Monday, November 30, 2009

How to use a tourniquet

The Blog "Injecting Advice" has a useful 1 page outline on how to properly use a tourniquet to inject more safely. See:

The BLOG itself is useful - you may want to consider signing up, or sharing it with your English-speaking team members.


New report on ATS use in Asia

UNODC has released a new report on ATS use in Asia - Patterns and Trends of Amphetamine-Type Stimulants and Other Drugs in East and South-East Asia, 2009.

With heroin use generally on the decline in Asia, increasingly our programs are (or will probably be) seeing ATS users. The tools to work with ATS users are often different. Methadone or other substitution therapry does not work with ATS users, for example. But ATS is, increasingly, injected - so NSP programs are likely to be part of the regional response to ATS use.

The report includes useful summaries of the ATS situation, country-by-country. Find the report at:

Wednesday, November 25, 2009

Global Fund Grants and Procurement of Harm Reduction Supplies in Eastern Europe and Central Asia - new report

Support from the Global Fund has been instrumental in increasing the availability of harm reduction services and supplies, such as clean needles and syringes. However, harm reduction organizations in the region are confronting an influx of poor quality supplies that threatens the success of their programs. Improving the quality of supplies is an important step toward an effective and sustainable HIV response. This report, by the Open Society Institute’s Public Health Program, evaluates Global Fund grants and procurement practices in Armenia, Georgia, Russia, and Tajikistan. In each country, needles and syringes have been procured that drug users do not find usable because, for example, they may be the wrong size or type.

The report is at:

Women, Harm Reduction and HIV. Report from Azerbaijan, Georgia, Kyrgyzstan, Russia, and Ukraine

Women who use drugs face a dual challenge: they are more vulnerable to both sexually and injection-transmitted HIV infection than male drug users, and they encounter greater obstacles to accessing the services they need. This report, by the Open Society Institute’s International Harm Reduction Development Program, summarizes the results of field assessments of women’s access to harm reduction, antiretroviral, and reproductive health services in five countries: Azerbaijan, Georgia, Kyrgyzstan, Russia, and Ukraine.

The report is at:

Global Fund Extension of HIV Prevention Programmes for People at High Risk for HIV in Russia

The International AIDS Society (IAS) and the International Harm Reduction Association (IHRA) today welcomed the announcement by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) to extend by two years its funding of HIV prevention programmes (known as the GLOBUS grant) in the Russian Federation at a cost of US$24 million. “This two-year extension will save thousands of lives,” said Robin Gorna, IAS Executive Director. “While this decision is very welcome, it is nevertheless a band-aid measure, not a long-term solution. External funding cannot prop up Russia’s HIV response forever. The onus is still on the Russian Government to listen to the science and 20 years of proven practice and put in place long-term harm reduction prevention programmes that will save tens of thousands of young Russian lives”.

More info at:

Friday, November 20, 2009

Detachable Needles and HIV - Research and Program Implications

Recently published literature indicates a likely link between using syringes with detachable needles and transmission of HIV and HCV. (See: William Zule, High dead-space syringes and the risk of HIV and HCV infection among injecting drug users, Drug & Alcohol Dependence, 2009.)

Syringes with detachable needles have larger “dead space” in them, able to hold 40 (or more) times the amount of blood compared to non-detachable syringe/needles. This greater “dead space” leads to greater amounts of blood left over in the syringe, which (presumably) leads to greater HIV/HCV infection rates. The evidence is still not strong enough to prove causation, but is strong enough that researchers are calling for programs to make some practical adjustments.

I’m recommending that you consider 2 simple additions to your IDU program:

Add some simple questions to our IDU TRaC questionnaires to:

Ask IDUs what they are using the inject: detachable or not

On those TRaCs where we also track HIV/HCV, see if there’s an association between using detachable s and higher rates of disease

I have asked Gary Mundy (Reg’l Researcher, Asia) to work on the questions.


IDU programs should:-

Inform clients of the potential greater risk of using detachables-
Consider procuring non-detachables, or, at least, actively promoting non-detachables

At the very least, ask your IDU clients what kinds of syringes and needles they are using. If detachable are common, then share with them this new evidence indicating that detachables may be more risky to use. This is a new area of harm reduction, and the evidence is still coming in. But it’s possible that we could help reduce transmission by paying more attention to the types of injecting equipment we are providing/promoting, as in this case.

Sunday, November 15, 2009

Social Networking and Drugs Work

PSI IDU programs, globally, are under-utilizing social networking methodologies to help influence the behaviors of our target groups.

Obviously, these technologies are most useful in environments where our staff, outreach workers, or program beneficiaries are using cell phones or internet. In most of our IDU countries, staff and outreach workers own cell phones. Those programs should consider how to use social networking technologies in their "Marketing Mix." One obvious option - use Twitter to get information out to outreach teams in an efficient manner.

For more information on social networking technologies being used in drugs work, please see the presentation below.


Sunday, November 8, 2009

The "Sharing" Question

A useful post, below, on how to ask drug users if/when they share equipment:


Thursday, November 5, 2009

Syringe sharing cut by two-thirds after injecting room opens

Having shown that the safer injecting facility in Vancouver benefited residents by reducing public injecting and injection-related litter, researchers have now shown that it also safeguarded its users by cutting the number who shared syringes by two-thirds.

To read more, go to:


Tuesday, November 3, 2009

'Asian Network of People who Use Drugs' Launched

Drug users from across Asia met in Bangkok in October 2009 to formally create the ‘Asian Network of People who Use Drugs’ (ANPUD). This new network aims to advocate for the rights of people who use drugs and help unify their voices in a continent which has the largest number of drug users in the world, yet poor access to harm reduction services in many places.

Find out more at:

Experts Urge Russia to Expand HIV Programmes for People Who Inject Drugs

As Moscow prepares to host the 3rd Eastern Europe and Central Asia AIDS Conference (EECAAC) on 28–30 October, the Eurasian Harm Reduction Network, the International AIDS Society and the International Harm Reduction Association issued a joint call to the Russian Government to dramatically expand access to HIV prevention programmes for people who inject drugs.

To see the statement, go to: