The main objective of this study is to show that People Who Inject Drugs (PWID) suffering initially from a major depressive disorder, a psychotic disorder and/or had a suicide risk and who received a community-based psychiatric intervention improve sustainably their mental health and are comparable after intervention to a population of PWID free of these disorders in terms of: * HIV/HCV exposure * Severity of substance use * Quality of life This is prospective one-year cohort study comparing 200 PWID diagnosed with a psychiatric disorder with 400 controls (200 PWID living with HIV and 200 PWID non-infected with HIV, both free of a diagnosis of depression, psychosis, suicidal risk at cohort initiation). Psychiatric intervention includes free psychiatric consultations and medications (issued on CBO sites), support from CBO members for appointments, information, treatment adherence, contact with families and tracing of those lost to follow-up. Target population and controls will also be proposed linkage to care (HIV, methadone) and harm reduction services.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
567
intervention will take place in CBO offices instead of mental health department, medication will be given freely and psychiatric consultations will be free. Trained CBO members will provide individual and collective support including recall of appointments and tracing of those lost to follow-up, information on mental health, main psychiatric disorders, psychiatric medication, their potential side effects and expected benefits, contact with families and continuous support
Mental Health Department
Haiphong, Hai Phong, Vietnam
Viral exposure score
Sum of the answers to several HIV/Hepatitis-C Virus (HCV)-related risk behaviors questions, weighed according to the significance of the risk (timeframe: last 6 months). Score range from 1 to 15. A higher score means a higher viral exposure
Time frame: Month 12
Severity of substance use score
Percentage of participants meeting at least one of the following criteria: persistent (last 6 months) injection practice (yes/no), daily heroin use (last 30 days), regular methamphetamine use (\> 4 times/last 30 days), alcohol misuse (defined with audit-c questionnaire with score \> 3 in men and \> 2 in women during last 6 months). Score ranges from 1 to 4. Higher score means a higher severity of suubstance use. Each criteria will also be assessed individually.
Time frame: Month 12
Quality of life score
5 items and self-rated health evaluation of the EuroQol-5D Scale (Q5D-5L)
Time frame: Month 12
Percentage of compliant participant :effectiveness of HIV treatment
HIV viral load among PWID living with HIV
Time frame: Month 12
Percentage of participant facing difficulty to access to care
Combination of quantitative and qualitative approaches will allow to quantify and describe structural or clinical factors conditioning access to care and which can explain the observed lack of therapeutics effectiveness in the population of the study.
Time frame: Month 12
Ppercentage of Psychiatric disorder associated with methamphetamine (meth) use
Incidence of methamphetamine-induced psychotic disorder, as measured by a clinical evaluation at each visit (using a MINI questionnaire plus clinical evaluation for confirmation)
Time frame: Month 12
HIV/HCV incidence
Comparaison of the incidence in the 2 arms
Time frame: Month 12
Incidence of psychiatric disorders in the control groups
Asessment for depression, psychosis and suicide risk at M0, M6 and M12 visits
Time frame: Month 12
Cost of a specialized community-based psychiatric intervention
Micro-costing analysis
Time frame: Month 12
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