Examining the impact of the first wave of COVID-19 and associated control measures on interventions to prevent blood-borne viruses among people who inject drugs in Scotland: an interrupted time series study

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Abstract

Background:
COVID-19 has likely affected the delivery of interventions to prevent blood-borne viruses (BBVs) among people who inject drugs (PWID). We examined the impact of the first wave of COVID-19 in Scotland on: 1) needle and syringe provision (NSP), 2) opioid agonist therapy (OAT) and 3) BBV testing.

Methods:
An interrupted time series study design; 23rd March 2020 (date of the first ‘lockdown’) was chosen as the key date.

Results:
The number of HIV tests and HCV tests in drug services/prisons, and the number of needles/syringes (N/S) distributed decreased by 94% (RR=0.062, 95% CI 0.041 to 0.094, p<0.001), 95% (RR=0.049, 95% CI 0.034 to 0.069, p<0.001) and 18% (RR=0.816, 95% CI 0.750 to 0.887, p<0.001), respectively, immediately after lockdown. Post-lockdown, an increasing trend was observed relating to the number of N/S distributed (0.6%; RR=1.006, 95% CI 1.001 to 1.012, p=0.015), HIV tests (12.1%; RR=1.121, 95% CI 1.092 to 1.152, p<0.001) and HCV tests (13.2%; RR=1.132, 95 CI 1.106 to 1.158, p<0.001). Trends relating to the total amount of methadone prescribed remained stable, but a decreasing trend in the number of prescriptions (2.4%; RR=0.976, 95% CI 0.959 to 0.993, p=0.006) and an increasing trend in the quantity prescribed per prescription (2.8%; RR=1.028, 95% CI 1.013 to 1.042, p<0.001) was observed post-lockdown.

Conclusions:
COVID-19 impacted the delivery of BBV prevention services for PWID in Scotland. While there is evidence of service recovery; further effort is likely required to return some intervention coverage to pre-pandemic levels in the context of subsequent waves of COVID-19.
Original languageEnglish
JournalDrug and Alcohol Dependence
Publication statusAccepted/In press - 9 Dec 2021

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