Screening, diagnosis and treatment of infectious diseases with at-risk populations: 20 years of data from a harm reduction program managed by Ares do Pinhal in Lisbon
Infectious diseases are a leading cause of death and disability in some vulnerable populations, such as drug users and the homeless. Harm reduction programs undertake a significant effort to screen, diagnose and treat these burdensome conditions. In the Mobile Outreach Program (MOP) managed by Ares do Pinhal in Lisbon (Portugal) since the beginning of the millennium, infectious diseases were always a priority.
Increasing the number of screenings and diagnosis -namely for TB, HIV, HBV, and HCV-, patient education for harm reduction concerning infectious diseases and drug use (to prevent new infections/reinfections), as well as fighting stigma and myths about treatment, and patient referral, remain a priority within the program. Also, concomitant management at the MOP of a methadone substitution program and treatment for infectious diseases, based on a direct observation treatment (DOT), characterize the program. The present data are based on the medical charts available at the program between 2001 and 2021.
The MOP managed around 8 323 individuals during the study period. Overall, 22 297 X-Rays were performed in 7 531 screened patients for TB. Results showed 361 TB+ results over these 20 years. For HIV, 28 660 screenings were performed, with an average incidence of 2,2% and a prevalence of 21% during these 20 years. Also, 28 566 AcHCV screenings were performed, with an incidence rate of 2.7%, and a 20-year prevalence of 65.9%. Lastly, for AgHbs, 28 544 were performed with an average prevalence of 4%.
These results highlight the importance of the MOP managed by Ares do Pinhal in the screening and subsequent referral of patients with infectious diseases since 2001. Although the current pandemic rose challenges to the MOP operation, efforts must be done to ensure that screening is quickly reintroduced in pre-pandemic levels.