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I am Dr. Key populations include men who have sex with men, transgender women, female sex workers, and people who inject drugs PWID. Additionally, these groups are criminalized, marginalized, and face substantial stigma, sexual and physical violence, and discrimination from their communities — all of which limit their engagement with health services in many settings. As a result, these groups not only have higher risk of diseases, but also have poorer health outcomes compared to the general population. Since then, I decided to focus my research on understanding the gaps and challenges in health programming for these groups in Rwanda and across sub-Saharan Africa. I believe that lessons learned from this project will inform national and regional efforts to offer health and social services to PWID. Globally, about 15 million people report injection drug use IDU 1, 2. PWID also face significant social and economic challenges with high burden of homelessness or unstable housing and high incarceration rates 1. Given this high burden of disease and social challenges, the World Health Organization recommends that countries design and implement programs to address the unique needs of PWID. Rwanda does not have a national program to address the health and social needs of PWID. This is mainly due to a lack of epidemiological data and the criminalization of injection drug use which complicate health programming for PWID in the country. These data showed that PWID are at high risk of morbidity and mortality, and that there is an urgent need for implementation of evidence-based harm reduction strategies. The objective of this project is to design and implement the first harm reduction program in Kigali, Rwanda. First, given the high level of needle syringe sharing, needle reuse and other unsafe injection practices found in our study, we will design and implement a syringe services program SSP for PWID in Kigali. SSP programs are evidence-based interventions recommended by the World Health Organization for all countries 5. These programs provide sterile needles, syringes, and other drug paraphernalia to PWID and have been shown to be effective in reducing unsafe injection practices and injection frequency. Additionally, they facilitate linkage of PWID to overdose prevention, substance use treatment programs, and other medical services while being cost effective Second, given the high number of drug-related overdoses reported by participants, the program will also include an opioid-related overdose prevention program that will include naloxone distribution. IIE Centennial Fellowship.

Injection Drug use Practices and HIV infection among People Who Inject Drugs in Kigali, Rwanda

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Participants underwent a structured interview and HIV testing. The median age at first injection was 23 years IQR HIV prevalence was 9. PWID reporting sharing needles at least half the time in the previous six months had increased likelihood of HIV-infection, compared to those who did not aPR: 2. The high prevalence of needle reuse and sharing practices highlight significant risk for onward transmission and acquisition of HIV and hepatitis B and C. PWID-focused harm reduction services, including needle and syringe programs, safer injection education, naloxone distribution, and substance use disorder treatment programs, are needed in Rwanda. This study was internally funded by HDI resources. CB is supported in part by the Desmond M. Tutu Professorship at Johns Hopkins University. I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance. I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist s and other pertinent material as supplementary files, if applicable. Nneoma E. Audace Niyigena: audace. The data can be made available upon reasonable request. Requests for data utilization should be sent to Dr. View the discussion thread. Skip to main content. Baral , Aflodis Kagaba. Jean Olivier Twahirwa Rwema. Data Availability The data can be made available upon reasonable request. Back to top. Previous Next. Posted August 08, Download PDF. Thank you for your interest in spreading the word about medRxiv. NOTE: Your email address is requested solely to identify you as the sender of this article. Message Subject Your Name has forwarded a page to you from medRxiv. Message Body Your Name thought you would like to see this page from the medRxiv website. Your Personal Message. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Share This Article: Copy. Citation Tools. Subject Areas. All Articles. Addiction Medicine Allergy and Immunology Anesthesia Cardiovascular Medicine Dentistry and Oral Medicine Dermatology Emergency Medicine Endocrinology including Diabetes Mellitus and Metabolic Disease Epidemiology Forensic Medicine Gastroenterology Genetic and Genomic Medicine Geriatric Medicine Health Economics Health Informatics Health Policy Health Systems and Quality Improvement Hematology Intensive Care and Critical Care Medicine Medical Education Medical Ethics Nephrology Neurology Nursing Nutrition Obstetrics and Gynecology Occupational and Environmental Health Oncology Ophthalmology Orthopedics Otolaryngology Pain Medicine Palliative Medicine Pathology Pediatrics Pharmacology and Therapeutics Primary Care Research Psychiatry and Clinical Psychology Public and Global Health Radiology and Imaging Rehabilitation Medicine and Physical Therapy Respiratory Medicine Rheumatology Sexual and Reproductive Health Sports Medicine Surgery Toxicology Transplantation Urology

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