatria i Addiccions—Hospital del Mar, Passeig Maritim 25-28, 08003, Barcelona, Spain

    G. Vallecillo, F. Fonseca, G. Marín, C. Castillo, F. Dinamarca & M. Torrens

  2. IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain

    G. Vallecillo, F. Fonseca, G. Marín, C. Castillo, F. Dinamarca, X. Durán & M. Torrens

  3. Departament of Psychiatry, Universitat Autònoma de Barcelona, Barcelona, Spain

    F. Fonseca & M. Torrens

Authors
  1. G. Vallecillo
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  2. F. Fonseca
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  3. G. Marín
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  4. C. Castillo
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  5. F. Dinamarca
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  6. X. Durán
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  7. M. Torrens
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Corresponding author

Correspondence to G. Vallecillo.

Ethics declarations

Ethical approval was obtained from the local ethics committee of the hospital (CEIC 2019/8779). All information collected from this study was kept strictly confidential. All study procedures were in accordance with the ethics committee standards.

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None of the authors declare any conflict of interest or has any financial disclosure.

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Vallecillo, G., Fonseca, F., Marín, G. et al. Reaching the 90–90–90 UNAIDS treatment target for people who inject drugs receiving integrated clinical care at a drug-use outpatient treatment facility. J Public Health (Berl.) 30, 481–486 (2022). https://doi.org/10.1007/s10389-020-01298-9

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  • DOI: https://doi.org/10.1007/s10389-020-01298-9

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