Three Infections, One Fight: Implementation Study Protocol
Introduction
Saskatchewan is confronting a public health crisis with high rates of HIV, syphilis, and hepatitis C virus (HCV) infections, especially among people who use drugs. Injection drug use significantly drives these overlapping epidemics, worsened by factors such as stigma, poverty, and limited access to culturally safe healthcare. There is an urgent need for innovative, community-driven strategies to enhance prevention, testing, and care linkage.
Methods and Analysis
This study will deploy a rapid assessment and response system in Regina, Saskatchewan, Canada, combining geospatial mapping of needle distribution with targeted pop-up interventions. Maps identifying needle hotspots will inform the rollout of community pop-up events offering point-of-care testing for HIV, syphilis, and HCV. These events will also provide education on pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP).
A convergent participatory mixed-methods design will evaluate the intervention’s feasibility, acceptability, and effectiveness, guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.
- Quantitative data will track changes in knowledge regarding PrEP and PEP, participant satisfaction, new diagnoses, and demographic characteristics.
- A qualitative substudy including 30 participants will explore experiences with the intervention, barriers to accessing care, and perceptions of service delivery.
This approach integrates geospatial data with community events to target prevention and testing efforts more effectively.
Author's summary: This study introduces a novel, community-centered method linking geospatial needle mapping with pop-up testing to improve prevention and care for HIV, syphilis, and HCV in Regina.