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Global training aims to
net wider youth audience
Tuesday 27 April 2010 – DAY TWO –
Daily Update
– 3
INTERVENTIONS TO COMBAT
the spread of
HIV among injecting drug users need to be
scaled up dramatically, Bradley Mathers of the
University of New South Wales told delegates in
Monday’s opening plenary,
Harm reduction:
next generation challenges.
He was reporting on the results of a global
systematic review of efforts to expand HIV
prevention – ‘a stocktake of where we are this far
into harm reduction’ – looking at how far
responses were meeting the needs of injecting
drug populations. There were documented
reports of injecting drug use in 151 countries,
which could add up to as many as 21.2m
people, he said. There was an ongoing process
of improving the data, but the best estimate of
IDUs living with HIV was around 3m, he said, half
of whom were concentrated in Eastern Europe
and South East Asia.
The review focused on needle and syringe
programmes, opioid substitution therapy and
antiretroviral therapy. Needle and syringe
programmes were confirmed in 82 countries, he
said, but this ranged from low to high coverage,
the latter defined as 200 needles/syringes
distributed per IDU per year. Most of the world fell
into the ‘low’ category, however, of fewer than
100 needles per IDU per year – which meant
‘potentially a large amount of HIV risk.’ Globally,
only 22 needles/syringes were distributed per
IDU per year, he said, which meant that only
around five per cent of worldwide injecting was
done using clean equipment.
Opioid substitution therapy was present in 71
countries, but absent in around 80 countries
where injecting occurs. Measuring the coverage
of programmes was difficult, but some countries
– mainly in Western Europe – were achieving
high-level coverage. However, coverage remained
low in most places and globally only eight people
per 100 IDUs were receiving opioid substitution
therapy, he told delegates. Worldwide, only four
IDUs received antiretroviral therapy for every 100
HIV-positive injectors, he said.
Interventions needed to be delivered to
scale and in combination, he stressed – at
present only a minority of countries were
delivering them to the scale required.
Acknowledging that it was ‘easier said than
done’, he told delegates that ‘these
interventions work best when delivered
together – we need to scale them up, and we
need to scale them up together.’
HIV interventions must be
‘scaled up dramatically’
HARMREDUCTION TRAINING
and services are not being targeted
on young people globally, according to Kyla Zanardi, Youth Rise’s
representative on HIV prevention.
With an estimated 6,000 new HIV infections each day among
young people aged 15 to 24, her project aimed to provide free
access to training and advocacy resources for young people on
HIV and Aids prevention and substance use.
A ‘youth engagement approach’ was the guiding principle,
complemented by adult partnerships, support and advice. Training
had to be ‘context-specific, flexible and creative’, outlining best
practice on harm reduction, HIV prevention, sexual health and
substance use.
Youth-led training sessions had been held in different countries,
to provide tangible guidance. Young people had been recruited for
the sessions by using an open call in a newspaper and through
word of mouth among local NGOs.
Peer training had proved particularly useful in encouraging
participants to volunteer for HIV and hepatitis C testing, and the
injecting drug users had been keen to ask for more information
after the sessions. Their feedback had included requests for
more interactive training so they had the opportunity to share
their own experiences, and a call for additional multimedia
material such as films and audio clips on overdose and drug
treatment – which could be difficult when working with local
NGOs with limited resources, commented Ms Zanardi.
With the project continuing its next phase of training in Mexico
and Canada, and development of a more comprenhesive education
process, a guide would be launched on World Aids Day, 1
December 2010.
Bradley Mathers:
Only around five per cent of
worldwide injecting is done using clean equipment.
AN INCREASE
in drug-related
violence in Mexico had driven the
growth of drug treatment centres but
compromised quality of care,
according to Aram Barra, a long-time
activist who had been working with
Youth Rise.
The ‘War on Drugs’ had resulted
in a ‘decree’, which modified general
health law and the federal criminal
code and aimed to differentiate
between drug users, small time
traffickers and the major drug
traffickers, he explained. It included
a table of maximum amounts that
could be carried by a person,
providing a compulsory route into
drug treatment centres.
These 329 ‘new life’ centres were
brand new and in many cases
situated in neighbourhoods that
were considered ‘risky’ for drug
crime. But fast growth had meant
that they lacked funding and had
inadequate facilities inside.
‘There is no systematic way of re-
cording people coming into the
centre, or whether their treatment
has been successful,’ said Mr Barra.
Furthermore, there was lack of
pragmatic drug policy and lack of
harm reduction policy.
‘On a positive note, they are so
badly funded that they are open to
receiving support and advocacy
material,’ he added. ‘They are willing
to collaborate with NGOs in the field
and share information.’
Aram Barra:
Poor funding leads to
open-minded attitudes to advocacy
and support.
Mexican
crime drives
‘inadequate’
treatment