1. Topic 3 Strategies that help reduce the transmission of HIV Slide 3.1

2. Previous Topics –the size of the problem of HIV –how HIV is transmitted –how people can reduce the likelihood of being infected with HIV during their personal life Slide 3.2

3. Broader strategies are required A person might have the skills to use a condom, but this is not enough The person also requires a range of other strategies to be in place Slide 3..3

4. A hierarchy of risk for Injecting Drug Use Risk 1.Never use drugs 2.Never inject drugs 3.If you do inject drugs: –use clean, new, unused, sterile injecting equipment –use infection control procedures –If new clean injection equipment cannot be used, only ever use your own equipment and disinfect all equipment between each use Slide 3.4

5. Activity What broad strategies are required to help people adhere to the hierarchy ? Slide 3.5

6. Commonly Used Terms Supply-Reduction Demand-Reduction Harm-Reduction Slide 3.6

7. Supply Demand Harm

8. Integrated –Some can be classified as more than one type –Some can affect (positively and negatively) the success of others. Slide 3.8

9. Multiple strategies are required Slide 3..9

10. Some examples of Harm-Reduction Strategies Pollution masks for children do not stop your children from breathing polluted air - they reduce the risk of harm. Motorbike helmets do not stop people from riding motorbikes, riding them in a dangerous fashion, or stop them from having accidents - they reduce the risk of serious injury from the risky behaviour. Bullet-proof vests for Police do not stop Police from taking risks, do not stop criminals from firing at police - they can reduce the harm to police.

11. Some drug-law enforcement activities can have a negative effect on the outcomes sought by Harm-Reduction patrolling near an NSP outlet which will deter an IDU from going near a NSP outlet arresting an IDU for "possession" while those involved in large-scale distribution escape being noticed arresting an IDU for possession of implements such as a needle and syringe when after they have visited a NSP Slide 3.11

12. The main elements of Harm- Reduction 1.The short-term goal of reducing the rapid transmission of HIV among IDUs and from them to the rest of the population 2.The use of the hierarchy of risks for IDU 3.The understanding that police cannot completely stop the production and distribution of drugs 4.The understanding that people will use drugs despite our attempts 5.The involvement of drug users Source: Adapted from The Centre for Harm Reduction, Macfarlane Burnet Centre for Medical Research and Asian Harm Reduction Network (2003). Manual for Reducing drug related harm in Asia. Centre for Harm Reduction, Melbourne. pp 35-36. Slide 3.12

13. Why Harm-Reduction? 1. The supply of drugs cannot be stopped 2. The demand for drugs cannot be stopped (continued next Slide) Slide 3.13

14. Slide 3.15 3. Your community and country is at risk - There are a lot of people with HIV/AIDS. - The death rate from HIV/AIDS is high. - You cannot tell who has HIV just be looking. - Some people inject drugs and HIV easily moves from the IDU to the rest of the community. - Some people have sex with other people – sometimes with many people. - People can get HIV from Injecting Drug Use, sexual activity. - It only takes you one time to engage in a risky behaviour to become infected with HIV.

15. 4. A good expenditure of money – It works. – A good return on investment

16. Effective Harm-Reduction Strategies for reducing HIV among Injecting Drug Users Education programs – informing IDUs of risks and developing their skills to reduce risks. Treatment programs – establishing treatment and drug substitution programs. Outreach Work - education and the use of peer educators. Access to clean, sterile needles and syringes and other equipment. Slide 3.16

17. Why do some people inject drugs in ways which place them at risk of HIV? Slide 3.17

18. addicted / dependent lack of knowledge of HIV and how prevent its transmission lack of access to unused needles and syringes scared to access a NSP because of fear of detection and discrimination by anyone and fear of detection and prosecution by police scared to try and get help with their drug use because of.... severe traumatic life events mental health issues Slide 3.18

19. What sorts of things might some Police do that would hinder the success of Harm-Reduction strategies? Refer to Handout Group exercise Slide 3.19

20. Assessment Task Writing a speech Slide 3.20