AEGiS-14IAC: Implementation of comprehensive harm reduction interventions in Spain. 1993-2000.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

DonateNow
Print this article

Implementation of comprehensive harm reduction interventions in Spain. 1993-2000.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. TuOrF1166)

Rodes A, Suarez M, Menoyo C, De la Fuente L, Bolea A, Parras F
Secretaria del Plan Nacional sobre el Sida. Ministerio de Sanidad y Consumo, Madrid, Spain

ISSUES: In Spain, AIDS incidence in 2000 was 59 cases per million with three out of five cases being among intravenous drug users (IDU). HIV prevalence amongst IDUs ranges 11-47% and syringe sharing between 20-30%.

DESCRIPTION: Interventions among IDUs were introduced and expanded in 1993 when prevalence was high. Key targets were current injectors not in treatment, unable or unwilling to stop injecting. Ideas of service accessibility, flexibility of service delivery, multiple and intermediate goals for treatment, and -most significantly- of harm minimization, were introduced.

ISSUES: A rapid development and expansion of syringe distribution and exchange, methadone treatment and outreach work has taken place in less than 7 years. Despite legal constrains regarding consumption of illegal drugs and a widespread prejudiced image of IDUs, a progressive inclusion of users users into programs and non-governmental associations has been observed. Exchange points increased sharply from 1996 to 2000 (450 and 1100 respectively) achieving a high degree of diversity (75% pharmacy-based, 12% in health centers and 12% through street-outreach workers, vehicles or in fixed premises). Ensuring the 1993 WHO Guidelines, the first experience of syringe exchange in a prison setting started in 1997, with 9 such programs already functioning in 2000. The number of IDUs who received a methadone treatment increased progressively from 28800 in 1995 to 78800 in 2000 (20200 in prison settings). In 2000 there were 9 associations of injecting drug users.

RECOMMENDATIONS: HIV epidemic among IDUs has proved to change with timely harm reduction measures. Spain failed to achieve this change. However new interventions were developed, and despite its difficulties and delay, were feasible and successful even in especially complex settings. In this population public health prevention works and needs to be sustained since even successful HIV prevention programs do not eliminate risk behaviors.

Keywords: AEGIS, Substance Abuse, Intravenous, Harm Reduction, Incidence, Prevalence, Risk-Taking, HIV Infections, Acquired Immunodeficiency Syndrome, Spain, HIV, HIV Seroprevalence, Disease Outbreaks, HIV Antibodies, Syringes, Prisons, nursing, immunologyKWDaegis,substanceabuse,intravenous,harmreduction,incidence,prevalence,risk-taking,hivinfections,acquiredimmunodeficiencysyndrome,spain,hiv,hivseroprevalence,diseaseoutbreaks,hivantibodies,syringes,prisons,nursing,immunology

020707
TuOrF1166

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.