Evidence map›Paper›PMID 37046029›Full record

SynthesisAIDS and behavior2023

The Impact of Needle and Syringe Exchange Programs on HIV-Related Risk Behaviors in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis Examining Individual- Versus Community-Level Effects.

Ping Teresa Yeh, Xuhao Yang, Caitlin E Kennedy, Kevin A Armstrong, Virginia A Fonner, Sherryn, Kevin R O'Reilly, Michael D Sweat

Open access · greenAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in AIDS and behavior, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Ping Teresa Yeh *Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA. teresa.yeh@jhu.edu.ORCID http://orcid.org/0000-0002-7425-0382
Xuhao Yang *Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
Caitlin E KennedyDepartment of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
Kevin A ArmstrongDivision of Global and Community Health, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
Virginia A FonnerDivision of Global and Community Health, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
SherrynDepartment of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
Kevin R O'ReillyDivision of Global and Community Health, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
Michael D SweatDivision of Global and Community Health, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
Johns Hopkins University · USMedical University of South Carolina · USFamily Health International 360 · US

Funding

Synthesizing HIV Behavioral Intervention Effectiveness in Developing CountriesR01MH090173 · NIMH · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI SWEAT, MICHAEL D · 2010 to 2019
$4.2M
The Evidence Project: Systematic Reviews of Critical HIV Interventions, and Disruption in HIV Services from COVID-19 in LMICR01MH125798 · NIMH · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI SWEAT, MICHAEL D · 2021 to 2025
$2.3M
HIV Intervention Effectiveness in Developing CountriesR01MH071204 · NIMH · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI SWEAT, MICHAEL D · 2004 to 2007
$1.2M
NIMH NIH HHS R01 MH071204NIMH NIH HHS R01MH071204NIMH NIH HHS R01 MH090173NIMH NIH HHS R01MH090173NIMH NIH HHS R01 MH125798NIMH NIH HHS R01MH125798
6 · The paper itself

Abstract

We conducted a systematic review and meta-analysis of the impact of needle and syringe exchange programs (NSP) on both individual- and community-level needle-sharing behaviors and other HIV-related outcomes in low- and middle-income countries (LMIC). A search of five databases for peer-reviewed trial or quasi-experimental studies reported through July 2021 identified 42 interventions delivered in 35 studies, with a total of 56,751 participants meeting inclusion criteria. Random-effects meta-analysis showed a significant protective association between NSP exposure and needle-sharing behaviors at the individual-level (odds ratio [OR] = 0.25, 95% confidence interval [CI] = 0.16-0.39, 8 trials, n = 3947) and community-level (OR 0.39, CI 0.22-0.69, 12 trials, n = 6850), although with significant heterogeneity. When stratified by needle-sharing directionality, NSP exposure remained associated with reduced receptive sharing, but not distributive sharing. NSP exposure was also associated with reduced HIV incidence and increased HIV testing but there were no consistent associations with prevalence of bloodborne infections. Current evidence suggests positive impacts of NSPs in LMICs.

Indexed as

HIV InfectionsSubstance Abuse, IntravenousDeveloping CountriesHumansNeedle-Exchange ProgramsRisk-TakingHIV preventionMeta-analysisNeedle/syringe exchange program (NSP)People who inject drugs (PWID)Systematic review

Identifiers

PMID37046029
PMCPMC10524190
OpenAlexW4365138595

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.