#117 FACTORS ASSOCIATED WITH LOW RATES OF ENGAGEMENT IN OPIOID SUBSTITUTION TREATMENT AMONG PEOPLE WHO USE DRUGS IN ATHENS


Author: Kalamitsis G, Sypsa V, Galinaki S, Roussos S, Hatzakis A, Malliori M

Theme: Social Science & Policy Research Year: 2019

Background: In 2016, the estimated population size of high-risk people who use drugs (PWUD)
in Greece was 17,067, of whom over 50% were in Athens. This population experienced an HIV
outbreak during 2011-2013 (HIV prevalence: 16.5%) and HCV prevalence is high (85%). Opioid
substitution treatment (OST) is an evidence-based intervention that can reduce the risk of
HCV/HIV transmission. Aim of this analysis is to assess the factors associated with engaging in
OST in a sample of PWUD reached in the centre of Athens.
Methods: In 2018, a study was implemented in the centre of Athens to elucidate the
anthropogeography of PWUD. Semi-structured interviews were conducted by assigned streetwork team members, who approached individuals in open drug scenes in Athens. To be
eligible, a participant should have been ≥18 years old, with use of psychoactive substances
during the previous week. Participants provided written informed consent form and
participation was anonymous. Multiple logistic regression was used to identify factors
associated with engagement in OST and odds ratios (OR) and 95% confidence intervals (95%
CI) were estimated.
Results: In a period of 3 weeks, 200 PWUD participated; their mean (SD) age was 37.5 (9.4),
79.9% were men and 32.8% reported country of origin other than Greece (mainly from East
Europe, North Africa/Middle East, Balkans). Overall, 45.5% were currently homeless while
56.1% used to stay/sleep out during the nights. Intravenous use was reported from 45% of
participants while 63.5% reported heroin as the main substance used. Only 24.8% reported
being engaged in OST. The factors that were associated with OST engagement were
nationality (OR(95% CI) Greek vs. Other: 5.15 (1.66, 16.01), p-value=0.005) and homelessness
(OR(95% CI) No vs. Yes: 3.17 (1.37, 7.33), p-value=0.007)(adjusted for age and gender).
Conclusion: A large proportion of active PWUD in the centre of Athens are not engaged in OST
with homeless and migrants being a particularly underserved population.
Disclosure of Interest: none

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