S Chandrasekaran1, N T T Kyaw2, A D Harries3,4, I A Yee1, P Ellan1, T Kurusamy1, N Yusoff1, G Mburu5, W M Z W Mohammad6, A Suleiman7. 1. Malaysian AIDS Council, Kuala Lumpur, Malaysia. 2. International Union Against Tuberculosis and Lung Disease, Myanmar Country Office, Mandalay, Myanmar. 3. International Union Against Tuberculosis and Lung Disease, Paris, France. 4. London School of Hygiene & Tropical Medicine, London, UK. 5. Department of Health Research, Lancaster University, Lancaster, UK. 6. School of Medical Sciences, Universiti Sains Malaysia, Penang, Malaysia. 7. Ministry of Health Malaysia, Putrajaya, Malaysia.
Abstract
Setting: Needle and Syringe Exchange Programme (NSEP) implemented by non-governmental organisations in Malaysia. Objectives: To determine enrolment, characteristics and retention in the NSEP of people who inject drugs (PWID) between 2013 and 2015. Design: Retrospective cohort study. Results: There were 20 946 PWID, with a mean age of 38 years. The majority were male (98%) and of Malay ethnicity (92%). Follow-up data were available for 20 761 PWID. Annual retention of newly enrolled PWID for each year was respectively 85%, 87% and 78% for 2013, 2014 and 2015, although annual enrolment over these years declined from 10 724 to 6288 to 3749. Total person-years (py) of follow-up were 27 806, with loss to follow-up of 40 per 100 py. Cumulative probability of retention in NSEP was 66% at 12 months, 45% at 24 months and 26% at 36 months. Significantly higher loss to follow-up rates were observed in those aged 15-24 years or ⩾50 years, females, transgender people and non-Malay ethnic groups. Conclusion: Annual retention of new PWID on NSEP was impressive, although enrolment declined over the 3 years of the study and cumulative loss to follow-up was high. A better understanding of these programmatic outcomes is required.
Setting: Needle and Syringe Exchange Programme (NSEP) implemented by non-governmental organisations in Malaysia. Objectives: To determine enrolment, characteristics and retention in the NSEP of people who inject drugs (PWID) between 2013 and 2015. Design: Retrospective cohort study. Results: There were 20 946 PWID, with a mean age of 38 years. The majority were male (98%) and of Malay ethnicity (92%). Follow-up data were available for 20 761 PWID. Annual retention of newly enrolled PWID for each year was respectively 85%, 87% and 78% for 2013, 2014 and 2015, although annual enrolment over these years declined from 10 724 to 6288 to 3749. Total person-years (py) of follow-up were 27 806, with loss to follow-up of 40 per 100 py. Cumulative probability of retention in NSEP was 66% at 12 months, 45% at 24 months and 26% at 36 months. Significantly higher loss to follow-up rates were observed in those aged 15-24 years or ⩾50 years, females, transgender people and non-Malay ethnic groups. Conclusion: Annual retention of new PWID on NSEP was impressive, although enrolment declined over the 3 years of the study and cumulative loss to follow-up was high. A better understanding of these programmatic outcomes is required.
Entities:
Keywords:
SORT IT; harm reduction; loss to follow-up; operational research; risk factors
Authors: Louisa Degenhardt; Bradley M Mathers; Andrea L Wirtz; Daniel Wolfe; Adeeba Kamarulzaman; M Patrizia Carrieri; Steffanie A Strathdee; Kasia Malinowska-Sempruch; Michel Kazatchkine; Chris Beyrer Journal: Int J Drug Policy Date: 2013-09-04
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