Tools and Curricula

Manual for Reducing Drug Related Harm in Asia

Centre for Harm Reduction, Macfarlane Burnet Centre for Medical Research, & Asian Harm Reduction Network (2003).

This comprehensive manual grew out of the combined efforts of people in Asia to stop HIV. The first section presents background information on drug use and HIV vulnerability, the rationale for harm reduction, and balancing and integrating the approaches of supply, demand, and harm reduction. Briefing papers on critical issues, such as mapping drug use in Asia and care and support of people who inject drugs with HIV, are included for use as advocacy tools in the region. The second section contains nine chapters on program design, implementation, and maintenance, including rapid assessments, voluntary counseling and testing, and addressing the needs of specific groups. The third section contains appendices with information on hepatitis A, B, and C; HIV; illicit drugs and their characteristics; and sexually transmitted infections. 

Training Guide for HIV Prevention Outreach to Injecting Drug Users: Workshop Manual

World Health Organization (2004).

This training package is for workshops orienting and training public health policymakers, program developers, program managers, implementers, and field workers on outreach to injecting drug users (IDUs) to prevent HIV transmission. The training package has four workshop modules. Orientation to Outreach among IDUs provides evidence for the effectiveness of outreach programs and assists decisionmakers in introducing and developing such programs. Developing Outreach Programs for HIV Prevention among IDUs provides assistance to individuals interested or involved in developing outreach programs. Managing Outreach Programs among IDUs is for those who have never managed an outreach program, but can also be used as additional training for current managers and outreach field supervisors. Core Skills in Outreach among IDUs is designed for initial training of outreach workers, or as a resource for ongoing training and review among experienced outreach workers.

Opioid Overdose: Preventing and Reducing Opioid Overdose Mortality

United Nations Organization on Drugs and Crime (UNODC) and World Health Organization (WHO) (2013).  

This discussion paper was developed in response to a 2012 resolution that called on UN Member States to include effective measures to prevent and treat drug overdose in national policies. In that resolution, the Commission asked the UNODC and WHO to review scientific evidence on preventing and treating of drug overdose, especially opioids, and derive best practices. This paper outlines what is known about opioid overdose and gaps in knowledge; and identifies approaches to preventing and treating opioid overdose. It includes information on risk factors: availability, combining opioids with other psychoactive substances, lack of treatment, and reduced tolerance following abstinence. The paper describes how to recognize and react to overdose, including use of naloxone, as well as policy and program strategies that could help prevent fatal overdose, such as reducing availability of opioids and increasing availability of treatment. It identifies gaps between current practice and recommendations, and outlines a number of potential new areas of work, including addressing overdose of prescription opioids.

Advocacy Guide: HIV/AIDS Prevention among Injecting Drug Users

World Health Organization (WHO), U.N. Office on Drugs and Crime (UNODC), and Joint U.N. Programme on HIV/AIDS (UNAIDS) (2004).

This guide provides a systematic approach to advocacy for HIV prevention and care among people who inject drugs (PWID) that can be replicated and adapted to various cultural, economic, and political settings. General principles of advocacy for HIV prevention and care for PWID are presented first. The guide provides a step-by-step process for establishing advocacy groups with specific goals, undertaking a situation analysis, developing a strategy, and implementing the strategy. It also contains descriptions of many tools and methods for achieving advocacy goals, and examples of their use in various country settings. Frequently used arguments related to HIV prevention among PWID are also included. Most methods in the guide can be used, after adaptation, at community, district, and national levels. 

Guide to Starting and Managing Needle and Syringe Programmes

World Health Organization (WHO), U.N. Office on Drugs and Crime (UNODC), and Joint U.N. Programme on HIV/AIDS (UNAIDS) (2007).

This guide is designed to help programs expand the response to HIV among PWID. Many more needle and syringe programs (NSPs) will need to be established to meet the harm reduction needs of the growing population of people who inject drugs. Sections I and II of this guide describe how to foster this process. Sections III and IV discuss how existing NSPs can expand the services that they offer and greatly increase their coverage. Scale-up of such programs must include establishing more NSPs in prisons and detention centers. Section V presents the particular needs of NSPs in such “closed settings.” A list of useful websites, publications, and networks appears at the end of the guide.

Technical Guide for Countries to Set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting Drug Users

World Health Organization (WHO), U.N. Office on Drugs and Crime (UNODC), and Joint U.N. Programme on HIV/AIDS (UNAIDS) (2009).

This guide explains the rationale for including nine different evidence-based interventions in a comprehensive package of HIV prevention, treatment, and care for people who inject drugs. Recommended interventions include harm reduction measures, HIV testing, counseling and treatment, and prevention and treatment of sexually transmitted infections, viral hepatitis, and tuberculosis. Frameworks are given for each recommended intervention. A checklist offers guided assessment of the availability, coverage, and quality of each intervention. 

Overdose Prevention and Response: A Guide for People Who Use Drugs and Harm Reduction Staff in Eastern Europe and Central Asia

Curtis, M., & Guterman, L. (2009).

Although this guide was produced with harm reduction staff and people who use drugs in Eastern Europe and Central Asia in mind, the information it contains is useful worldwide. The guide explains the basics of overdose, such as what happens to the body during overdose; and the duration, potency, and overdose risks of different drugs. It describes the risk factors associated with overdose prevention and explains how to recognize an overdose. There is a section on responding step-by-step to an overdose, including a guide to rescue breathing and instructions for administering naloxone in the case of opioid overdose. A chapter for trainers on how to use the information provided completes the guide.

Good Practice Guide: HIV and Drug Use: Community Responses to Injecting Drug Use and HIV

International HIV/AIDS Alliance. (2010).

This comprehensive guide to HIV and drug use, written in clear, accessible language, aims to support community-based harm reduction and HIV programs, with a focus on developing and transitional countries. The guide thoroughly explains the issues of drug use, HIV, and health; and covers programs for special populations—women, children and young people, and prisoners—in a separate section. It spells out approaches to harm reduction, including community mobilization and gender-sensitive programming, and highlights the importance of involving all stakeholders, including people who use drugs, in programming. The guide describes the HIV/AIDS Alliance good practice standards in detail, and spells out the key characteristics of effective programs.

HIV in Prisons: Situation and Needs Assessment Toolkit

Weilandt, C., & Greifinger, R. (2010).

Aimed at national governments, particularly those of low- and middle-income countries, this toolkit first explains HIV in the prison context. It then provides the necessary tools to conduct the situation and needs assessments required before HIV intervention programs can be implemented. Although it focuses on HIV and tuberculosis-related HIV, it is also relevant to sexually transmitted infections and hepatitis. The toolkit recommends the establishment of a multidisciplinary steering committee and lays out a stepwise assessment process. Annexes include templates for consent forms and questionnaires, checklists, and information about sampling methodology.

From Top to Bottom: A Sex-Positive Approach for Men Who Have Sex with Men

Annova Health (2011).

This manual, developed in South Africa but relevant in regions across the world, was put together with health care providers in mind. The manual is divided into six sections: introduction to the manual; overview of men who have sex with men (MSM) in terms of sexuality and sexual identity and key terminology; the broader public health strategies relating to MSM; the role of the health care provider in terms of providing quality, competent MSM services; the potential mental health problems that affect MSM; and practical guidelines in relation to the medical management of sexual health problems that may affect MSM.

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