Table 5 Use of harm reduction, drug treatment, HIV/HCV testing and treatment services and associated individual and structural level risk factors

Afghanistan

Todd, 2009 [53]

24% used drug treatment service (abstinence-based counselling, detoxification support through pharmacological intervention)

MV

Factors associated with attending a drug treatment service: using a new needle with each injection AOR 1.91 (95% CI 1.12–3.26); prior incarceration AOR 1.81 (95% CI 1.04–3.13)

Todd, 2011 [57]

53.8% using harm reduction services at time of enrollment

51.3% receiving needles/syringes from NSP

MV

Factors associated with use of needle-syringe programmes: initiated drug use with injecting AOR 2.58 (95%CI 1.22–5.44); shared injecting works in last 3 months AOR 1.79 (95% CI 1.16–2.77); prior incarceration AOR 1.57 (95%CI 1.06- 2.32); frequency of daily injection AOR 1.40 (95%CI 1.08–1.82); lived outside Afghanistan in the last 5 years AOR 0.61 (95%CI 0.41–0.91); perceived need for addiction treatment AOR 0.15 (95%CI 0.03–0.70)

Ruisenor-Escudero, 2015 [45]

54.2% retained in OST after 18 months

UV

Factors associated with retention in OST: being older (p = 0.01); being single (p < 0.01); reporting daily family contact in the past month (p < 0.01); older age at first heroin use (p = 0.01); fewer number of psychotic symptoms (p < 0.01)

Rasekh B, 2018 [43]

Completion of drug addiction treatment (psychological support, behavioural counselling and social support) (% completed n/a)

MV

Factor associated with treatment completion: previous history of drug addiction treatment AOR 2.46 (95%CI 1.14–5.30); attending motivational interviewing prior to hospitalization AOR 43.98 (95%CI 17.21–112.39); using heroin AOR 4.74 (95%CI 1.32–16.97)

Colombia

Borda, 2021 [38]

HIV—4.7%

HCV—22.8%

87.0%)

HIV testing:87%

HCV testing: 72.8%

HIV treatment: 75% (6/8)

HCV treatment:15.4% (6/39)

UV

Factors associated with not HIV testing: didn't know where to get a test (OR 5.68 95% CI 1.11–29.06, p 0.020)

Factors association with not HCV testing: I don't want to know results (OR 2.50, 95% CI 1.13–5.52, p 0.021); I don't know where to go for testing (OR 7.24, 95% CI 3.10–16.91, p < .0001); I don't like people at testing site (OR 3.76, 95%CI 1.08–13.18, p 0.028)

Factors associated with not accessing HIV medical treatment: don't have transportation to medical care (OR 0.23, 95% CI 0.05–0.99, p 0.034)

Factors associated with not accessing HCV medical treatment: treated poorly at a clinic in the past (OR 3.28, 95% CI 1.09–9.89, p 0.027); don't trust doctors (OR 3.04, 95% 1.01–9.17, p 0.041); "too administrative steps" (OR 2.60, 95% 1.25–5.42, p 0.009); "doctor's appointment is too far" (OR 3.96, 95% I 1.87–8.40, p < .0001)

Myanmar

Saw, 2013 [50]

77% ever tested for HIV (PWID); 46% ever tested for HIV (PWUD)

MV

Factors associated with HIV testing among PWID: being married AOR 0.24 (95% CI 0.06–0.94); injecting drugs at least twice daily AOR 0.30 (95% CI 0.09–0.97);.regular job AOR 4.50 (95% CI 1.08–23.17); receiving drug treatment AOR 13.07 (95% CI 3.38–50.53); self-perceiving as at risk of contracting HIV AOR 5.70 (95% CI 1.40–23.25); Shan AOR 0.30 (95%CI 0.11–0.84) or Kachin ethnicity AOR 0.30 (95%CI 0.10–0.87) compared to Burma ethnicity; reporting poly drug use within last 3 months (AOR 0.33 (95%CI 0.14–0.77); ever received drug treatment AOR 3.58 (95%CI 1.38–9.24); ever registered as a drug user AOR 4.38 (95%CI 1.31–14.65); self-perceiving as at risk of HIV infection AOR 4.46 (95%CI 2.06–9.65)

Saw, 2014 [47]

14.7% ever tested for HIV

MV

Factors associated with HIV testing: Female (compared to male) MA user AOR 27.02 (95%CI 11.44–63.83); having higher education AOR 3.96 (95%CI 1.20–13.02); currently living with one’s spouse/sexual partner AOR 3.92 (95%CI 1.06–14.56); being employed AOR 2.80 (95%CI 1.17–06.72); having ever visited NGO clinics or met NGO workers AOR 16.95 (95%CI 7.71–37.26); having ever been diagnosed with an STI AOR 4.83 (95%CI 2.31–10.13); having ever wanted to receive help to stop drug use AOR 4.96 (95%CI 2.23–11.05)

Aye, 2018 [30]

76% retention in OST at 6 months

90% HIV/HBV/HCV testing uptake

MV

Factors associated with non attendance at OST (loss to follow-up): using drugs for experimental reasons (AOR 2.0; 95%CI 1.3–3.0); administering drugs using routes other than intravenous (e.g. inhalation) AOR 2.3 (95% CI 1.1–4.6); history of needle sharing AOR 1.5 (95% CI 1.1–2.0)

Lum, 2020 [39]

HIV testing: 45% (2016; 85% (2018); HIV: 37% (2016); 38% (2018); and initiation onto ARV: 48% (11/23 in 2016); 19% (9/47 in 2018)

UV

Factors associated with ART initiation: only age measures, but no significant association

O’Keefe, 2018 [42]

19% insufficient coverage of NSP (defined as numbers of n/s syrige received divided by numbers of time injecting)

MV

Factors associated with insufficient coverage: Mandalay sites and Pyin Oo Lwin site (compared to the Yangon sites) AOR: 0.30 (95% CIs 0.11- 0.80), AOR 0.39 (95%CIs 0.18–0.87); acquiring sterile syringes from sources other than the DIC (e.g., pharmacies or shooting galleries) AOR 2.04 (95% Cis 1.08–3.82); re-use of own unsterile syringes AOR 5.19 (95%Cis 2.57–10.48)