Ahead of World AIDS Day on 1 December, the EU drugs agency (EMCDDA) has released today a new toolkit offering countries the latest guidance on monitoring infectious diseases, such as HIV/AIDS and viral hepatitis (B,C), among people who inject drugs (PWID) (1). The toolkit is designed to help health professionals improve their monitoring practice in order to reduce the burden of disease in this vulnerable group and improve the coverage and quality of services delivered.
Prepared closely with experts, country representatives and international and EU agencies (2), the toolkit updates earlier guidance (3), and presents new monitoring methods and indicators in a more flexible and user-friendly format. It is currently composed of three modules:
- Module 1: Behavioural indicators — Behavioural and sociodemographic information is crucial to the monitoring of infectious diseases. This is because the transmission of viruses such as HIV and hepatitis B and C among PWID strongly depends on risk behaviours (e.g. needle sharing, unprotected sex) and socioeconomic, policy and other environmental factors (e.g. marginalisation, contact with services). The aim of this module is to propose a set of PWID-specific indicators that allow comparable, reliable and policy-relevant data to be collected on behavioural and sociodemographic aspects of blood-borne infections in this group in Europe. These indicators would complement existing biological monitoring and cover risk and protective behaviours, testing and service uptake.
- Module 2: Example questionnaire — The questionnaire presented in this module will help standardise the epidemiological measures used in the surveillance of behavioural and other drug-related infectious disease indicators. It provides detailed sample questions to be used in interviews in care centres or community settings and is designed to be applied in national or local studies.
- Module 3: Methods of bio-behavioural surveys — This module provides guidance on how to implement and use biological and behavioural studies conducted among PWID as a tool in routine surveillance at country and European level. It provides an overview of methods and existing resources for monitoring through repeated studies in this group. Among the issues discussed are the most recent methods to harmonise second generation surveillance of PWIDs in Europe (4).
Preventing and controlling infectious diseases among PWID has been the focus of a series of EMCDDA–ECDC meetings held this autumn (5). The two agencies have also worked together on an updated joint risk assessment on HIV (6) and guidance on the Prevention and control of infectious diseases among people who inject drugs (2011)(7).
(1) More on the three-module toolkit and on World AIDS Day.
(2) Including: European Centre for Disease Prevention and Control (ECDC); UNAIDS; World Health Organization (WHO).
(3) EMCDDA (2006), ‘Protocol for the implementation of the EMCDDA key indicator drug-related infectious diseases (DRID)’, draft version 6 October 2006, EMCDDA, Lisbon).
(4) Second generation surveillance for HIV/AIDS is defined as ‘the regular, systematic collection, analysis and interpretation of information for use in tracking and describing changes in the HIV/AIDS epidemic over time.’
(5) EMCDDA DRID–DRD meeting, 16–18 October, Lisbon; EMCDDA meeting for candidate and potential candidate countries to the EU, 29–30 October, Sarajevo; ECDC–EMCDDA meeting for experts from Bulgaria, Greece, Hungary, Romania, Finland and Sweden, 18–19 November, Bucharest; EMCDDA–ECDC meeting for experts from Belgium, Estonia, Latvia, Lithuania and Poland, 21–22 November, Tallinn.
(6) Eurosurveillance rapid communication.
(7) HIV in injecting drug users in the EU/EEA, following a reported increase of cases in Greece and Romania
ECDC and EMCDDA guidance. Prevention and control of infectious diseases among people who inject drugs