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Open Access Enrolment and retention of people who inject drugs in the Needle & Syringe Exchange Programme in Malaysia

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Setting: Needle and Syringe Exchange Programme (NSEP) implemented by non-governmental organisations in Malaysia.

Objectives: To determine enrolment, characteristics and retention in the NSEP of people who inject drugs (PWID) between 2013 and 2015.

Design: Retrospective cohort study.

Results: There were 20 946 PWID, with a mean age of 38 years. The majority were male (98%) and of Malay ethnicity (92%). Follow-up data were available for 20 761 PWID. Annual retention of newly enrolled PWID for each year was respectively 85%, 87% and 78% for 2013, 2014 and 2015, although annual enrolment over these years declined from 10 724 to 6288 to 3749. Total person-years (py) of follow-up were 27 806, with loss to follow-up of 40 per 100 py. Cumulative probability of retention in NSEP was 66% at 12 months, 45% at 24 months and 26% at 36 months. Significantly higher loss to follow-up rates were observed in those aged 15–24 years or 50 years, females, transgender people and non-Malay ethnic groups.

Conclusion: Annual retention of new PWID on NSEP was impressive, although enrolment declined over the 3 years of the study and cumulative loss to follow-up was high. A better understanding of these programmatic outcomes is required.
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Keywords: SORT IT; harm reduction; loss to follow-up; operational research; risk factors

Document Type: Research Article

Affiliations: 1: Malaysian AIDS Council, Kuala Lumpur, Malaysia 2: International Union Against Tuberculosis and Lung Disease, Myanmar Country Office, Mandalay, Myanmar 3: International Union Against Tuberculosis and Lung Disease, Paris, France, London School of Hygiene & Tropical Medicine, London, UK 4: Department of Health Research, Lancaster University, Lancaster, UK 5: School of Medical Sciences, Universiti Sains Malaysia, Penang, Malaysia 6: Ministry of Health Malaysia, Putrajaya, Malaysia

Publication date: June 21, 2017

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  • Public Health Action (PHA), The Union's quarterly open access on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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