Expanding Medication-Assisted Therapies in Central Asia
Trial Parameters
Brief Summary
Central Asia (CA) represents the most rapidly growing HIV epidemic region worldwide, concentrated in people who inject drugs (PWID) and their sexual partners, and scaling up opioid agonist therapies (OAT) in this region is the most cost-effective strategy to prevent new HIV infections, and more effective when combined with antiretroviral therapy (ART). The investigators propose to use the Network for the Improvement of Addiction Treatment (NIATx) implementation strategy to scale-up OAT in three diverse Central Asian countries (Kazakhstan, Kyrgyzstan, Tajikistan) and guided by the Exploration-Planning-Implementation-Sustainment (EPIS) framework. Understanding the trajectories of implementation and scale-up in this context may emerge through creating communities of practice, especially when cohesion and competence evolves, and may guide other healthcare delivery challenges in the region (e.g., HIV, TB); as well as build important regional expertise and understanding implementation trajectories should help support OAT program sustainability.
Eligibility Criteria
Inclusion Criteria: i. Aim 1: The inclusion criteria for Aim 1 Consists of: 1. Quantitative surveys for PWID 1. 18 years or older 2. Meeting DSM-V criteria for opioid dependence 3. Be either treatment naïve and seeking OAT or be on OAT for \< 90 days 2. Organizational Assessments for OAT Delivery Staff 1. 18 years or older 2. Currently working as an OAT delivery professional at an OAT delivery site 3. Focus Groups (PWID on OAT) 1. 18 years or older 2. Meeting DSM-V criteria for opioid dependence 3. Be either treatment naïve and seeking OAT or be on OAT for \< 90 days 4. Focus Groups (PWID not on OAT) 1. 18 years or older 2. Meeting Diagnostic and Statistical Manual of Mental Disorders(DSM)-V criteria for opioid dependence 3. Be OAT naïve (defined as never having been on OAT or having not received treatment for \> 1 year) 5. Focus Groups (OAT delivery staff) 1. 18 years or older 2. Currently working as an OAT delivery professional at an OAT delivery site ii. Aim 2: The inclusion criteri