Viktor Mravcik, MD, Assoc Prof, PhD, Director of Research and Innovation, Spolecnost Podane ruce o.p.s
Barbara Janikova, BSc, MA, Head of Infections Research, Spolecnost Podane ruce o.p.s.
Injecting drug use remains a serious public health challenge in the Czech Republic, with an estimated 42,700 people who inject drugs (PWID) in 2022. High-risk behaviours associated with injecting drug use significantly increase the transmission of HCV and HIV, with 45% of new HCV cases linked to PWID. In Brno, around 2,200 PWID live, including 400 in socially excluded areas like Cejl, where public drug use and marginalisation persist. Despite harm reduction efforts, gaps remain in addressing health risks and access to care. In response, Společnost Podané ruce launched the country’s first mobile DCR in September 2023, offering supervised drug use and testing services. In its first nine months, 90 clients used the DCR for 120 drug administrations—98% via injection. The initial survey after launch suggests that while the DCR has begun to attract its intended target population, further efforts are needed to improve engagement, particularly among methamphetamine users.
This project aims to evaluate the DCR’s impact on injection risk behaviours (IRBs) and the associated risks of HCV and HIV transmission among opioid and methamphetamine users, with a focus on PWID particularly those with high-risk drug use patterns.
Additionally, the project will assess the DCR’s effect on clients’ physical and mental health, social circumstances—including legal involvement—and its role in improving community safety in socially excluded areas, especially Brno’s “Cejl” neighborhood.
This project employs a longitudinal study design combined with community-based research to assess the impact of the Drug Consumption Room (DCR) on health outcomes, social integration, and injection risk behaviours (IRBs) among people who inject drugs (PWID). An estimated cohort of 50 DCR clients will be followed over two years with data collection every three months through interviews, surveys, and health assessments. This will cover physical and mental health, substance use, and social circumstances. A mixed-methods approach will also evaluate community-level effects on public safety, including reductions in public drug use, syringe litter, and petty crime, via surveys and interviews with residents and business owners, supplemented by routine data analysis. Supporting activities include expanding DCR and outreach to underserved groups, information campaigns to address misinformation, and on-site routine testing for HCV, HIV and other infections. The project’s findings will be disseminated nationally and internationally to raise awareness of DCR effectiveness.
The main output will be an increase in DCR utilization as the project aims to reach a minimum of 300 individual clients, with an expected average of three visits/drug administrations per day, including both new clients and repeated visits from existing clients. Data from the longitudinal study with a cohort of 50 DCR clients will offer insights into how DCR services improve client health and quality of life. These findings will impact future policy recommendations. The project will promote earlier detection and treatment of hepatitis C and HIV among PWID, helping reduce the disease burden in this vulnerable group. Public health benefits will include lower transmission rates and improved community safety, as the DCR helps reduce public drug use and maintain cleaner urban areas. At the policy level, findings will advocate for the inclusion of DCRs in the Czech Republic’s national harm reduction strategies.