A Novel Contingency Management Intervention in the Context of a Syndemic of Drug-Related Harms in Glasgow: First Year of the ‘WAND’ Initiative

Author: John Campbell Kirsten Trayner Andrew McAuley Julie Craik Carole Hunter Saket Priyadarshi Shanley Smith Sharon Hutchinson

Theme: Epidemiology & Public Health Research Year: 2022

To address the high levels of drug-related harms among people who inject drugs (PWID) in Glasgow,
a novel contingency management intervention was developed to engage high-risk PWID with a
package of harm reduction measures (referred to as the WAND initiative: Wound care, Assessment
of injecting, Naloxone, and Dried blood-spot test). PWID are encouraged to re-engage every threemonths, and receive a £20 cash-voucher for each engagement. Our aims were to assess if WAND
engaged and re-engaged a high-risk group of PWID, and enabled short-term behaviour change
among those who had re-engaged within the first year of implementation.
Baseline injecting risk data of WAND participants from 1st Sept-2020 to 30th Aug-2021 were
compared to PWID recruited through the Needle Exchange Surveillance Initiative (NESI) survey in
Glasgow during 2019-20. Among individuals who took part in the first six months of WAND, the
extent of re-engagement was determined and, among those who re-engaged, intervention coverage
compared between baseline and final engagement.
831 people engaged in WAND; 78% were male and 52% aged 40+ years. Compared to NESI
participants, those in WAND reported a higher prevalence of cocaine injecting (WAND: 65%; NESI:
56%), benzodiazepine use (WAND: 62%; NESI: 54%), a recent overdose (WAND: 34%; NESI: 23%) and
skin and soft tissue infection (SSTI) (WAND: 53%; NESI: 20%). Among those who first engaged in
WAND during Sept 2020-Feb 2021 (n=546), 40% re-engaged by Aug-2021. Among those who reengaged (n=215), reporting a BBV test in the last six months increased from 60% to 87%. In addition,
naloxone carriage on the day of interview increased from 22% to 32%.
During the pandemic, WAND was able to engage a large number of high-risk PWID, and re-engage a
substantial minority, within a relatively short period. Initial findings suggest that WAND may help
promote short-term behaviour change.
Disclosure of Interest Statement:
SJ Hutchinson received Honoria from Gilead; all remaining authors have nothing to disclose.

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