|Drug Use and HIV Vulnerability (UNAIDS, 2001, 238 p.)|
|Chapter 1: Main report|
It is recommended that countries examine their drug and HIV policies and attempt to achieve greater congruence and compatibility between the two, ensuring that there are no legislative impediments that constrain the implementation of necessary measures to prevent HIV transmission among drug users and their sexual partners.
It is recommended that stake holders, including the national drug and HIV/AIDS control agencies, international and local non-governmental organisations as well as drug users, ex-users and people with HIV/AIDS develop consensus on the best way forward and develop mutually endorsed and acceptable preventive policies.
It is recommended that countries give consideration to instituting regular policy review procedures, and consider adopting more evidence-based policies. These reviews might also include a cost analysis of different treatment options so as to meet the challenge of judicious allocation of scarce resources.
It is recommended that countries adopt a comprehensive approach to treatment and prevention of drug use and HIV transmission. A wide range of services are needed to meet the multiple needs of drug users. The scale of these interventions should be increased and sustainability assured.
It is recommended that information, education and communication strategies and materials be reviewed, to ensure the accuracy and veracity of drug and HIV/AIDS preventive messages. It is further recommended that countries ascertain that those vulnerable to drug use and those already using drugs be provided with accurate information about the potential health risks that arise from their behaviour and ways of reducing the risk.
It is recommended that measures paying special attention to the prevention of harmful drug use among drug users be undertaken, for example focusing on preventing, wherever possible, the switching from smoking or inhaling to injecting drugs.
It is recommended that policy makers be urged to consider employing prevention and treatment approaches that are in alignment with the principles of 'public health' and 'health promotion' in preference to law enforcement approaches that emphasizes punishment as the principal means of promoting behaviour change.
It is recommended that countries place more emphasis on increasing the availability of voluntary treatments for drug use, most specially treatments that are 'user friendly', 'low threshold' and that employ flexible treatment policies. Attention should also be given to catering for those drug users who have special needs.
It is recommended that countries adopt inter-sectoral training programmes to broaden the knowledge, understanding and skills of drug and HIV/AIDS workers, opinion leaders and decision-makers working in key areas impacting on drug use and HIV vulnerability. Such persons include, for example,
(a) Various ministry personnel who are engaged in policy making or funding or operating services (e.g. Health, Home, Social Justice and Empowerment, Labour, Social Affairs, Public Security, Finance);
(b) Other public sector workers who might come across drug users in the course of their work (e.g. police, teachers and educators, doctors, nurses, drug workers, pharmacists, social workers, psychologists, outreach workers, peer educators, religious leaders and others);
(c) Researchers, social and political scientists who may be interested in studying the drug problem, the interface between drug use and HIV/AIDS to upgrade the data gathering capacities in the countries.
It is recommended that special attention be paid to enhancing the quality of training for direct service providers in the drug field. Countries should consider adopting a strategic approach to training, identifying who needs what training and for what specific purposes, and focusing as much as possible on a training of trainers so as to maximize the reach and sustainability of these strategies.
It is recommended that countries consider broadening the goals and methods of drug treatment from an abstinence-only goal to encompass treatment and prevention strategies that are more accepting of interim goals.
It is recommended that in countries where injecting is a feature of drug use, explore and consider the use of a range of opioid substitution pharmacotherapies and the distribution or exchange of needles and syringes, and of sterilizing materials.
It is recommended that programmes targeting the prevention of HIV/AIDS among drug users include information about safe sex, focusing on both users and their sexual partners.
It is recommended that countries consider promoting and facilitating the establishment of self help organizations for drug users that could initiate advocacy and enable users and ex-users to create mutually supportive environments.
It is recommended that countries give special attention to the provision of drugs and HIV/AIDS preventive services among drug users presently incarcerated in prisons and other long term labour rehabilitation facilities.