Implementation of an educational intervention for safer injection in the European context: preliminary results from the EUROSIDER project
Objective: The Eurosider project is a transferability study to implement in 4 European countries an individually-tailored support and education for safer injection (ITSESI) for people who inject drugs. This community-based intervention has already been has shown its effectiveness in reducing HIV-HCV risk practices in France. INSERM (France), AIDES (France), Correlation Network (Hollande) take in charge the coordination. Praksis (Greece), ARAS (Romania), IHF (Bulgaria) and GAT (Portugal) implement the project on the field. The project will last for 24 months.
Methods: The project uses mixed methods and implementation science. It will start with a first exploratory step using quantitative data of each local context chosen for the implementation of the ITSESI intervention and some qualitative interviews with key informers. The second phase will consist in implementing and evaluating this community-based educational intervention, starting with a training process in the selected contexts. For the evaluation phase, this study will enrol 300 PWID (75 per harm reduction centre or per country) seeking support for their injection practices and to provide them with the intervention. They will be interviewed using a face-to-face questionnaire at baseline (M0) and at 6 months (M6). This evaluation will also use a qualitative study conducted in each site using focus group and semi-structured interviews with participants to investigate their experience, perception and possible difficulties related to this educational intervention.
Results: From the context assessment, the results showed that financing HR activities for people who inject drugs (PWID), especially the sustainability of Needle Syringes Exchange Program (NSP), has emerged as a determining factor for the feasibility of the implementation of ITSESI as well as the National Drug Policy. The training phase was carried out by AIDES (training of trainers) Based on this session and the production of a training manual, these partners were able to train their fieldworkers in their own country. The tools and methods of the training are contributing to guide the next steps with the observation of injection’s practice and the educational session. The implementation of the intervention has started in the partner countries and will be evaluated after 6 months with an intervention group and a control group. These results should be available in October 2019.
Discussion: The results will show the effectiveness of the intervention on HIV-HCV risk practices and other complications among PWID and analyze the transferability of this harm reduction tool. It also demonstrates that ITSESI implementation in different contexts needs to gather material, technical skills and advocacy to ensure a favorable environment.