Overview

These guidelines aim to provide a strategic approach to reducing morbidity and mortality related to TB and HIV among at-risk drug users and their communities in a way that promotes holistic and person-centered services. They are intended for professionals dealing with the drug users who have the most problematic patterns of use and who have the greatest risk of HIV and TB, especially those who inject drugs.

Contents

• STEERING GROUP
• GUIDELINE GROUP
• ABBREVIATIONS
• EXECUTIVE SUMMARY
• PURPOSE
  • Aim
  • Target population
  • Target audience
• INTRODUCTION
  • Population of interest
  • Injecting behaviour
  • Services for drug users
  • TB strategy
• METHODS
  • Steering Group
  • Scoping
  • Guideline Group
  • Guiding principles
  • Evidence retrieval, assessment and summarizing
  • Development of the recommendations
  • Peer review
  • Stakeholder consultation
  • Layout of the guidelines
• EPIDEMIOLOGY
  • Drug use
  • Injecting drug use
  • HIV epidemic in drug users
  • TB in drug users
  • Gender and drug use
  • Prisons
• JOINT PLANNING
  • Background
  • Key issues
  • Summary of findings
• KEY INTERVENTIONS
  • Preventing TB transmission by controlling infection
  • Intensified case-finding for TB and testing for HIV
  • Summary of findings
  • Treatment
  • Preventing TB through isoniazid preventive therapy
  • Preventing HIV
• OVERCOMING BARRIERS
  • Models of service delivery
  • Prisons and other places of detention
  • Adherence
  • Common types of comorbidity
• WEB LINKS TO POLICIES, GUIDELINES AND MANUALS
• REFERENCES
• ANNEX 1 DEFINITIONS OF DRUG USE ACCORDING TO THE 10^TH REVISION OF THE INTERNATIONAL CLASSIFICATION OF DISEASES
• ANNEX 2 METHODS
• ANNEX 3 RESEARCH QUESTIONS IDENTIFIED TO STRENGTHEN THE EVIDENCE FOR THE UPDATE OF THESE GUIDELINES
• ANNEX 4 INFECTION CONTROL ACTIONS
• ANNEX 5 STAKEHOLDER CONSULTATION
• POLICY BRIEF

The World Health Organization (WHO) developed these guidelines in collaboration with the United Nations Office on Drugs and Crime (UNODC) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) and in consultation with a group of technical experts. Igor Toskin and Alasdair Reid prepared the initial scoping and first draft. Kathrin Thomas, Christian Gunneberg and Annette Verster finalised the guidelines.

WHO will review whether the recommendations in these guidelines need to be updated by 2012 at the latest and will publish the conclusions of the review.

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.

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