In Kazakhstan, only one-third of the 19,000 HIV-positive people who inject drugs in needle syringe programs are linked to HIV care. Scaling up integrated, cost-efficient HIV services for this community is sorely needed.
SIG's BRIDGE study* aims to fill this gap and evaluate the implementation, effectiveness, and sustainability of an integrated HIV service model in 24 needle syringe programs located in four Kazakhstani cities. The seven-day training to implement this study within these programs just launched.
How can the BRIDGE model help this community?
The power of peer influence cannot be understated. The BRIDGE model leverages this power though peer-driven recruitment of people who inject drugs in needle syringe programs using social network strategies. Further, BRIDGE integrates rapid HIV testing within the needle syringe programs (with harm reduction clinic nurses), and links these individuals to HIV care.**
Findings will have important public health implications and support the WHO 90-90-90 goals for improving HIV service delivery for people who inject drugs in the Central Asian region and other countries with injection driven epidemics.
The BRIDGE Implementation Strategy
The BRIDGE study team is testing an implementation strategy which includes the 7-day training on the BRIDGE program protocols for each needle syringe provider in the month prior to roll-out in their study site.
Each program will be provided with intervention manuals and all necessary materials for conducting the intervention. The strategy also includes follow-up coaching and supervision provided by the needle syringe program nurse and by an AIDS center supervisor.
Finally, the strategy includes a community of practice to encourage shared problem-solving and sustainability.
Learn more about the BRIDGE Program
The BRIDGE program was developed using an integration of three components: (1) a Social Network Strategy (SNS), a peer-driven recruitment approach, which has demonstrated effectiveness in reaching hidden and hard to reach populations of unknown HIV status and successfully linking them to HIV testing; (2) HIV Counseling, Testing, and Referral (CTR), adhering to WHO and CDC guidelines for confidential, HIV Rapid Testing conducted by AIDS center nurses and accompanying confirmatory test; and (3) ARTAS, an evidence-based case-management intervention to link recently-diagnosed HIV-positive persons to care and retain them in care. By combining these three-evidence based interventions into a single program, BRIDGE presents a streamlined approach to identifying, testing and linking HIV-positive PWID to care.
* Using a stepped wedge and mixed methods, Hybrid Type 1 design.
**Using the ARTAS (Anti-Retroviral Treatment and Access to Services) case management model.