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  • Rapid Decline in HCV Incidence among People Who Inject Drugs Associated with National Scale-Up in Coverage of a Combination of Harm Reduction Interventions

    Posted on August 21st, 2014 TimB No comments

    Government policy has precipitated recent changes in the provision of harm reduction interventions –injecting equipment provision (IEP) and opiate substitution therapy (OST) – for people who inject drugs (PWID) in Scotland.

    We sought to examine the potential impact of these changes on hepatitis C virus (HCV) transmission among PWID. We used a framework to triangulate different types of evidence: ‘group-level/ecological’ and ‘individual-level’. Evidence was primarily generated from bio-behavioural cross-sectional surveys of PWID, undertaken during 2008-2012. Individuals in the window period (1–2 months) where the virus is present, but antibodies have not yet been formed, were considered to have recent infection. The survey data were supplemented with service data on the provision of injecting equipment and OST. Ecological analyses examined changes in intervention provision, self reported intervention uptake, self-reported risk behaviour and HCV incidence; individual-level analyses investigated relationships within the pooled survey data. Nearly 8,000 PWID were recruited in the surveys. We observed a decline in HCV incidence, per 100 person-years, from 13.6 (95% CI: 8.1–20.1) in 2008–09 to 7.3 (3.0–12.9) in 2011–12; a period during which increases in the coverage of OST and IEP, and decreases in the frequency of injecting and sharing of injecting equipment, were observed. Individual-level evidence demonstrated that combined high coverage of needles/syringes and OST were associated with reduced risk of recent HCV in analyses that were unweighted (AOR 0.29, 95%CI 0.11–0.74) and weighted for frequency of injecting (AORw 0.05, 95%CI 0.01–0.18).

    We estimate the combination of harm reduction interventions may have averted 1400 new HCV infections during 2008–2012.

    This is the first study to demonstrate that impressive reductions in HCV incidence can be achieved among PWID over a relatively short time period through high coverage of a combination of interventions.

    Download Full Paper

  • Report on the current state of play of the Council Recommendation on the prevention and reduction of health-related harm associated with drug dependence in the EU and candidate countries

    Posted on December 4th, 2013 TimB No comments

    The report on the current state of play of the Council Recommendation of 18 June 2003 on the prevention and reduction of health-related harm associated with drug dependence  has been finalised. The report results of the work of experts from Gesundheit Österreich Forschungs – und Planungsgesellschaft mbH (GÖ FP GmbH) and SOGETI, in close collaboration with EAHC, EMCDDA, DG SANCO, and DG JUST.

    It presents the updated overview of the implementation of the Council Recommendation in the EU countries, Croatia and several candidate countries, including country profiles, as well as analyses of regional and EU epidemiological trends.

    The study also assesses the availability of – access to- and -coverage of- harm reduction measures based on the answers to a policy survey.

    The available scientific evidence regarding interventions to prevent and reduce health-harms associated with drug dependence was analysed and five systematic Literature Reviews  were produced.

    The epidemiological background data, using data available at the EMCDDA, as well as other relevant information, and trends from 2003 to 2011 were analysed as well as main trends in availability and coverage of harm reduction measures introduced by the Council.

    The main output is a set of conclusions regarding the follow-up of the Council Recommendation, based on the application and combination of the scientific effectiveness of interventions and the availability and coverage.

    Finally, the report provides country overviews  on harm reduction policies, services and facilities.


  • Hepatitis C treatment access and uptake for people who inject drugs: a review mapping the role of social factors

    Posted on May 8th, 2013 TimB No comments

    Evidence documents successful hepatitis C virus (HCV) treatment outcomes for people who inject drugs (PWID) and interest in HCV treatment among this population. Maximising HCV treatment for PWID can be an effective HCV preventative measure. Yet HCV treatment among PWID remains suboptimal. This review seeks to map social factors mediating HCV treatment access.


