DAILY UPDATE

DAYTWOTuesday 27 April 2010

LACK OF APPROPRIATE INFORMATION

andeducation is putting young people at riskaccording to representatives from Youth Rise.Each made the case for non-judgementalinterventions, tailored for the youth audience.Most injecting drug users started practisingbefore the age of 25, yet few HIV prevention pro-grammes focused on youth, said Chantale Kallas,from the Lebanon,

pictured above with colleagues Anita Krug and Lynn Itani

. Local data showed that72 per cent of IDUs were less than 30 years oldand more than 80 per cent shared needles. Riskybehaviour was linked to inadequate informationand no access to health centres.Five per cent of all deaths between ages fiveand 29 were attributable to alcohol use in a 1990study, and a significant number of the estimated13.2m IDUs worldwide were young people. Nearlyhalf of HIV infections related to young people aged14 to 24, and 5.4m young people worldwide wereinfected with HIV.Consultation led by UN groups called for apackage of confidential adolescent-friendlyservices that respected the rights of children to beheard and have their views taken into account.‘We need to help children to build resilience andbe better problem-solvers,’ said Ms Kallas,advising that any initiatives should be appropriateto the overall context of their community. Thiscould be achieved by incorporating peereducation and integrating young people’s serviceswith other sectors of the community, as well asmaking sure health providers were specificallytrained in youth-friendly approaches.‘It’s important that outreach teams go to placeswhere young people hang out,’ she said. Talking tothem confidentially in their own environment made itmore likely they would participate in voluntary coun-selling and testing for HIV and hepatitis B and C.‘Our Youth Rise experiences have shown wecan customise services, she added. ‘Youth cultureis different from adult culture, so you need to beflexible. Information must be written for a youthaudience. It is also important to differentiatebetween use and abuse –if you get young peopleinvolved you will know the best language to use.’ To demonstrate that initiatives for young peoplewere a worthwhile investment, she quoted feedbackfrom a former Youth Rise member: ‘Provideresources to us and we will do so much with them.’

Youth Rise lead the call for young people’s involvement

HIGHLIGHTS

Tuesday 27 April

PLENARY SESSION

Martin Acuna

examines the recentshift towards decriminalisation indrug-related policies in the Argentine Republic and Latin American countries.

Genevieve Harris

explores roomfor manoeuvre in the global drugprohibition regime governed by theUN-based treaty system. The innovation and evidence thatback up the Portuguese nationalstrategy on drugs, presented by

Alex Stevens

Steve Rolles

tells delegates whatan evidence-based drug policybased on public health and harmreduction might look like.

DIALOGUE SPACE

12.30 – 17.30

Beginning with

Jamie Bridge

and

Elie Aaraj

’s talk show

Dogmaversus stigma

, there will be livelydiscussions on a variety of subjects.

FILM FESTIVAL

Showing films from around theworld from 12.30 in the cinema,auditorium level, and continuing at17.15 at FACT movie theatre – seemap on the back of the programme.

Lunch break from 12.30 – 14.00

Sessions

P2:

Ann Fordham will bereplaced by GenevieveHarris.

P2:

Fatima Trigueiros will bereplaced by Alex Stevens.

M04:

Cheryl White will notpresent.

M05:

Ernest Drucker will notpresent.

C16:

Will be chaired by BradleyMathers.

C17:

Dave Burrows will notpresent.

C22:

Zaw Thein Oo and RaffiBalian will not present.

C22:

Brito Irma will present

Before you get burnt:University Peer Education

C24:

Marie-Claude Couture willbe replaced by Lisa Maher.

Bringing the youthaudience:

KathrineJack, staff attorneyatthe NationalAdvocates forPregnantWomenand her son Omsample the vastarray of posters onshow on level 3 of the conferencecentre. You willfind a guide toposterpresentations inthe back of yourconferencehandbook.

2–

Dail

y Up

dat

– DAY T

WO– Tuesday 27 April 2010

Aboutthe daily update

Message for Tweeters!

If you are Tweeting from the IHRAconference, please remember to includethe ‘hashtag’(#)ihra and your message willbe added to the Facebook page of www.injectingadvice.com

Calling all doctors

There will be a meeting of IDHDP onWednesday 28 April at 13.45 at Suite 8,Jury’s Inn, 31 Keel Wharf, Liverpool (justopposite the conference centre). IDHDP inthe International Doctors for Healthy DrugPolicies, an international e-network whoseaim is to reduce drug-related harm bysupporting doctors worldwide to improvetheir practice and influence peers andpolicymakers. Come and be a part of theworldwide voice for healthy drug policies.www.idhdp.com

EuroHRN Launches today

Come along to the launch of theEuropean Harm Reduction Network(EuroHRN) on Tuesday 27 April at13.30–14.30 to hear about the network’splans and the opportunity to join up. Themeeting takes place at Jury’s Inn, 31 KeelWharf, Liverpool (opposite the conferencecentre). If you can’t make the meeting butwant to know more, email Maria Phelan atmaria.phelan@ihra.net

notices...notices...notices...

