Three infections, one fight: An implementation study protocol
Introduction
Saskatchewan is experiencing a public health crisis due to high rates of HIV, syphilis, and hepatitis C virus (HCV) infections, mainly affecting people who use drugs. Injection drug use significantly drives these overlapping epidemics, worsened by structural barriers like stigma, poverty, and a lack of culturally safe healthcare.
Urgent, innovative, and community-informed solutions are required to enhance prevention efforts, testing availability, and linkage to care services.
Methods and Analysis
This study will introduce a rapid assessment and response system in Regina, Saskatchewan, Canada. It will combine geospatial mapping of needle distribution hotspots with targeted pop-up intervention events.
Needle hotspot maps will direct community-based pop-up events that provide point-of-care testing for HIV, syphilis, and HCV. These events will also offer education on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).
Study Design
A convergent participatory mixed-methods approach will evaluate the intervention's feasibility, acceptability, and effectiveness, following the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.
- Quantitative data will measure changes in participants’ knowledge about PrEP and PEP, satisfaction with the interventions, new diagnoses, and demographics.
- Qualitative substudy will involve 30 participants to explore experiences, obstacles to care, and views on service delivery.
"Innovative, community-informed approaches are urgently needed to improve prevention, testing and linkage to care."
Author's summary: This study aims to reduce HIV, syphilis, and hepatitis C in Regina by mapping needle use hotspots and delivering targeted testing and education through community pop-up events.
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