  • Power to Empower : The impact of harm reduction in Vancouver

    Posted on February 12th, 2012 TimB No comments

    It illustrates the impact a drug consumption room and harm reduction service which has positive outcome for the drug users and the local community

  • The Economic Crisis is a Danger for Harm Reduction in Portugal

    Posted on February 6th, 2012 TimB No comments

    Portugal is well known for its progressive drug policy – but the economic crisis may undermine effective harm reduction services in the country. Read a short report from our Portugese partner, APDES, and learn how NGOs fight to keep harm reduction on the agenda!

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  • Investing in Young People – Harm Reduction in Lebanon

    Posted on January 29th, 2012 TimB No comments

    When we speak about injecting drugs use and HIV, we rarely pay any attention to the Middle-East. But if you think that injecting drug use is not prevalent in these countries and young people have no access to heroin or amphetamine — you are wrong. Harm Reduction International — the former IHRA — recognized the gap between the picture shown by governments and the reality of the streets when it decided to organize its latest international harm reduction conference in Beirut, Lebanon in April 2011. Our filming crew was there to explore this gap too. We interviewed drug users, professionals and researchers,

  • An Advocate’s Guide of Harm Reduction Programs to Economic Analysis

    Posted on October 3rd, 2011 TimB No comments

    People who work in and advocate harm reduction programs talk a lot about evidence. In the face of political and moralistic opposition to what we do, we know we are right because science – the public health evidence base – is on our side. Hundreds of studies have shown beyond any reasonable doubt that needle exchange, opioid substitution therapy, outreach programs, and other harm reduction approaches reduce the spread of disease, link people to care and treatment, and produce all types of other health and social benefits.

    Read the rest of this entry »

  • Why Russia Needs Gender-Sensitive Harm Reduction

    Posted on August 7th, 2011 TimB No comments

    In Russia, as in many countries, women who use drugs face  profound structural and individual challenges to access essential health care. According to the UN Office of Drugs and Crime, Russia is home to 1.6 million injecting drug users and women are estimated to make up as many as 40 percent. Meanwhile, more than one third of the country’s people who inject drugs are believed to be living with HIV. Yet local groups who provide harm reduction services report as few as one in six of their clients are female.

    Poverty, stigma, domestic violence, police harassment, and fear of losing custody of their children are only some of the barriers preventing women who use drugs from seeking medical and counseling services.  And if they do come for medical care, they are likely to be denied access or receive substandard services from doctors and nurses who are not trained and not prepared to deal  with their issues.


  • Harm reduction and brief interventions for ATS users

    Posted on June 26th, 2011 TimB No comments

    This brief outlines public health interventions directed at those who use amphetamine-type stimulants (ATS). Research indicates that the majority of ATS users are casual/experimental users who do not require intensive treatment interventions. Instead, they require information and counselling to enable them to appreciate the potential risks from ATS use and take measures to mitigate these harms.


  • Drug use and harm reduction in Afghanistan

    Posted on May 21st, 2011 TimB No comments

    93% of the world opium is produced in Afghanistan and, there were, in 2009, 1 500 000 drug users in the country. Furthermore, the pattern of drug use in Afghanistan has been changing from smoking to injecting. Kabul, the capital, is home to 50 % of the country’s heroin users (around 20000 people according to UNODC in 2009).

    Médecins du Monde (an international humanitarian Non-Governmental Organization) has been active in Afghanistan for the past 24 years in the implementation of different health programs. Since 2006, MDM focuses on prevention, care and treatment for (injecting) drug users, known as the highest risk group regarding HIV/AIDS in the country.
    The Afghan Ministry of Public Health and MdM started a pilot program for opioid substitution therapy and the first 10 persons received methadone in February 2010.

    This slideshow compiles testimonies of patients under methadone therapy. The photographs were taken by Sandra Calligaro. Ms. Calligaro is a French photographer born in 1981, working in Afghanistan for the last 4 years and collaborating with international media and NGOs.

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