|Titre :||Infections among people who injected drugs in the UK, 2018. An update, December 2019|
|Titre de série :||Shooting Up|
|Auteurs :||Public Health England ; Health Protection Scotland ; Public Health Wales ; Public Health Agency Northern Ireland|
|Type de document :||Rapport|
|Editeur :||London : Public Health England, 2019|
|Format :||52 p.|
|Discipline :||MAL (Maladies infectieuses / Infectious diseases)|
Thésaurus TOXIBASEINJECTION ; ACTIVITE SEXUELLE ; USAGER ; INFECTION ; BACTERIE ; VIRUS ; HEPATITE ; VIH ; FACTEUR DE RISQUE ; PARTAGE DE SERINGUE ; TYPE D'USAGE ; DROGUES DE SYNTHESE ; VACCINATION ; EVOLUTION ; COCAINE ; CRACK ; INTERVENTION
* Preventable bacterial infections are increasing.
Over half of people who inject drugs (PWID) report having a recent symptom of a bacterial infection. Severe bacterial infections in PWID have been increasing since 2013/14. The cause of the rise is not clear and there are likely to be several factors involved, including an ageing population of PWID with poorer vein and skin health, changes in injection practices with a rise in groin injection in recent years, and a large proportion of PWID reporting homelessness, and likely conditions of poorer general hygiene and unsterile injecting.
* There is early evidence for a reduction in chronic hepatitis C prevalence, however rates of new infection are unchanged.
Hepatitis C (HCV) continues to be a major problem among PWID in the UK, with around 1 in every 4 currently infected with HCV. There is early evidence for a modest reduction in chronic hepatitis C prevalence concomitant with the scale-up of direct acting antiviral (DAA) treatment among PWID. [...]
* HIV levels remain low, but risks continue.
In the UK, around 1 in 100 PWID are living with HIV. Although the prevalence of HIV remains low, outbreaks of HIV among people who inject drugs continue to occur, notably the ongoing incident in Glasgow. Most PWID living with HIV have been diagnosed and are accessing HIV care. However, HIV is often diagnosed at a late stage among PWID. It is crucial that HIV testing is offered regularly, and that care pathways for HIV are maintained and adapt to changing patterns of risk.
* Hepatitis B vaccine uptake needs to be sustained, particularly in younger age groups.
* Continued sharing and re-use of injecting equipment remains a concern.
Sharing levels reported in England, Wales and Northern Ireland have not improved in recent years and only around 3 in 5 PWID reported adequate needle/syringe provision for their needs. Re-use of an individual's own injecting equipment is commonly reported in the UK and can also put individuals at risk of infection.
* Changes in psychoactive drug preferences could lead to riskier injecting practices.
The changing patterns of psychoactive drug use remain a concern because changes in psychoactive drug preferences can lead to riskier injecting practices such as increased frequency of injecting, sharing equipment, or groin injecting. Injection of crack cocaine has increased in England and Wales, and injection of powder cocaine has increased in Scotland.
* Provision of effective interventions need to be maintained and optimised.
The provision of effective harm reduction interventions to reduce risk and prevent and treat infections needs to be maintained and optimised. These interventions include NSP, OST and other treatments for drug misuse and dependence. Vaccinations and diagnostic tests for infections need to be routinely and regularly offered to people who inject or have previously injected drugs. Care pathways and treatments should be optimised for those testing positive for blood borne viruses.
|Domaine :||Drogues illicites / Illicit drugs|
|Refs biblio. :||114|
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