Additional Resources

International Harm Reduction Association

International Harm Reduction Association (IHRA). (2016).

The website of this important global advocacy organization houses the Global State of Harm Reduction 2014 report.

The latest edition of the Global State of Harm Reduction includes the latest estimates around the response to drug-related HIV, viral hepatitis and tuberculosis.

It also integrates updated information on harm reduction services into each regional chapter, including on needle and syringe programs and opioid substitution therapy; harm reduction services in the prison setting; access to antiretroviral therapy for people who inject drugs; regional overdose responses; policy development; civil society developments; and information relating to funding for harm reduction.

Injecting Drug Use and Prisons Publications

World Health Organization (WHO) (2016).

This section of the WHO website houses a wealth of publications pertaining to injecting drug use and prisons. The site is divided into several sections The first comprises documents on injection drug use in general; the second covers technical publications on the topic; the third provides publications on policy and advocacy. The site also contains a section on training materials, and related topics and links.

The Asian Harm Reduction Network

AHRN is regional information and support network created to link and support the courageous people operating programmes providing assistance to injecting drug users in Asia to prevent HIV transmission.

Drug Abuse and HIV/AIDS: Lessons Learned: Case Studies Booklet, Central and Eastern Europe and the Central Asian States

Joint United Nations Programme on HIV/AIDS and United Nations Office for Drug Control and Crime Prevention (2001).

Profound social and economic change in Eastern Europe and Central Asia has created conditions that make the countries in these regions particularly vulnerable to drug use and the spread of HIV. This booklet, aimed largely at policymakers and practitioners, presents an overview of lessons learned and challenges for the future. Examples from 11 countries (Belarus, Bulgaria, the Czech Republic, Hungary, Kazakhstan, Lithuania, Poland, the Russian Federation, Slovakia, Slovenia, and Ukraine) illustrate how drug abuse and HIV prevention strategies and interventions have been introduced into specific national and local contexts, and the responses to a number of important challenges. The case studies are grouped according to the focus of the project, as follows: fieldwork, political mobilization and strategy development, and training and networking. This collection shows the different adaptations that take place in response to local concerns, and also provides an up-to-date picture of the challenges commonly confronted in developing HIV prevention strategies among people who inject drugs.

Center for AIDS Prevention Studies Prevention Toolkit

University of California, San Francisco. (2006).

This content-rich website houses a wealth of HIV prevention resources, including over 60 referenced fact sheets that summarize important HIV prevention topics in a readable two-page format. There are detailed descriptions of model programs, both ongoing and completed, and interventions with full curricula available for download. Survey instruments that have been tested by the Center for AIDS Prevention and are adaptable to local settings are also available, as are evaluation manuals and a selection of resources guides. All content is also available in Spanish.

A Handbook for Starting and Managing Needle and Syringe Programmes in Prisons and Other Closed Settings

United Nations Office on Drugs and Crime (2014). 

This handbook is a practical guide to support implementation of needle and syringe programs (NSPs) in prisons and other closed settings. Although NSP programs are recognized as critical to preventing HIV and hepatitis among drug users, only eight countries reported enacting such programs in prisons. The handbook is aimed at decisionmakers and staff who can approve and implement NSP programs: prison administrators and staff, ministry and public health officials, national HIV and drug programs, and others. It addresses practical, legal, and security issues that can preclude such programs from being implemented. It reviews the prevalence of HIV and other bloodborne diseases in prisons, and how drug use and risk behaviors contribute to these epidemics, the scientific evidence for prison NSP (PNSP) and other interventions for harm reduction, and relevant legal frameworks. The handbook lays out elements of PNSP, including analyses of advantages and disadvantages of specific approaches. It includes specific advocacy strategies and tools: documentation, legal and policy analysis, outreach to diverse decisionmakers, and engaging media. Clear and specific steps for implementing a PNSP program are laid out in tables and checklists, and explained in text. Case studies throughout illustrate real-world experience with policy development, implementation, and problem-solving. The handbook concludes with a list of regional and international resources, and annexes include policies and questionnaires used in an existing program.

HIV/AIDS Prevention and Care for Female Injecting Drug Users

United Nations Office on Drugs and Crime (2006).

This four-page brief highlights why among people who inject drugs (PWID), females are more vulnerable than their male counterparts. Risks include infected injections (women PWID commonly inject after their male partner has), high-risk sex, stigma over behavior that contradicts expectations of women as nurturers, and physical vulnerabilities. Women who are even more vulnerable are commercial sex workers, women in prison, and pregnant females. Many existing services do not reach female PWID because the services cannot meet their specific needs. To better reach female PWID, comprehensive gender-sensitive services are recommended, including HIV counseling and testing, treatment for sexually transmitted infections, antiretroviral therapy for prevention of mother-to-child transmission, condoms, sterile needles and syringes, and gender-sensitive treatment for drug dependence.

High Coverage Sites: HIV Prevention Among Injecting Drug Users in Transitional and Developing Countries: Case Studies

Burrows, D. (2006).

Part of the Joint United Nations Programme on HIV/AIDS (UNAIDS) Best Practice Collection, this document contains seven case studies from countries in the former Soviet Union, Asia, and Latin America. These sites were selected because over half of people who inject drugs (PWID) have been reached by at least one HIV prevention program, hence the term high coverage. Each case study includes an overview of the country’s drug use and epidemiology, services, and state of coverage. The last chapter synthesizes the lessons learned, identifying common features among them as well as challenges for comprehensive HIV-related programs. The report’s most significant finding is that high-level coverage can indeed be attained by programs addressing HIV among PWID in developing and transitional countries.

"Nothing About Us Without Us": Greater, Meaningful Involvement of People Who Use Illegal Drugs: A Public Health, Ethical, and Human Rights Imperative

Canadian HIV/AIDS Legal Network, International HIV/AIDS Alliance, and Open Society Institute (2008).

People who use illegal drugs have demonstrated that they can organize themselves and make valuable contributions to the community, including expanding the reach and effectiveness of HIV prevention and harm reduction services, by making contact with those at greatest risk, providing much-needed care and support, and advocating for their rights and the recognition of their dignity. This report documents the public health and human rights rationales for including people who use drugs in the development of HIV harm reduction programs. Recommendations on how to increase their involvement include addressing systemic barriers to allow a greater involvement of people who use drugs; supporting organizations of people who use drugs; involving people who use drugs in consultations, decisionmaking or policymaking bodies, advisory structures, and community-based organizations; and providing international leadership on greater involvement. 

Harm Reduction Developments 2008: Countries with Injection-Driven HIV Epidemics

Open Society Institute (2008).

In 2007, people who inject drugs (PWID) comprised the largest share of total HIV cases in at least 20 nations in Asia and the former Soviet Union. This report provides an overview of harm reduction efforts in Central and Eastern Europe, the former Soviet Union, and five Asian countries. Examples of effective programs being implemented include syringe and needle exchange programs, advocacy, opioid substitution therapy (OST), harm reduction work in prisons, and programs with commercial sex workers, among others. Data presented include PWID as a percentage of HIV cases, OST availability, and estimates of PWID reached by HIV prevention services in these countries. Despite advances in harm reduction, much work remains. Issues identified as needing increased investigation and action in the future include women and harm reduction, sexual health and harm reduction, African injecting drug use epidemics, and evidence-based and humane drug treatment. 


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