Infectious disease screening rates among people who use drugs in open drug scenes: a brief report

Background and objectives People who use drugs (PWUD) face a high risk of infectious diseases. . Brazil has one of the world’s largest crack-cocaine markets, with major cities struggling with public health challenges linked to open drug scenes (ODS), where illicit drugs are openly used and traded. Epidemiological data on screening rates and infection prevalence within ODS in Brazil remain scarce. This study examines the self-reported prevalence of screening tests for tuberculosis (TB), HIV, syphilis, and hepatitis B (HBV), and C (HCV), as well as the factors influencing screening rates.Methods Three cross-sectional, self-report surveys of 900 PWUD in ODS in São Paulo between 2017 and 2022 were analysed.Results The majority of participants were male (68.26%), with a mean age of 36.89 years, and who frequented the ODS for five years or more (53.51%) Screening rates varied by disease, with the highest overall prevalence for HIV (63.59%) followed by TB (59.93%) and Syphilis (59.56%), HBV (50.22%) and HCV (48.94%). Across all infections, screening rates declined between 2017 and 2022. Factors associated with screening included age, gender, education, survey year, and lenght of time frequenting the ODS.Conclusion Findings highlight gaps in screening coverage. We advocate for a national serial bio-behavioral survey of PWUD in ODS to accurately assess screening prevalence, infection rates, and risk factors, which remain unmonitored.