Cent Eur J Public Health 2009, 17(4):191-197 | DOI: 10.21101/cejph.a3562

Select Barriers to Harm-reduction Services for IDUs in Eastern Europe

Nadja Kehler Curth¹, Liv Nanna Hansson¹, Frederikke Storm¹, Jeffrey V. Lazarus^1,2

¹ Department of Public Health, Copenhagen University, Denmark

² Copenhagen School of Global Health, Copenhagen University, Denmark

Background: In eastern Europe, the high prevalence rates of HIV and the hepatitis C virus (HCV) are concentrated among injecting drug users (IDUs). Harm reduction programmes such as needle and syringe programmes and opioid substitution therapy (OST) have been shown to be effective in preventing these infections. However, structural barriers can limit their effectiveness by hindering access.

Methods: Through use of a semi-structured online survey sent to 65 professionals in the region, this study explores the prevalences of age restrictions, user fees or a lack of confidentiality for these programmes as well as HIV/HCV testing programmes.

Results: Twenty respondents reported that age restrictions were not widespread in the 11 reporting countries, apart from for OST. User fees were found to be very common in HCV testing and varied for other services. It was stated to be common to inform parents of young IDUs who receive HIV services, but not to inform public authorities when IDUs enter harm reduction programmes.

Conclusion: Where access to services is limited or confidentiality is compromised, as reported in this pilot study, it is crucial that health-care guidelines and national legislation are reformed to ensure access to these evidence-based interventions.

Keywords: harm reduction, health policy, hepatitis, HIV, eastern Europe, central Asia

Received: May 5, 2009; Revised: June 23, 2009; Accepted: June 23, 2009; Published: December 1, 2009  Show citation