Malaysian AIDS Council publishes needle and syringe programme study
25 July 2017
Malaysian AIDS Council (MAC) has published the nation’s first study on enrolment and retention of people who inject drugs in needle and syringe exchange programmes (NSEP) implemented by non-governmental organisations (NGOs).
Injecting drug use counts for a third of new HIV infections outside of sub-Saharan Africa. With Asia particularly affected, HIV prevalence is recorded at between 20-28% among people who inject drugs (PWID) in this region. In Malaysia, injecting drug use is a main driver of the HIV epidemic.
Needle and syringe exchange programmes are one of many harm reduction interventions that are an effective HIV prevention method for this key population. In Malaysia, the non-governmental NSEP is implemented through an outreach programme, whereby former drug users act as peer workers with current drug users, distributing clean needles and syringes in exchange for used ones, and providing information on safe injecting practices, safer sex and HIV.
The study looked at 20,946 PWID who were enrolled in the NSEP between 2013-2015, finding that retention at the end of the year of enrolment was an impressive 85%, 87% and 78% respectively. Cumulative probability of retention was 66% at 12 months, 45% at 24 months and 26% at 36 months. However, there was an annual decline in enrolment of about 40% year-on-year.
Some possible explanations were noted as to why enrolment rates declined, including country-wide saturation of the programme, a reduction in risk-taking behaviour in this key population, being referred to methadone maintenance therapy (MMT), stopping injecting use, incarceration or leaving the area.
Gathering data like this is an important first step in ensuring the NSEP is fit for purpose. However, more research is needed to conclude the reasons for these programmatic outcomes.