Three infections, one fight: an implementation study protocol
Introduction
Saskatchewan is experiencing a public health crisis marked by high rates of HIV, syphilis, and hepatitis C virus (HCV) infections, primarily affecting people who use drugs. Injection drug use significantly contributes to these overlapping epidemics, worsened by structural challenges like stigma, poverty, and limited access to culturally safe healthcare. Urgent, innovative community-driven strategies are needed to enhance prevention, testing, and care linkage.
Methods and analysis
This study will establish a rapid assessment and response system in Regina, Saskatchewan, Canada, combining geospatial mapping of needle distribution in the community with pop-up intervention events.
- Needle hotspot maps will guide community-based pop-up events offering point-of-care testing for HIV, syphilis, and HCV.
- These events will provide education on pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP).
- A convergent participatory mixed-methods design will evaluate the intervention's feasibility, acceptability, and effectiveness following the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.
- Quantitative data will measure changes in knowledge about PrEP and PEP, participant satisfaction, new diagnoses, and demographics.
- A qualitative substudy with 30 participants will explore experiences with the intervention, barriers to care, and perceptions of service delivery.
“This study will integrate geospatial mapping with community interventions to improve access to testing and prevention services for HIV, syphilis, and HCV among people who inject drugs.”
Author’s summary: This protocol outlines a community-led approach using needle mapping and pop-up clinics to tackle HIV, syphilis, and hepatitis C in Regina, focusing on engagement and reducing health barriers for drug users.