Grant: Project Grant - Priority Announcement: HIV/AIDS and STBBI

Ending the global epidemics of HIV and hepatitis C virus (HCV) is possible through targeted prevention and treatment programs. People who inject drugs are a priority population for such programs given their increased risk for HCV and HIV infections. However, progress towards elimination of HIV and HCV has been hampered by a lack of attention to gender differences in risk behaviours and the outcomes of prevention and treatment programs in people who inject drugs. This makes it hard to know if programs are working as well as they could for all people who inject drugs. It is also difficult to know if current strategies will achieve HCV and HIV elimination, or if strategies that try to reduce gender differences may accelerate progress towards ending these diseases. To address these knowledge gaps, we will study gender differences in HCV and HIV among people who inject drugs, and simulate outcomes of different prevention and treatment programs to identify those that most effectively reduce HCV and HIV infections in this population. Specifically, we will 1) synthesize existing research evidence on gender and HCV/HIV infections among people who inject drugs; 2) analyze data from more than 15,000 people who inject drugs in four cities [Montreal, Canada; Athens, Greece; Churachandpur, India; and Nairobi, Kenya] to estimate the size of key gender differences; and 3) comprehensively integrate sex and gender differences into mathematical models of HCV and HIV epidemics. This work will enable us to outline roadmaps to HCV and HIV elimination that overcome gender inequalities. Findings will be adaptable to other contexts, and will guide local, regional, and global recommendations on how best to achieve and sustain HCV and HIV elimination among one of the most at-risk populations.