Coverage of opioid substitution therapy

Export Indicator

Percentage of people who inject drugs receiving opioid substitution therapy
What it measures

A programme’s ability to deliver opioid substitution therapy among people who inject drugs as a method of directly reducing injecting frequency. The target coverage is 50%.

Rationale

Opioid substitution therapy represents a commitment to treat opioid dependence and reduce the frequency of injecting, preferably to zero. It is the most effective, evidence-based public health tool for reducing use among the people who inject opioids. Opioid substitution therapy provides crucial support for treating other health conditions, including HIV, tuberculosis and viral hepatitis.

Numerator

Number of people who inject drugs and are receiving opioid substitution therapy at a specified date

Denominator

Number of opioid-dependent people who inject drugs in the country

Calculation

Numerator/denominator

Method of measurement

For the numerator: Programme records: for example, opioid substitution therapy registries.

For the denominator: Size estimation of opioid dependent people: users or injectors.

Measurement frequency

Annual

Disaggregation
  • Gender (male, female and transgender).
  • Age (<25 and 25+ years).
  • Type of provider (public services, key population-led organization, NGOs, or other entities). Please see page 33 for additional guidance.
  • Name of the organization/s. Please indicate the name and URL/website (if available) of the key population-led organization, NGOs, or other entities that are providing these services.
  • Cities and other administrative areas of epidemiologic importance.
Additional information requested

If there are subnational data available, please provide the disaggregation by administrative area, city, or site using the space provided. You may also upload an Excel spreadsheet of these data instead of entering them in the online tool. Submit the digital version of any available survey reports using the upload tool.

Strengths and weaknesses

The population size estimate used as the denominator should be appropriate for the numerator: not all opioid substitution therapy recipients have a history of injecting and not all people who inject drugs use or are dependent on opioids.

Biobehavioral surveys can collect this information but are often biased by an inclusion criterion of being a current injector. This would exclude those people receiving opioid substitution therapy who may not be injecting anymore or who may deny current injecting in order to access the OST programme.

Further information

Tool to set and monitor targets for HIV prevention, diagnosis, treatment and care for key populations. Geneva: World Health Organization; 2015 (https://apps.who.int/iris/bitstream/handle/10665/177992/9789241508995_eng.pdf?sequence=1&isAllowed=y).

 

United Nations Office on Drugs and Crime, International Network of People Who Use Drugs, UNAIDS, United Nations Development Programme, United Nations Population Fund, World Health Organization et al. Implementing comprehensive HIV and HCV programmes with people who inject drugs: practical guidance for collaborative interventions. Vienna: United Nations Office on Drugs and Crime; 2017 (https://www.inpud.net/en/iduit-implementing-comprehensive-hiv-and-hcv-programmes-people-who-inject-drugs).

 

Operational Guidelines for Monitoring and Evaluation of HIV Programmes for People who Inject Drugs. In: MEASURE Evaluation [Internet]. Chapel Hill (NC): MEASURE Evaluation; c2019 (https://www.measureevaluation.org/resources/tools/hiv-aids/operational-guidelines-for-m-e-of-hiv-programmes-for-people-who-inject-drugs).

 

Related Indicators
 
KP.3 Coverage of OST, 2020, WHO Consolidated HIV strategic information guidelines: driving impact through programme monitoring and management (https://www.who.int/publications/i/item/consolidated-hiv-strategic-information-guidelines).