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Type of submission: Oral
Conference track: Research
Topics: Key Populations and Harm Reduction
Presenting author: Sarah Larney
Sarah Larney, Louisa Degenhardt, Amy Peacock, Janni Leung, Matt Hickman, Jason Grebely, Evan Cunningham, Samantha Colledge, Peter Vickerman, Michael Lynskey
Background: Key and neglected populations among people who inject drugs include young people, women, sex workers, and men who have sex with men. These populations may experience heightened stigma and may be at particular risk for blood borne viral infections. There is little epidemiological data about key and neglected populations within the broader population of people who inject drugs. As part of a global systematic review of injecting drug use, we aimed to characterise populations who inject drugs in terms of age, sex and risk exposures.
Methods: We systematically reviewed data on injecting drug use and people who inject drugs. Data sources included peer-reviewed literature; reports from government, intergovernmental organisations, non-government organisations, and other institutions; and databases held by United Nations and other agencies. Studies published from 2008 onwards were included, and there were no restrictions on language of publication.
Results: Data were extracted from over 1,100 documents. There is considerable variation globally in the age profiles of people who inject drugs, with young people making up a greater proportion of people who inject drugs in low- and middle-income countries (LMIC) compared to high-income countries (HIC). Women comprise up to one-third of people who inject drugs in HIC, but typically a much smaller proportion in LMIC. In countries where there are few women who inject drugs, they may be excluded from studies of people who inject drugs, preventing assessment of risk and harm. Injecting and sexual risk exposures are often assessed among people who inject drugs, but there is enormous inconsistency in how these are measured. Data on injecting and sexual risk are often not disaggregated by sex or other characteristics, making it difficult to identify key populations at particular risk of harm.
Conclusion: Key and neglected populations are often poorly characterised in studies of people who inject drugs. This interferes with efforts to provide targeted harm reduction interventions that take into account their particular needs. Standardisation of data collection and targeted sampling would help to increase global data on key and neglected populations of people who inject drugs.