DRIVE-TB

General Information

Full name: Towards tuberculosis elimination among people who inject drugs: evaluation of a community-based intervention in Vietnam

Donors:

National Agency for AIDS Research - Emergent Infectious Diseases (ANRS-MIE)
University Montpellier, France
New York University, USA

Period: 9/2023 - 2026

Location: Hai Phong city

Implementer: Coastal Region Office

According to data from the Vietnam National Tuberculosis Program in 2023, the estimated number of TB patients co-infected with HIV is around 4,300 people. The risk factors for TB recurrence and reinfection in HIV/TB co-infected patients include non-adherence to combined HIV treatment, poor medical care conditions, epidemiological factors, TB bacteria strains adapted to immunocompromised patients, etc. The likelihood of TB infection in people with HIV is 50%, which is 10 to 30 times higher than in non-infected individuals. Therefore, coordination between TB and HIV prevention and control efforts is crucial for the early detection and treatment of co-infected patients. It can extend their lifespan, improve their quality of life and reduce transmission to the community.

A major challenge in TB adherence treatment for PWID is the complex interaction between TB medications (including the 3HP regimen for latent TB) and methadone or other drugs. Side effects, withdrawal symptoms, and general discomfort often lead to treatment discontinuation. Methadone dosage adjustments, bound by strict medical regulations, are often not timely enough to manage acute symptoms, further complicating adherence

To advance the goal of Ending TB, SCDI is implementing the DRIVE TB project, which evaluates the efficacy of community-based interventions among people who inject drugs (PWID) in Hai Phong. Implementation of DRIVE TB is facilitated by the involvement of core members from CBOs who previously spearheaded the DRIVE-HIV (Drug use and infectious disease in Hai Phong) study project from 2016 to 2020. The CBOs experienced in working with PWID have enhanced their capacity in project operations and maintain a close partnership with SCDI.

The project conducts TB screening for people who inject drugs using the Respondent Driven Sampling (RDS) method, combined with latent TB using QFT and HIV testing. Patients with active/latent TB will be referred to healthcare facilities for treatment, combined with ARV, methadone, and mental health services referrals. Treatment adherence support is highlighted as one of the activities of 2024. The CBOs, with extensive experience in outreach and support, not only conducted screenings and counseling but also played a crucial role in treatment adherence support and facilitating referrals to health facilities. CBOs will closely follow up with clients, supporting and encouraging them to complete the TB treatment process. DRIVE TB is going on until 2025, aiming to reduce the risk of TB in the community of people who inject drugs toward the goal of ending TB by 2035.

2023 Key results

In 2023, 1179 people who inject drugs received free HIV testing and TB screening, and 40 patients with active tuberculosis and 91 individuals with latent tuberculosis were referred and supported for treatment adherence.

2024 Key results

In 2024, 1564 clients were screened and received counselling on TB-related information. Among them, 34 active TB cases were detected. Additionally, 194 individuals were invited for latent TB screening by QFT test, resulting in the identification of 39 latent TB cases

70 clients were supported undergoing active TB treatment, of whom 29 completed the full treatment course. For latent TB, 88 clients received adherence support, with 58 completing treatment and attending final follow-up visits.

DRIVE-TB also provided various social support services: 27 nutrition and supplement packages, 7 methadone treatment supports, 21 instances of medical cost assistance, 15 health insurance cards; facilitated psychiatric referrals and treatment for 7 clients.