Grenfell, Pippa; Baptista Leite, Ricardo; Garfein, Richard; de Lussigny, Smiljka; Platt, Lucy; Rhodes, Tim; (2013) Tuberculosis, injecting drug use and integrated HIV-TB care: a review of the literature. Drug and alcohol dependence, 129 (3). pp. 180-209. ISSN 0376-8716 DOI: https://doi.org/10.1016/j.drugalcdep.2012.11.013
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Abstract
BACKGROUND: People who inject drugs (PWID) are at increased risk of tuberculosis (TB) and reduced retention in treatment. There is a need to document strategies for integrated delivery of HIV, TB and drug dependency care. METHODS: This article reviews the literature on rates of TB mono- and co-infection, and published and grey literature descriptions of TB and HIV-TB care, among PWID. RESULTS: Latent TB infection prevalence was high and active disease more common among HIV-positive PWID. Data on multidrug-resistant TB and co-infections among PWID were scarce. Models of TB care fell into six categories: screening and prevention within HIV-risk studies; prevention at TB clinics; screening and prevention within needle-and-syringe-exchange (NSP) and drug treatment programmes; pharmacy-based TB treatment; TB service-led care with harm reduction/drug treatment programmes; and TB treatment within drug treatment programmes. Co-location with NSP and opioid substitution therapy (OST), combined with incentives, consistently improved screening and prevention uptake. Small-scale combined TB treatment and OST achieved good adherence in diverse settings. Successful interventions involved collaboration across services; a client-centred approach; and provision of social care. No peer-reviewed studies described models of integrated HIV-TB care for PWID but grey literature highlighted key components: co-located services, provision of drug treatment, multidisciplinary staff training; and remaining barriers: staffing inefficiencies, inadequate funding, police interference, and limited OST availability. CONCLUSIONS: Integration with drug treatment improves PWID engagement in TB services but there is a need to document approaches to HIV-TB care, improve surveillance of TB and co-infections among PWID, and advocate for improved OST availability.
Item Type | Article |
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Faculty and Department | Faculty of Public Health and Policy > Public Health, Environments and Society |
Research Centre | Centre for Maternal, Reproductive and Child Health (MARCH) |
PubMed ID | 23306095 |
ISI | 318754700002 |
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Filename: Grenfell et al 2013_JDAD_Author Accepted Manuscript.pdf
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