Reaching out to drug users and communities

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WDP Preventing HIVYasmin Batliwala

Who are WDP?

• WDP is a medium sized agency in the Third Sector

• We work with drug users at all stages of their use• Clients range from chaotic users, ambiguous

about their use, to those who are maintaining their abstinence

• WDP works – In the criminal justice system (custody suites and

courts)– In community settings – With the children of drug using parents– With families

Who are WDP?

• WDP has a reputation for providing– Quality services– A qualified, committed workforce of 250– Excellence in training and developing

employees• WDP sees over 500 clients a month in its needle

exchange services• WDP sees over 200 clients a month in its

criminal justice services

The early UK experience

• ACMD stated that “ the threat to individual and public health posed by HIV and AIDS was much greater than the threat posed by drug misuse”

• Thus HIV was the catalyst for needle exchange provision in the UK

The early UK experience

• Prevalence of HIV in the UK 0.2% general population

• Prevalence statistics `95 - `99 suggest rates in IDU HIV rates reduced from 5.7% - 2.9%. Stabilised in the rest of the UK

• This reduction and stabilisation has been attributed to needle exchange provision and other harm reduction initiatives

UK- contemporary picture• Rate of HIV infection

amongst DU increased • Average of 1 in 50

across UK, London rates higher approx 1 in 25

• Prevalence amongst new injectors (last 3 years) is an indicator of recent transmission rates

UK – contemporary picture

• UAPMP study suggests that new infections at their highest ever levels

• 34% of this sample of more than 3000 DUs reported never having had a HIV test

• On testing, 47 individuals found to have HIV antibodies yet only 47% were aware that they were infected

• Lowest awareness rate ever recorded

Why?

• Increased heroin availability and use

• Initial HIV message watered down

• Rise of crack use (crack users more likely to test positive)

• Rise of speedballing

• New generations of drug users not exposed to so much awareness raising

Why increase in sharing?

• Rise of Hepatitis C = nihilistic attitude?

• Bigger pool of infected users

• Needle Exchange provision wide but not always accessible when needed

• STILL poor knowledge re sharing

• Also early research methodology not specific enough (Just asked about sharing needles)

What is WDP doing?

• WDP sees an average of 500 clients a month over 3 different sites in needle exchange services

• WDP also supports the police in giving out needle packs in stations across Westminster

• WDP = London wide coverage

WDP Needle Exchange Van

• The mobile needle exchange offers a unique service

• Works outside office hours and in clients own environment

• Sees 50 clients per month with multiple interactions

WDP Needle Exchange Van

• Offers advice and information

• Engages with users who do not access services

• Engages with sex workers• Gives out condoms• Takes back supplies of

used needles• A “ pick and mix” of

needles given

WDP - Innovation

• All WDP employees are given comprehensive training re harm reduction

• All employees give harm reduction advice at assessment including safer sex advice

WDP - Innovation

• Needle exchanges offer packs with: – Water– “never share” needles– “Pick and mix needles”– Condoms– Bins– Acid– Expert advice

WDP - Innovation

• Dry spot testing• Encourage testing• Non invasive• Economic• Integrated treatment

WDP - Innovation

• Working with sex workers

• Giving out condoms, lip salve

• Expert advice and information

• Working in partnership

• Has lead to women’s group– Working with 10 – 12 women weekly

WDP - Innovation

• WDP works in partnership with pharmacies

• Delivers harm reduction advice to wider client group

• Reaches those that will not attend services

• Provides expert advice and information

Thank You