2. RISK AND HARM REDUCTION OUTREACH ACTIVITIES

3. BETO SANTOS, Driver - CHRIS MOEMA, Project Coordinator

4. PROJECT “TÁ LIGADO?” ▪ A partnership between Psicotropicus and government institutions concerned with social and health vulnerabilities related to illegal drugs and alcohol use. ▪ Financed by UNODC/Brazilian Ministry of Health.

5. POOL OF GOVERNMENT INSTITUTIONS LED BY PSICOTROPICUS ▪ State Health Secretary of Rio de Janeiro (HIV/AIDS and Mental Health) ▪ HIV/AIDS County Coordination of São João de Meriti and Niterói ▪ Alcohol and Drugs Psychosocial Attention Centers (CAPs-AD) ▪ Program for Alcohol and Drugs (PROJAD) of Federal University of Rio de Janeiro

6. PROJECT PERIOD ▪ January 2010 to January 2011 – extended in Rio for another three months ▪ Total: 15 months - São João de Meriti (March-May 2010) - Niterói (June-August 2010) - Rio de Janeiro (September 2010 – March 2011) ▪ Each municipality: 02 visits a week

7. BASIC TEAM A local agent, an outreach professional and the project coordinator. Volunteers.

8. Team and Psicotropicus supervisor

9. SPECIAL CHARACTERISTIC ▪ The drug using scene in the city of Rio de Janeiro was located inside a favela ruled by drug dealers – JACAREZINHO. (Oct 2012: state forces took over the community. An Unity of Pacifying Police – UPP – is now in place over there. Drug dealers fled to other areas.)

10. CRACKLAND IN JACAREZINHO AND TEAM AT WORK

11. BODY CONDITIONS ▪ Lack of hygiene ▪ General uncare of body, dirty skin ▪ Low weight ▪ Dirty and dark nails and fingers – especially thumb and index finger – due to burning caused by constant use of lighters to smoke the crack rocks.

12. PROBLEM TO SOLVE ▪ Drug users have difficulty to access health and social services due to health professionals’ stigma, prejudice and lack of proper training. ▪ This situation favors exclusion and segregation, reinforcing the vulnerability of these people to social and health risks and harms.

13. FIELD ACTIVITIES ▪ Evaluate living conditions of users. ▪ Referral to local health and social assistance services - whose professionals had previously undergone training. ▪ Distribution of harm reduction material: pipes for smoking crack, balm lipsticks, condoms, and chocolate milk.

14. CRACK PIPE, BALM LIPSTICK, CONDOM, PRINTED INFORMATION INSIDE A BOX FOR GLASSES

16. PLASTIC WATER BOTTLE with ALUMINIUM TOP

17. OTHER FIELD ACTIVITIES ▪ Carry out risk assessment for sexually transmitted infections and drug using. ▪ Stimulate HIV and hepatitis testing. ▪ Fill in questionnaires, to learn about most essential, urgent health and social needs.

18. Questionnaires voluntarily filled in by users

19. OBJECTIVES ▪ Work as a pilot project through intervention in three urban areas recognized as spaces where people who use drugs live in situation of social vulnerability. ▪ Enable multidisciplinary teams and strategic partners to perform this type of harm reduction intervention. ▪ Build instruments to collect data and information about social and health needs of drug users - mostly crack users. ▪ Monitor and evaluate the pilot experience. ▪ Create conditions to future sustainability and dissemination of successful actions of the pilot experience.

20. JACAREZINHO, RIO – 2010 ▪ Field Days: 21 ▪ Total of non-registered users: 985 ▪ Total registered users : 95 (8.9%) ▪ Total Users: 1.068 ▪ Average users seen per day: 50.8 ▪ Total injecting drug users: 12 (1.1%)

21. NUMBER OF SUPPLIES PROVIDED (N = 1.068) Lip balms: 1.007 Pipes: 873 Straws: 254 Condoms: 7.804 Chocolate Milk: 1.278 Disposal box: 24 Kits for Injecting Drugs Users: 17 Educational Material: 1.471