|Drug Abuse and HIV/AIDS: Lessons Learned - Case Studies Booklet - Central and Eastern Europe and the Central Asian States (UNAIDS, 2001, 113 p.)|
Harm reduction principles. In the present document, the following three principles are referred to as harm reduction principles:
(a) Reaching out to injecting drug users;
(b) Discouraging the sharing of contaminated injecting equipment by providing sterile injecting equipment and disinfectant materials;
(c) Providing substitution treatment.
These principles are part of the principles for preventing HIV infection among drug users compiled by WHO in cooperation with UNAIDS and the Council of Europe in 1998. Another two principles concern information, communication and education; and provision of easy access to health and social services. The above-mentioned principles should not be viewed in isolation from overall national drug strategies or national AIDS programmes. They are, however, valuable in guiding national policies and programmes as regards the specific goal of reducing HIV transmission among injecting drug users.
Low-threshold services. Services for drug users are known as low-threshold services when they are easily accessible by clients, and when abstinence is not a prerequisite for service provision. Often, such services work with clients on an anonymous basis. They are designed to attract future clients by offering, besides drug-related services, other services that respond to the immediate needs of clients, such as free or cheap food, clothing or shelter.
Narcology, narcological centre. Narcological centres are specialized governmental health-care institutions in the newly independent States that provide outpatient and inpatient treatment and rehabilitation of substance abuse disorders. Narcological centres and dispensaries are usually also responsible for gathering data on substance abuse and for the coordination of preventive activities in a certain area (country, region or city). The narcological treatment system in the former Union of Soviet Socialist Republics has included, since its foundation in 1976, the principle of compulsory treatment at the narcological centres.
Roma communities. Although the Romani people are often referred to as gypsies (but prefer to be known by their more proper designation, Roma), not all gypsies or nomadic peoples are Roma. The Roma are descendants of the ancient warrior classes of India, in particular the Punjab, and they are identifiable by their language, religion and customs, which can be directly linked to those of the Punjabi in northern India.
Trust point. A term used for drug, HIV and STI preventive services in Kazakhstan, which allow their clients to remain anonymous. They are often low-threshold services (see above) and run by non-governmental organizations. The term indicates the main objective of the services, namely that of creating trust between drug users and drug and health-care services, thus establishing contact with and providing services to out-of-treatment populations.
The need for trust points is explained by the fact that, in accordance with existing regulations in Kazakhstan, all drug users must be recorded by name in the governmental medical establishments of a particular type, known as dispensaries for drug addicts, which are in close contact with the police. Persons who have been registered in the dispensaries cannot be employed in many sectors of the economy. In consequence, drug users do their best to avoid contact with the state health service.