Feasibility, Acceptability, and Preliminary Efficacy of a Pilot Study To Integrate Buprenorphine into a Harm-reduction Drop-in-Center in Kampala, Uganda

Illicit drug use has been increasing rapidly in Sub-Saharan Africa in the past decade. However, until recently HIV prevention has largely ignored people who inject drugs and medications to treat opioid use disorder (MOUD) were largely absent. This paper reports results of a pilot intervention that integrated buprenorphine into a harm-reduction drop-in-center for people with opioid use disorder (OUD) in Kampala, Uganda. We collected implementation outcomes and changes in self-reported drug use after buprenorphine initiation. We conducted qualitative interviews with a subset of 14 participants who had initiated buprenorphine. Sixty-two participants were screened for OUD, of whom 57 were eligible for buprenorphine; of those, 55 initiated buprenorphine and 39 were still taking buprenorphine at three months (70.9%). Participants reported significant reductions in opioid use, marijuana and cocaine at 3-month follow up (p < 0.001, p = 0.006 p < 0.001 respectively). Integration of buprenorphine into DICs was successful and removed many barriers patients face in accessing MOUD.