Injecting Drug Use and Youth: PSI s Programs. Shimon Prohow HIV Department Population Services International

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1 Injecting Drug Use and Youth: PSI s Programs Shimon Prohow HIV Department Population Services International

2 PSI and HIV Male and Female Condoms HIV Counseling and Testing Male Circumcision Tuberculosis Treatment Communications targeting MARPs: Men Who have Sex with Men Injecting Drug Users Multiple Concurrent Partnerships Etc. page 2

3 PSI and IDU PSI conducts IDU programming in 10 countries: Russia, China, Myanmar, India, Thailand, Vietnam, Kazakhstan, Tajikistan, Kyrgyzstan and Mexico. PSI s IDU programming s main goals include: Reduce intravenous HIV transmission Reduce sexual transmission among IDUs Prevent death by overdose page 3

4 Specific Objectives of PSI s IDU Programs Reduce youth initiation of IDU Reduce needle sharing Increase condom use among IDU Mobilize pharmacies to scale-up delivery of sterile injecting equipment Reduce risk behaviors among IDU CSWs Increase IDU uptake of drug treatment Increase IDU uptake of VCT Ensure Naloxone availability to IDUs page 4

5 IDU Programs Targeting Youth Local norms limit access to youth for IDU programming. PSI provides general population services that can be accessed by youth. PSI works to prevent initiation of injection. page 5

6 Russian Situation Analysis 64% of PLWHA are IDUs. In St. Petersburg, 30% of tested IDUs were HIV+. Fewer than 1% of Russian IDUs have access to HIV prevention services. IDUs face significant social and legal stigma. Youth often begin injecting as young as 10 or 12. page 6

7 Russian Case Management USAID-funded program to meet the comprehensive needs of IDU in Russia. Provides service to IDU by: Increasing access to health and social services. Providing behavior change guidance. Reintegrating IDU into the community. PSI provides direct case managers who assist IDU to locate and identify services. As of last October, PSI reached over 550 individuals. 408 of them received medical services at hospitals. 213 of them received services at City Drug Abuse Clinic. page 7

8 Russian Substance Abuse Prevention PSI-funded pilot program to reach out to low-income youth, providing them with alternatives to injecting. Created leisure zone activities, such as sports, computer classes, theater and the arts. Provided correct information on substance abuse and HIV prevention. Offered counseling and communication skills to youth and parents to make healthy life decisions. page 8

9 Russian Substance Abuse Prevention 2008 Results Over 4500 youth and 920 parents received HIV/SAP training and consultations. About 50 families participated in family therapy. Over 180 youth-focused health and education professionals trained. Significantly increased parental participation, resulting in an uptake of medical and psychological services. page 9

10 Break the Cycle Uzbekistan In 2006, 62% of new HIV cases in Central Asia were attributed to injecting drug use. 86% of IDUs reported a sibling or friend helped during their first injection. Break the Cycle works with existing injectors. page 10

11 Break the Cycle Uzbekistan PSI developed the Break the Cycle (BTC) which encourages current IDUs: Not help others initiate IDU. Not inject in presence of non-idus. Not talk about the benefits of IDU. Develop skills to refuse unwelcome requests to help someone learn to inject. IDU willingness to self-report allows for program evaluation. page 11

12 Break the Cycle Project Details Educated youth at risk of initiating injecting drug use Involved current IDUs in program design and trainings Supported IDUs to reduce behaviors that lead to non- IDUs start injecting Utilized existing harm reduction infrastructure Delivered interventions through rehabs and needle syringe programs (NSPs) Involved existing outreach workers (mostly drug users) in project implementation Integrated program into other harm reduction topics covered by peer educators Provided other health services to drug users (overdose prevention, drug treatment, and VCT) page 12

13 Break the Cycle Results From 2006 to 2008, the percent of IDUs assisting with first injection dropped 14% in Uzbekistan and 9% in Kyrgyzstan. The estimated number of new IDUs dropped by 55%. Break the Cycle is currently being replicated in Vietnam. page 13

14 Break the Cycle Lessons Learned Current IDUs are willing to work to discourage initiation of injecting. Programs can easily utilize existing infrastructure. Measuring results can be very complicated. page 14

15 PSI, IDU and Youth PSI s IDU programming s main goals: Reduce intravenous HIV transmission Reduce sexual transmission among IDUs Prevent death by overdose PSI s programs are diverse and unique to the local situations. page 15

16 Thank you. Shimon Prohow page 16

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