The Daily Update

is produced on behalf ofIHRA by CJ Wellings Ltd, publishers of

Drink and Drugs News

(DDN) in the UK. DDN is afree fortnightly magazine circulated to peopleworking in all areas of the drug and alcoholfield, and is read worldwide online. The DDNwebsite, which contains current and backissues of the magazine, is freely accessible at

www.drinkanddrugsnews.com

. To advertise inDDN email

ian@cjwellings.com

Daily updates will be available on Monday,Tuesday, Wednesday and Thursday morningsat the conference, and will include latechanges to the programme.Reporting team: Claire Brown, David Gilliver, IanRalph. Design: Jez Tucker. For editorial enquiriesor feedback, please email claire@cjwellings.com

Programmechanges

TUESDAY 27 APRIL 2010

Escalatingexcitement:

Monday'sdelegates breakfrom a morning'shard work to headfor lunch.

Global training aims tonetwider youth audience

Tuesday 27 April 2010 – DAY T

WO–

Dail

y Update

– 3

INTERVENTIONS TO COMBAT

the spread of HIV among injecting drug users need to bescaled up dramatically, Bradley Mathers of theUniversity of New South Wales told delegates inMonday’s opening plenary,

Harm reduction: next generation challenges.

He was reporting on the results of a globalsystematic review of efforts to expand HIVprevention – ‘a stocktake of where we are this farinto harm reduction’ – looking at how farresponses were meeting the needs of injectingdrug populations. There were documentedreports of injecting drug use in 151 countries,which could add up to as many as 21.2mpeople, he said. There was an ongoing processof improving the data, but the best estimate of IDUs living with HIV was around 3m, he said, half of whom were concentrated in Eastern Europeand South East Asia. The review focused on needle and syringeprogrammes, opioid substitution therapy andantiretroviral therapy. Needle and syringeprogrammes were confirmed in 82 countries, hesaid, but this ranged from low to high coverage,the latter defined as 200 needles/syringesdistributed per IDU per year. Most of the world fellinto the ‘low’ category, however, of fewer than100 needles per IDU per year – which meant‘potentially a large amount of HIV risk.’ Globally,only 22 needles/syringes were distributed perIDU per year, he said, which meant that onlyaround five per cent of worldwide injecting wasdone using clean equipment.Opioid substitution therapy was present in 71countries, but absent in around 80 countrieswhere injecting occurs. Measuring the coverageof programmes was difficult, but some countries– mainly in Western Europe – were achievinghigh-level coverage. However, coverage remainedlow in most places and globally only eight peopleper 100 IDUs were receiving opioid substitutiontherapy, he told delegates. Worldwide, only fourIDUs received antiretroviral therapy for every 100HIV-positive injectors, he said.Interventions needed to be delivered toscale and in combination, he stressed – atpresent only a minority of countries weredelivering them to the scale required. Acknowledging that it was ‘easier said thandone’, he told delegates that ‘theseinterventions work best when deliveredtogether – we need to scale them up, and weneed to scale them up together.’

HIV interventions mustbe‘scaled up dramatically’

HARM REDUCTION TRAINING

and services are not being targetedon young people globally, according to Kyla Zanardi, Youth Rise’srepresentative on HIV prevention.With an estimated 6,000 new HIV infections each day amongyoung people aged 15 to 24, her project aimed to provide freeaccess to training and advocacy resources for young people onHIV and Aids prevention and substance use. A ‘youth engagement approach’ was the guiding principle,complemented by adult partnerships, support and advice. Traininghad to be ‘context-specific, flexible and creative’, outlining bestpractice on harm reduction, HIV prevention, sexual health andsubstance use. Youth-led training sessions had been held in different countries,to provide tangible guidance. Young people had been recruited forthe sessions by using an open call in a newspaper and throughword of mouth among local NGOs.Peer training had proved particularly useful in encouragingparticipants to volunteer for HIV and hepatitis C testing, and theinjecting drug users had been keen to ask for more informationafter the sessions. Their feedback had included requests formore interactive training so they had the opportunity to sharetheir own experiences, and a call for additional multimediamaterial such as films and audio clips on overdose and drugtreatment –which could be difficult when working with localNGOs with limited resources, commented Ms Zanardi.With the project continuing its next phase of training in Mexicoand Canada, and development of a more comprenhesive educationprocess, a guide would be launched on World Aids Day, 1December 2010.

Bradley Mathers:

Only around five per cent ofworldwide injecting is done using clean equipment.

AN INCREASE

in drug-relatedviolence in Mexico had driven thegrowth of drug treatment centres butcompromised quality of care,according to Aram Barra, a long-timeactivist who had been working with Youth Rise. The ‘War on Drugs’ had resultedin a ‘decree’, which modified generalhealth law and the federal criminalcode and aimed to differentiatebetween drug users, small timetraffickers and the major drugtraffickers, he explained. It includeda table of maximum amounts thatcould be carried by a person,providing a compulsory route intodrug treatment centres. These 329 ‘new life’ centres werebrand new and in many casessituated in neighbourhoods thatwere considered ‘risky’ for drugcrime. But fast growth had meantthat they lacked funding and hadinadequate facilities inside.‘There is no systematic way of re-cording people coming into thecentre, or whether their treatmenthas been successful,’ said Mr Barra.Furthermore, there was lack of pragmatic drug policy and lack of harm reduction policy.‘On a positive note, they are sobadly funded that they are open toreceiving support and advocacymaterial,’ he added. ‘They are willingto collaborate with NGOs in the fieldand share information.’

Aram Barra:

Poor funding leads toopen-minded attitudes to advocacyand support.

Mexicancrime drives‘inadequate’treatment