Feasibility of Interventions on People Who Inject Drugs in Vietnam

Study Overview
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Brief Summary
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This study aims at assessing the feasibility of implementing an interventional cohort of people who inject drugs in Haiphong, Viet Nam. For this purpose, the investigators will conduct a RDS survey to i) assess the current situation of drug use behaviour, HIV and Hepatitis C Virus (HCV) infection in the study population and ii) recruit participants for the longitudinal phase. The latter will consist of enroling the most difficult to reach People Who Inject Drugs (PWID) (those not followed by health centers), including early injectors, Men who have Sex with Men (MSM) and female sex workers (FSW) and following them up for 6 months in order to estimate the follow-up rate and preliminary estimates of HIV and HCV incidence.

Detailed Description
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Objectives: The primary objective of the DRIVE-IN project is to evaluate the feasibility of implementing an interventional cohort of PWID in Haiphong. Such a cohort (DRIVE) will be instrumental in demonstrating the efficacy of a community-involved intervention integrating prevention and care in order to reduce HIV and HCV transmission among PWID in Haiphong. The main expected result of DRIVE-IN is to demonstrate that enrolment and follow-up of various hard-to-reach subgroups of PWID is feasible in the local context. These feasibility objectives will be evaluated using a set of relevant indicators. Design: The research will first include a respondent-driven sampling (RDS) survey, including a maximum of 600 PWID. Then 250 RDS participants (i.e about a quarter of the future DRIVE cohort) will be selected for a longitudinal study, with an enrolment and 3 follow-up visits at week 4, 12 and 24. In parallel, four qualitative studies will be implemented: one study to explore how to reach the hardest-to-reach and most-at-risk PWID, one feed-back study on PWID feeling about their participation in the research, one study investigating the reasons of drop-outs, and a final study on the research process itself. Endpoints: The RDS will describe the target population and the patterns of drug use. The feasibility of implementing an interventional cohort will be evaluated on several indicators: International multi-disciplinary research network is operational Completion of recruitment within the time frame Follow-up rate >80% at 24 weeks Implementation and increased access to peer-led interventions Establishment of a data management center Improved laboratory capacities for research Documented support of local and national authorities Study population RDS survey Inclusion criteria Age > 18 years Self-reported drug injector confirmed by a positive urinary test and either skin marks of injection or knowledge of injecting procedures Signed informed consent Non-inclusion criteria Unable of understanding informed consent and answering questionnaires Longitudinal study Inclusion criteria Having participated to the RDS survey Signed informed consent specific to the longitudinal study Non-inclusion criteria Ongoing Methadone Maintenance Therapy (MMT) Ongoing antiretroviral therapy Health status not compatible with study follow-up Have a plan to move out of Haiphong over the next two years. Have been sentenced recently to a prison term Follow-up and study visits contents: Participants of the longitudinal phase will be followed at week 4, 12 and 24 (final visit). During the RDS, face-to-face questionnaires will be applied on drug use, sexual health, and referral to care and repeated at each follow-up visit, along with the record of medical events. In addition, a urinary test will be collected at the RDS to assess the range of recent drugs used, and repeated at the final follow-up visit (week 24). Finally, at the RDS and final visit, HIV, HCV, Hepatitis B Virus (HBV) serology will be done along with appropriate counselling. Sample size: 603 PWID will be enrolled in the RDS survey 250 RDS participants will be enroled in the longitudinal phase, including: 140 PWID for > 2 years, including females 50 recent injectors (< 2 years from first injection) 30 FSW who inject drugs 30 MSM who inject drugs

Official Title
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Feasibility of an Interventional Project to Reduce HIV Incidence Among People Who Inject Drugs in Haiphong, Viet Nam

Conditions
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HIV, Hepatitis Virus, Substance Abuse

Intervention / Treatment
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* Other: no intervention is assessed


Participation Criteria
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Eligibility Criteria
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Inclusion criteria Being more than 18 years of age Being drug injector confirmed by a positive urine drug test with knowledge of injecting procedures Having signed the informed consent form For the Longitudinal study - having participated in the RDS survey Exclusion criteria Unable to understand informed consent and how to answer a questionnaire For the longitudinal study - being under methadone maintenance therapy and antiretroviral treatment Having a health condition not compatible with study follow-up Plan to move away from Haiphong in the next 2 years Serving a sentence in prison

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: no intervention is assessed|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Cohort Participants Attending the Last Follow-up Visit at W52 | Number of participants who were followed up and not lost to follow-up after enrolment into cohort. | 52 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HCV Seroconversion | Number of new HCV infection among HCV negative (at RDS) cohort participants over 1 year period | 52 weeks | 
| HIV Seroconversion | Number of new HIV infection among HIV negative (at RDS) cohort participants over 1 year period. | 52 weeks | 
| Incidence of HCV Infection | The HCV incidence was calculated by 100person/year | 52 weeks | 
| HIV Incidence | HIV incidence was calculated by 100person/year. With zero conversion, we choose 2.5% unilateral confidence interval. | 52 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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People who inject drugs, Vietnam, Community support groups