Unitaid – Global Health Campus

This study aims to generate evidence on best practice approaches for implementing LDSS/N distribution programs that enhance acceptability and sustain high levels of LDSS/N uptake (effectiveness) among people who inject drugs. Data generated will also be used in mathematical modelling to estimate the impact and cost-effectiveness of scaling up LDSS/N for people who inject drugs at a country-level. This evidence will inform national and WHO guidance and recommendations on LDSS/N distribution in Ukraine.

1. Explore community values and preferences for LDSS/N in the context of other harm reduction supplies available to PWID.

2. Identify barriers and facilitators to access and uptake of LDSS/N among PWID.

3. Design and implement an LDSS/N distribution program informed by community values and preferences.

4. Evaluate the feasibility and effectiveness of this LDSS/N distribution program on increasing LDSS uptake (primary outcome) by:

 a. Measuring patterns of LDSS/N uptake;

 b. Identifying the enablers and challenges affecting the supply chain for LDSS/N;

 c. Documenting the legal, social and regulatory enablers and challenges affecting the successful introduction and maintenance of LDSS/N distribution;

 d. Evaluating demand creation approaches.

5. Estimate the effectiveness of this LDSS/N distribution program by measuring the difference in BBV (HCV/HIV) incidence between those who exclusively use LDSS/N and those who do not (secondary outcome).

6. Model the potential public health impact (HIV and HCV infections averted) and cost-effectiveness of LDSS/N distribution for PWID within harm reduction settings.