1. Social and medical care of intravenous drug users in the Central Bohemian Region Czech Republic PhDr. Pavla Doležalová regional anti-drug coordinator

2. Content Demographic figures from CBR Social and health care network facilities for drug users Mobility of services A model of the spectrum of services in a low-threshold center Intravenous drug users with HIV in the services network Harm reduction program Conclusion

3. Some demographic figures of CBR The CBR region comprises 14% area of the CR, have 12 districts Population Central Bohemia Region: 1 144 071. Population Prague: 1 170 571. Population Czech Republic: 10 220 577. Source: ČSÚ 2004

4. Social and health care facilities network for drug users Policy of the Basic Network of Health and Social Services for Drug Addicted Persons in the CB Region Key document – financial analysis and schedule Approved by political representation of CBR Coordination at regional level- committee and working group focusing on HIV/AIDS, education programs, co-financed by respective ministries, region, municipalities.

7. Mobility of services Interconnecting K-C and psychiatric care services with a focus on AT Based on following principles: Increase and maintain quality of life of IDU The aim is to ensure: Proficiency Accessibility Interconnection Complexity Low-threshold principle

8. Model of the spectrum of services in low-threshold centers K-centrum: outreached programs– HR, university, secondary school, social workers- social care, counseling etc. Psychiatrist-AT specialist - diagnosis, pharmacotherapy, substitution, psychotherapy, family therapy Clinical psychologist - diagnosis, psychotherapy, family therapy etc.

9. Intravenous drug users with HIV in the services network Harm reduction program Crisis intervention Information, nutrition and hygienic services, counseling, education Laboratory tests and after care Reduction of the demand Diagnostic filter and referral to consequent services Individual and group psychotherapy Family therapy Relapse prevention Pharmacotherapy Substitution Counseling Expertises

10. Harm reduction program-HIV prevention by IDU as a part of the prevention of public health care -KC Harm reduction program-HIV prevention by IDU as a part of the prevention of public health care -KC In 12 districts of CBR, the program is fully accessible starting in 2007 Always less expensive than after treatment or repression, it increases the interest for treatment. It reduces the risks especially of hepatitis, HIV/AIDS and other infections diseases IDU ( CBR-prevalence of HIV/AIDS in IDU in 2006: 8,5% from in total 82 persons). HIV monitoring, KC- preliminary tests in collaboration with National Reference Laboratories

11. Consequences: How to improve efficiency of care for IDU? Analysis of needs, research studies, financial analysis, monitoring, concept, human resources… Obtain Political support Obtain Financial sources Networking Interconnect social and health services, to increase the quality of life To ensure high quality and complex, accessible care, high- skilled professionals Evaluation

12. Thank you for your attention dolezalova@kr-s.cz