Identifying, linking, and treating people who inject drugs and were recently infected with HIV in the context of a network-based intervention

ABSTRACT

Identifying and linking people to care soon after HIV infection could limit viral transmission and protect their health. This work aims at describing the continuum of care among recently HIV-infected people who inject drugs (PWID) and participated in an intervention in the context of an HIV outbreak in Athens, Greece. The Transmission Reduction Intervention Project (TRIP) conducted risk network-based contact tracing and screened people for recent HIV infection. A comprehensive approach with a case management component that aimed to remove barriers to accessing care was adopted. Follow-up data on antiretroviral treatment (ART) and HIV-RNA levels were obtained from HIV clinics. TRIP enrolled 45 recently HIV-infected PWID (80% male) with a median viral load at recruitment of 5.43 log₁₀ copies/mL. Of the recently infected persons in TRIP, 87% were linked to care; of these, 77% started ART; and of those on ART, 89% achieved viral load <200 copies/mL. TRIP and its public health allies managed to get most of the recently HIV-infected PWID who were identified by the program into care and many of them onto ART. This resulted in very low HIV-RNA levels. Treatment as prevention can work if individuals are aided in overcoming difficulties in entry to, or attrition from care.

Trial registration: Uniform Trial Number identifier: NCT01827228.

KEYWORDS:

• Continuum of care
• treatment cascade
• recent HIV infection
• social network
• HIV
• outbreak

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

This intervention was financially supported by the United States (US) National Institute on Drug Abuse (NIDA) (DP1 DA034989). The Greek Organization against Drugs provided facilities for interviews and blood collection.