ArticleAddiction science & clinical practice2024
"Take services to the people": strategies to optimize uptake of PrEP and harm reduction services among people who inject drugs in Uganda.
Article in Addiction science & clinical practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 7 citations in OpenAlex.
- "[I]t will be like a full course meal": healthcare worker perspectives on strategies to optimize integration of PrEP into medication for opioid use disorder and needle and syringe exchange programs for people who use drugs in Kampala, Uganda.Addiction science & clinical practice · 2026Article
- Feasibility, Acceptability, and Preliminary Efficacy of a Pilot Study To Integrate Buprenorphine into a Harm-reduction Drop-in-Center in Kampala, Uganda.AIDS and behavior · 2026Article
- Awareness of drug supply changes and uptake of fentanyl testing services among people who use drugs in Kampala, Uganda.Drug and alcohol dependence · 2025Article
- Advancing pre-exposure prophylaxis (PrEP) implementation for people who use drugs: an introduction to and lessons from the special series.Addiction science & clinical practice · 2025Article
- The effect of sexual orientation, gender identity, and marital intention on HIV prevention outcomes among MSM students in Southeast China.Scientific reports · 2025Article
- Identifying barriers and coping strategies for pre-exposure prophylaxis disclosure: experiences of Ugandan adolescent girls engaged in transactional sex-a qualitative study.Frontiers in global women's health · 2025Article
- Characterising people who inject drugs, and association with HIV infection: A situation analysis in Kampala City, Uganda.PLOS global public health · 2025Article
Corrections and comments
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Authors and funding
16 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundPeople who inject drugs (PWID) are at increased risk of HIV acquisition and often encounter barriers to accessing healthcare services. Uganda has high HIV prevalence among PWID and lacks integrated pre-exposure prophylaxis (PrEP) and harm reduction services. Understanding PWID experiences accessing and using harm reduction services and PrEP will inform strategies to optimize integration that align with PWID needs and priorities.
methodsBetween May 2021 and March 2023, we conducted semi-structured interviews with PWID in Kampala, Uganda. We recruited participants with and without previous experience accessing harm reduction services and/or PrEP using purposive and snowball sampling. Interviews were audio recorded, translated, and transcribed. We used thematic analysis to characterize motivations for uptake of harm reduction and HIV prevention services, and strategies to optimize delivery of needle and syringe programs (NSP), medications for opioid use disorder (MOUD), and PrEP.
resultsWe conducted interviews with 41 PWID. Most participants were relatively aware of their personal HIV risk and accurately identified situations that increased risk, including sharing needles and engaging in transactional sex. Despite risk awareness, participants described engaging in known HIV risk behaviors to satisfy immediate drug use needs. All reported knowledge of harm reduction services, especially distribution of sterile needles and syringes, and many reported having experience with MOUD. Participants who had accessed MOUD followed two primary trajectories; limited resources and relationships with other PWID caused them to discontinue treatment while desire to regain something they believed was lost to their drug use motivated them to continue. Overall, PrEP knowledge among participants was limited and few reported ever taking PrEP. However, participants supported integrating PrEP into harm reduction service delivery and advocated for changes in how these services are accessed. Stigma experienced in healthcare facilities and challenges acquiring money for transportation presented barriers to accessing current facility-based harm reduction and HIV prevention services.
conclusionsMeeting the HIV prevention needs of PWID in Uganda will require lowering barriers to access, including integrated delivery of PrEP and harm reduction services and bringing services directly to communities. Additional training in providing patient-centered care for healthcare providers may improve uptake of facility-based services.
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