Lancet paper on IDU

The Lancet published a paper that researched shortfalls in HIV prevention, treatment, and care services for injecting drug users (IDUs) worldwide. The findings revealed that international “coverage of HIV prevention, treatment, and care services in IDU populations is very low” and are nowhere near the levels required to meet the needs of the population.

Read a summary of the report at:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2960232-2/fulltext

See a map summary of the Eurasia region at:
http://www.ihra.net/Assets/581/1/GSHREurasia.pdf

Harm Reduction Overview

Neil Hunt (the creator of the Break the Cycle intervention in the UK) has put together a superb overview document outlining the main components of harm reduction.

The authors describe the document as follows:

This overview addresses both understandings of harm reduction and summarises its key principles before going on to consider the strength and nature of the evidence of the effectiveness of various forms of ‘harm reduction’ intervention. In doing so, some consideration is also given to criticisms of harm reduction that are occasionally encountered.

The document is called:

A review of the evidence-base for harm reduction approaches to drug use

It may be downloaded at:
http://www.ihra.net/Assets/23/1/HIVTop50Documents11.pdf

Cheers
Rob

Substitution therapy in C. Asia

Opioid Substitution Therapy (OST) is one of the most important components of a comprehensive harm reduction program. A new report out (see link below) outlines the state of OST in Central Asia, where PSI is one of the main development partners working with IDUs.

Rob

http://www.harm-reduction.org/images/stories/library/ost_final_2010.pdf?utm_source=IDPC+Monthly+Alert&utm_campaign=1761d6a25b-IDPC_March_Alert3_24_2010&utm_medium=email

$19

The Australian government has calculated the cost benefit of their harm reduction program. The study found an average "savings per syringe distributed" of $19. In other words, each needle going out saved the Australian tax payers $19 in other costs, had the intervention not existed (i.e. AIDS treatment, etc.)

You can download a brief summary at:

http://www.anex.org.au/downloads/Fact%20Sheet%20-%20NSP%20Return%20On%20Investment.pdf

This report might be useful in your advocacy work to convince partners that providing prevention services for drug users is a worthwhile endeavor with measurable results (including savings for tax payers).

Rob

HIV Counseling and Testing in Prisons

The WHO and UNAIDS have released new guidance on offering HIV counseling and testing in prisons. The technical paper and policy brief can be found at: http://www.who.int/hiv/pub/idu/tc_prisons/en/index.html

IDU in many countries face mandatory HIV counseling and testing (HCT) in prisons. They are not offered quality counseling and are not provided their test results. Advocacy around improved HCT is an important step in scaling up comprehensive harm reduction for IDU. These documents can be a helpful guides as individual country programs conduct advocacy with law enforcement and seek to improve services offered within prisons. Shifting perception of drug use from a public security concern to a public health concern takes time and advocating for comprehensive harm reduction in prisons is a major step in the right direction.

Hepatitis C and Syringes with Detachable Needles

A new study coming out of Yale has found the Hepatitis C virus survives in syringes with detachable needles longer than in syringes with an attached needle (i.e. an insulin syringe). http://inef.ie/?p=2976 Prior to this study, cohort studies among IDU populations in the US have found a higher HIV prevalence among populations using syringes with detachable needles than in those using a syringe with an attached needle.

Combined, these studies send a powerful message about needle and syringe distribution. Wherever possible, IDU should be encouraged to use syringes with an attached needle. A few thoughts for your programs:

1) Continue to meet the local IDU population with a needle/syringe that they will accept and use. The most important behavior is to ensure IDU are using sterile needles and syringes. If the local IDU population will not use a syringe with an attached needle, do not stop distributing the type of syringe/needle they will use.

2) Wherever possible, peer educators and other outreach workers should counsel IDU about the greater safety offered by a syringe with an attached needle. IDU should be encouraged to use this type of needle.

"Insite" - Vancouver's Supervised Injection Site

With the Winter Olympics in Vancouver, "Insite", Vancouver's supervised injection site has been in the press. Four articles at slate.com offer an interesting first hand account of the site. You can find the articles at: http://www.slate.com/id/2242828/entry/2242868/

The photo journal that accompanies the articles is particularly interesting: http://www.slate.com/id/2242828/slideshow/2242811/fs/0//entry/2242812/