HIV Prevention Knowledge Base
Combination Approaches: Harm Reduction for Injecting Drug Users
Asian Harm Reduction Network Library
Asian Harm Reduction Network (AHRN). (2010).
The AHRN's searchable online library offers registered users access to thousands of documents related to injecting drug use, with a focus on Asia. HIV is one of six main topics in the collection. Free subscription to an electronic newsletter is available and back issues may be downloaded or read online.
View AHRN Website
The Harm Reduction Coalition
The Harm Reduction Coalition. (2010)
The Harm Reduction Coalition is a national U.S. advocacy and capacity-building organization that promotes the health and dignity of individuals and communities affected by drug use. It advances policies and programs that help people overcome the adverse effects of drug use, including overdose, HIV, hepatitis C, addiction, and incarceration. In addition to training materials, calendars, and community resources, the website provides links to local services as well as ways that people can get involved.
View Harm Reduction Coalition Website
Open Society Institute: Harm Reduction and Drug Use
Open Society Institute (OSI). (2010).
One of the components of the OSI's Public Health program is harm reduction and drug use. This website contains OSI's resources and information on their work, including publications, articles, and multimedia on harm reduction and drug use. Events and resource links are also available.
People Who Use Injecting Drugs—Technical Policies of the UNAIDS Programme
A critical resource for policy development, this website brings together technical guidance, position papers, and policy briefs from UNAIDS. The technical guide lays out targets for access to HIV prevention, treatment, and care for IDUs. There are policy briefs on antiretroviral therapy and on the reduction of HIV transmission through drug dependence treatment, outreach, and NSPs. Position papers outlining the U.N. system's policy on HIV prevention among IDUs and a statement on HIV prevention and care strategies for IDUs round out the collection.
Harm Reduction Developments 2008: Countries with Injection-Driven HIV Epidemics
In 2007, IDUs 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, OST, harm reduction work in prisons, and programs with commercial sex workers, among others. Data presented include IDUs as a percentage of HIV cases, OST availability, and estimates of IDUs 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.
View Report (PDF, 1.35 MB)
"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, & OSI. (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 developing 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, decision-making, or policymaking bodies, advisory structures, and community-based organizations; and providing international leadership on greater involvement.
View Report (PDF, 870 KB)
High Coverage Sites: HIV Prevention Among Injecting Drug Users in Transitional and Developing Countries: Case Studies
Burrows, D. (2006).
Part of the 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 IDUs 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 IDUs in developing and transitional countries.
View Report (PDF, 1.57 MB)
HIV/AIDS Prevention and Care for Female Injecting Drug Users
This four-page brief highlights why female IDUs are more vulnerable than their male counterparts, including infected injections (women IDUs 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 IDUs because the services cannot meet their specific needs. To better reach female IDUs, comprehensive gender-sensitive services are recommended, including HIV counseling and testing, treatment for STIs, antiretroviral therapy for prevention of mother-to-child transmission, condoms, sterile needles and syringes, and gender-sensitive drug dependence treatment.
View Report (PDF, 95 KB)
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.
Policy and Programming Guide for HIV/AIDS Prevention and Care among Injecting Drug Users
This guide distills the principles of policies and programs that have worked well in responding to the HIV epidemic among IDUs. The guide is meant to be used by those developing such policies and programs throughout the world in conjunction with other WHO guides (see Guide to Starting and Managing Needle and Syringe Programmes and Advocacy Guide: HIV/AIDS Prevention among Injecting Drug Users). This guide shows how the strategies for each part of a comprehensive response are built and fit together.
View Report (PDF, 848 KB)
Drug Abuse and HIV/AIDS: Lessons Learned: Case Studies Booklet, Central and Eastern Europe and the Central Asian States
UNAIDS & UNODC. (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 IDUs.
View Report (PDF, 958 KB)
The Asian Harm Reduction Network: Supporting Responses to HIV and Injecting Drug Use in Asia
This report presents the epidemiology of HIV in Asia and the genesis of the ARHN in response to evidence that IDUs represent a growing proportion of the HIV epidemic. ARHN focuses on supporting existing programs through strengthening existing ties and providing support for new responses through information dissemination, training, advocacy, and networking. AHRN has demonstrated that harm reduction is both possible and worth pursuing in Asia, sharing information through Listservs, reports, research repositories, and other means. The organization details lessons learned in establishing such a network in the last section of the report.
View Report (PDF, 414 KB)
Injecting Drug Use and Prisons Publications
This section of the WHO website houses a wealth of publications pertaining to injecting drug use and prisons. The site is divided into three sections. The first comprises documents on injection drug use in general; the second covers injection drug use in the prison context; and the third provides access to information produced by the WHO's regional offices. Many documents cited as essential reading in Appendix 1 of The U.S. President's Emergency Plan for AIDS Relief: Comprehensive HIV Prevention for People Who Inject Drugs, Revised Guidance (2010) may be found here.
International Harm Reduction Association
International Harm Reduction Association (IHRA). (2010).
The website of this important global advocacy organization houses the Global State of Harm Reduction 2010 report, detailing major developments and presented region-by-region. A two-page summary, What is harm reduction?, is available to download in 11 languages, and there is a comprehensive library of reports, briefings, and presentations on harm reduction. There are details of the IHRA's upcoming annual international conference, and the conference archive has materials and program details from the event in previous years.
View International Harm Reduction Association Website