IHRD grantees and partners from 19 countries in Eastern Europe, Central Asia, and Asia attended the OSI seminar “Moving Harm Reduction Policy Forward: Non-Coercive Drug Treatment and Sexual and Reproductive Rights for Injecting Drug Users,” which included presentations, a training, discussions, and site visits to harm reduction services in Amsterdam.

The first day of the seminar focused on sexual and reproductive health and rights of drug users. Topics discussed included women’s access to accurate information about drug use, pregnancy, and mother-to-child transmission of HIV; reproductive rights of drug users, including those with HIV; tailoring harm reduction programs to suit the needs of women; preventing sexual transmission of HIV among drug users; and ways to address drug using women’s increased vulnerability to HIV. Women are often less visible to harm reduction workers because they are more likely to have a partner or friend obtain their syringes and drugs. Unprotected sex with a drug using partner can elevate women’s risk of HIV, and gendered power imbalances may make it more difficult for women to negotiate condom use or avoid sharing needles. Pregnant drug users are often urged to have abortions or to give up their children, and are denied accurate information about the effects of drug use during pregnancy and prevention of mother-to-child transmission of HIV. Seminar participants came up with possible designs for harm reduction programs for women, identifying key issues in their countries and developing advocacy strategies.

On the second day, participants discussed the forms of drug treatment available in their countries, and ways to advocate for voluntary, evidence-based drug treatment that respects drug users’ human rights. In some countries, including Thailand, Indonesia, and China, drug users can be forced into treatment camps that may involve unpaid labor, humiliation, and violence. Substitution treatment with methadone or buprenorphine is proven to be the most effective treatment for opiate addiction, and helps prevent HIV by reducing drug use and injection. Yet it is available to only a tiny fraction of opiate users worldwide, and is often provided in punitive or overly restrictive programs that are not integrated with other forms of harm reduction. In Russia, with an estimated two million injecting drug users and the largest HIV epidemic in Europe, substitution treatment is illegal.

The third day included a training on overdose prevention, with discussion of how to develop a successful prevention program. Opiate overdose deaths can be prevented by mouth-to-mouth breathing or by injection with naloxone, an opiate antagonist that safely reverses the effects of heroin. Yet because overdose prevention trainings are rare and naloxone is not available in many countries, overdose continues to take the lives of thousands of drug users.

For full information on the seminar, including presentations and additional materials in English and Russian, visit http://health.osf.lt/en/seminars/.