IMPACT report - SANANIM Prague; February 21,

Reporting until 8 February clients requested to participate from that – 426 females and 1032 males – 178 refused ImpAcT project before – 345 was not eligible for ImpAcT testing – 1122 was eligible for ImpAcT testing from that – 607 clients were tested on HIV / TB – 64 clients were retested In total HIV screening test and 671 clinical screening symptoms on TB

Reporting until 8 February clients in IMPACT were tested on HIV and clinical screening symptoms on TB 64 clients were retested 671 HIV screening test and 671 clinical screening symptoms on TB 0 HIV reactive rapid tests 38 clients referred to the clinic testing because of positive TB symptoms 11 clients underwent x-ray and other tests in the clinic centre – result nobody have TB

Information about the clients tested Socio-Demographics data 64% of tested clients are men (66% clients of contact centre are men) - men and women using testing and service equally Average age is 30,7 years (almost same as average client of contact centre) 93,2% tested clients were born in Czech Republic (same % in the group of all clients of contact centre) Just 8 clients were from risky post Soviet region other foreigners were Slovaks.

Information about the clients 44% live mostly in unstable accommodation in the last 12 months 43% have primary level of education, nobody claimed - never went to school/ never completed primary school, 1,6% higher education, the rest have secondary level of education 64% tested client are unemployed; just 13,9% of responses declare permanent employment 39% tested clients were in the prison

Information about the clients Drug anamnesis average age when the client started using drugs regularly is 17,9 average duration of regular drug use is 12.8 years Drug use: Combinations of drugs is very usual Outreach programme average age is 27,5 average duration of regular drug use is 8 years

Information about the clients Drugs used in last four weeks – heroin – 16,9% – pervitin – 77,5% – subutex – 49,6% – benzodiazepins – 24,5% – cannabis – 52,4 % – alcohol – 25,6% – Metadon – 8,6%

Information about the clients Injected used drugs in last four weeks: heroin – 15% subutex - 45,7% pervitin - 70,7% 90 % of clients tested so far have injected drugs in the last four weeks

Information about the clients Risky behaviour: 60,1% ever injected with a used syringe or needle from someone else - it is not corresponding to reality 45,1% ever shared spoon, filter and other items for application 5,7% tested clients had sex for money or drugs in the last 12 months. 16,5% respondent refused to answer

Information about the clients Testing: 18% were tested on HIV for the first time in ImpAcT – 109 clients average time since last HIV test is 3 years 44,2 % have never been tested on TB; 20,3% dont know

Project implementation Project is run in 3 facilities. Kontaktní centrum (Drop-in) Terénní programy (Outreach) CADAS (Substitution and Detox) Project management and coordination Every 14 days we have regular coordination meetings of whole project ImpAcT team Central office responsible for overal management and Project local manager responsible for implementation

Project implementation In every facility… one responsible person for ImpAcT. implementation Key workers responsible for data collection/entry combining the two roles (researcher and nurse or social worker) anamnestic data from the questionnaire used for pre and post test counselling reward (meal ticket) increase motivation of clients for testing - especially in case of retesting cooperation with two other low threshold drug services prohibition from the city (District Prague 2) to place the ambulance to another drug sites increase in the number of tests - from 50 to more than 100 per month

Failures low number of clients from risk regions (post Soviet, Vietnam) closed hard reached groups out of contact with services it should be extra project oriented just for reaching these groups 0 HIV and 0 TB positive clients – is it failure? Low number of clients recommended for TB confirmation reach the specialised unit

Successes increasing HIV provided test (2010 just 123 tests per a year, in Impact we predicted 950 tests) shortening periods between tests – before Impact average period between test was 3 years (more than 10% clients were retested, in the end of project will be higher percent) 109 clients were tested on HIV for the first time started cooperation with TB clinic and start to monitoring TB clinical symptoms parallel with impact we test also on HCV and syphilis - we found 232 HCV and 16 syphilis. we started to use user friendly on-line questionnaire – it makes data collection easier