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This collection has been divided into 18 separate topic areas. To view the documents in each section, as well as a description of the section itself, please click on the links below.
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1. The meaning of harm reduction in the context of HIV prevention for injecting drug users (IDU)
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2. Epidemiology of injecting drug use (IDU) and related HIV infection
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3. HIV/AIDS prevention policy and programming
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4. Assessing local and national need for interventions
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5. Resource allocation/requirements
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6. Injecting drug user (IDU) risk behaviours
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7. Sexual risk behaviour
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8. Needle and syringe programs (NSPs)
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9. Substitution treatments
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10. Antiretroviral (ARV) treatment
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11. Health promotion and drug education (including prevention of drug use)
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12. Outreach and peer education
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13. Marginalised groups (such as youth, ethnic/indigenous, prisoners, gay men and women)
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14. The risks associated with non-injecting drug use
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15. Drug user organisations
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16. Advocacy
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17. Human Rights
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18. UN Position Statements and Papers on HIV and injecting drug use (IDU)
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Documents have been labelled (P) if they are policy and/or commentary; (G) if they are guidelines, practice guides and/or manuals; (R) if they are reviews of literature; (O) if they are pieces of original research; and (M) for miscellaneous or other types of document.
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1. The meaning of harm reduction in the context of HIV prevention for injecting drug users (IDU)
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This section examines the notion of harm reduction, which is defined in IHRA’s “What Is Harm Reduction” briefing paper as “policies and programmes which attempt primarily to reduce the adverse health, social and economic consequences of mood altering substances to individual drug users, their families and communities”. This concept of harm reduction is examined in relation to reducing the risk of HIV infection for injecting drug users. Papers in this section include a review (R) of the evidence for harm reduction, guidelines (G), a framework for implementing harm reduction policies for IDUs and a fact sheet about the meaning of harm reduction (M).
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2. Epidemiology of injecting drug use (IDU) and related HIV infection
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Epidemiology is defined as the study of diseases in populations. This section therefore covers the epidemiology of HIV among IDU worldwide (R), as well as guidelines on gathering data and conducting surveillance in order to estimate the prevalence of IDU and HIV (G).
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3. HIV/AIDS prevention policy and programming
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This section includes papers about how best to deliver HIV prevention, as well as papers on the effectiveness of individual and public health interventions. The documents in this section include detailed guidelines for implementing effective, evidence-based programs for preventing HIV/AIDS among IDU (P)(G)(O).
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4. Assessing local and national need for interventions
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This section includes papers on the technique of ‘Rapid Assessment and Response’ (RAR), described by the Centre for Research on Drugs and Health Behaviour as “identifying the extent and nature of health risk behaviours and associated health consequences and to identify existing resources and opportunities for intervention” (from www.rararchives.org/Intro_To_RA.html. Papers in this section include an international review by the World health Organization (WHO) of rapid assessments that have been conducted on drug use (R), and WHO guidelines for conducting ‘Rapid Assessment and Response’ at a local and national level (G).
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5. Resource allocation/requirements
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This section provides information on how the funding required for developing and operating successful HIV prevention programs for injecting drug users (IDU) in developing countries can be estimated (O).
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6. Injecting drug user (IDU) risk behaviours
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This section refers to the risks associated with injecting drugs, especially the risk of HIV infection and how these risks can be reduced. Included in this section is the comprehensive ‘Manual for Reducing Drug Related Harm in Asia’, published by the Centre for Harm Reduction (P)(G).
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7. Sexual risk behaviour
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This section describes the spread of HIV through sexual behaviour by injecting drug users (IDU). Included in this section is the ‘Rapid Assessment and Response Guide on Psychoactive Substance Use and Sexual Risk Behaviour’ published by the World Health Organization (G).
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8. Needle and syringe programs (NSPs)
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This section summarises the strong evidence that NSP can reduce HIV infections among injecting drug users (IDU) without increasing illicit drug use. The section includes comprehensive guidelines on the establishment and management of NSP (R)(G)(P)(O).
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9. Substitution treatments
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This section reviews the evidence for substitution treatment programs for injecting drug users (IDU) to prevent HIV infection. It includes guidelines on the establishment and operation of substitution treatment programs for IDU (G)(R).
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10. Antiretroviral (ARV) treatment
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This section covers ARV treatment for HIV-positive persons, including guidelines and procedures relating to injecting drug users (IDU) in particular (G)(P).
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11. Health promotion and drug education (including prevention of drug use)
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This section describes how drug education can be made more effective in reducing the spread of HIV, and includes guidelines on preventing drug use among children and adolescents (G).
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12. Outreach and peer education
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This section describes the techniques of outreach and peer education as a means of reducing HIV infection among injecting drug users (IDU). There are reviews of the evidence that outreach and peer education can help to reduce HIV (R), pieces of original research on outreach among street-recruited drug users in India (O), and guidelines on how to conduct outreach with IDU (G).
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13. Marginalised groups (such as youth, ethnic/indigenous, prisoners, gay men and women)
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This section reviews the evidence for the effectiveness of HIV prevention strategies infection among injecting drug users (IDU) from some marginalised groups. Papers include a guide for researchers evaluating HIV prevention programs among young IDU (G), and a review of the effectiveness of interventions for marginalised and particularly vulnerable IDU such as prisoners, indigenous peoples, men who have sex with men and sex workers (R).
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14. The risks associated with non-injecting drug use
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This section covers the risks of HIV infection which are associated with drug use that is administered by means other than injection. One example, which is examined, is the increased risk of HIV infection through the heightened sexual risk behaviours that can result from non-injecting crystal methamphetamine use (P).
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15. Drug user organisations
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Drug user organisations are run by, and for, former or active drug users. They aim to improve the health and human rights of drug users through activism, promoting and using the principles of harm reduction, and offering peer support and education (O).
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16. Advocacy
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According to the World Health Organization (WHO), advocacy refers to “building political and popular support to effect policy change and to mobilise resources”. The papers in this section include an advocacy guide for preventing HIV among injecting drug users (IDU) produced by WHO (G), as well as policy and commentary papers regarding the reduction of HIV infection among IDU (P).
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17. Human Rights
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This section discusses human rights in the context of injecting drug users (IDU) and HIV. Papers in this section include a handbook for legislators on HIV/AIDS human rights and the law (G), and discussion papers on the need to offer protection to HIV-positive individuals and drug users (P).
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18. UN Position Statements and Papers on HIV and injecting drug use (IDU)
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This section is concerned with HIV/AIDS prevention, intravenous drug users (IDU) and harm reduction on a transnational level. The papers presented here are endorsed by the United Nations and its subsidiary institutions, such as Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Office on Drugs and Crime (UNODC). As a result, these documents are grounded in international law, treaties and conventions. In this section, you will find explicit endorsements of harm reduction policies as an effective way of reducing global HIV infections among IDU. There are also explicit approvals for the resulting harm reduction interventions such as sterile needle-syringe exchange programmes, substitution treatment and peer outreach (P)(G).
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