1. Reaching out to drug users and communities “ ” WDP Preventing HIV Yasmin Batliwala

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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)

10. 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

11. 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

12. 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

13. WDP - Innovation All WDP employees are given comprehensive training re harm reduction All employees give harm reduction advice at assessment including safer sex advice

14. WDP - Innovation Needle exchanges offer packs with: –Water –“never share” needles –“Pick and mix needles” –Condoms –Bins –Acid –Expert advice

15. WDP - Innovation Dry spot testing Encourage testing Non invasive Economic Integrated treatment

16. 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

17. 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

18. Thank You