Theme: Epidemiology & Public Health Research Year: 2024
Background: People who inject drugs (PWID) in Thessaloniki, Greece’s second-largest city, constitute a vulnerable population impacted by a recent HIV outbreak (2020-2021) and high mortality during 2019-2022. Official data regarding the PWID population size are unavailable. This study aims to be the first to estimate the number of PWID in Thessaloniki and to assess the coverage of needle and syringe programs (NSP).
Methods: The “ALEXANDROS” program was a community-based intervention implemented in 2019-2021 to increase diagnosis and treatment for infectious diseases among PWID. Through five rounds of Respondent-Driven Sampling, 1,100 unique PWID were recruited; 75.9% and 53.7% reported injecting in the past 12 months and past 30 days, respectively. PWID could participate in multiple rounds and a unique code was used to identify participants among rounds. Capture-Recapture with log-linear models was employed on the data from the multiple rounds (sources) to estimate the population size of those who injected in the past 12 months and past 30 days.
Results: The estimated number of PWID who injected in the past 30 days and in the past 12 months was 823 (95%CI: 790–855) and 1,525 (95% CI: 1,337–1,712), respectively. Based on these two estimates and the number of syringes distributed in Thessaloniki in 2020 (12,000) and 2021 (increased to 58,000 due to the HIV outbreak), NSP coverage was 8-15 and 38-71 syringes/PWID/year in 2020 and 2021, respectively.
Conclusion:
This study provides the first estimation of the PWID population size in Thessaloniki, Greece, during a period with an emerging HIV outbreak and high mortality. Our findings indicate the need for such estimates to provide as accurate as possible denominators for NSP coverage and, thus, guide harm reduction efforts. The estimated coverage falls short of recommended levels, highlighting the need for expanded access to NSP in Thessaloniki.