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PSI/China's Kunming Drug-User Harm Reduction Drop-In Center
吸毒人员减少危害活动中心
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• Drug Abuse and HIV/AIDS in Yunnan
• The Need for New Strategy
• The Harm Reduction Concept
• The Harm Reduction Concept
• An Integrated Set of Core Services
• A Supportive Environment
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| Drug Abuse and HIV/AIDS
in Yunnan Province |
| Yunnan Province is one of the areas of China with alarmingly
high rates of drug use.Yunnan also has one of the highest
prevalence rates of HIV/AIDS infection. Intravenous drug use
and sharing of syringes are the primary causes of HIV/AIDS
transmissions in the region. It is estimated that 70% of the
HIV infections in Yunnan are due to injecting drug use. Drug
abuse negatively impacts not only the users themselves, but
also their families, their communities and society at large.
The continued high prevalence of drug use brings in its wake
mounting health problems, not least of which is an acceleration
of the spread of HIV/AIDS, which in turn dramatically increases
the financial burden on limited health resources. |
| The Need for a New
Strategy |
| Drug abuse is no longer just a legal issue, but has become
a critical public health and social issue as well. Compulsory
and, to a lesser extant, voluntary detoxification programs
are currently the standard means of dealing with drug abuse
in China. Although positive results have been achieved via
these detoxification programs, the extremely high rate of
relapse following release from these programs is still a major
concern. Among the causes of relapse are social isolation
and the lack of a supportive environment to encourage the
maintenance of the newly acquired, healthier behaviors. Both
current and former drug users are the targets of social stigma
and discrimination. Due to these prejudices, many former drug
users have difficulty finding permanent employment. Post-detoxification
support services, such as counseling and vocational guidance,
are insufficient, if available at all. Current users have
little to no access to needed health services and health information,
since most existing service points are not geared towards
the problems particular to drug users, and drugs users, being
marginalized, cannot readily access them. Consequently, important
information and services that could reduce the negative health
consequences of drug use, including exposure to HIV/AIDS,
are not readily available to those most at risk and most in
need. |
| The Harm Reduction
Concept |
| Harm reduction is a set of non-judgmental, realistic strategies
to empower drug users and their communities to reduce the
negative consequences of drug use. First developed in the
early 1970’s, Harm Reduction has, after more than 20 years
continuous practice, succeeded in significantly reducing the
harmful consequences of drug use in Europe, the United States
and several developing countries. The government of the People’s
Republic of China has now incorporated the Harm Reduction
strategy into its current Five-Year Action Plan. |
| Goals and
Objectives |
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In order to reduce the negative consequences of drug use
for both the individual and the community, and to stem the
rate of HIV/AIDS transmission, Population Services International
(PSI) has established a Drop-in Center for current and former
drug users. PSI’s goal in establishing this drug user Drop-in
Center—the first of its kind in Yunnan Province—is to reduce
the spread of HIV/AIDS by promoting healthier behaviors
and safer sexual practices and by reducing post detoxification
relapse rates.
To reach this goal, the drop-in center will provide an
integrated set of services aimed at:
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Educating drug users to undertand and recognize the danger
of high-risk behaviors, such as sharing syringes and needles,
multiple sex partners and unprotected sex; |
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Promoting the adoption of safer, healthier behaviors; |
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Increasing psycho-social and peer support for the maintenance
of healthy behaviors; |
| • |
Building life and job skills to facilitate reintegration
into society. |
| An Integrated Set of
Core Services |
| The Drop-in Center will provide a set of core services to
encourage the adoption of healthier behaviors. The entry point
for these services will be the intake counselor, who, using
a case management approach, will assess the needs of the individual
client and orient him or her to the appropriate services and
activities, both internal and external. Core services within
the Drop-in Center will include peer education, multimedia
information, education and communciation programs, individual
and family counseling, self-help groups for both former and
current users and a drug abuse and HIV/AIDS information hotline.
Essential products will be made available, eventually including
a needle exchange and condom distribution program. Vocational
training workshops and civic work projects will help clients
increase their sense of self-worth and promote reintegration
into general society. Outreach activities will bring needed
information to the community and help introduce prospective
clients to the Drop-in Center. A service database and referral
system will ensure that clients gain access to appropriate
external services, while maximizing cooperation with existing
support programs. |
| A Supportive Environment |
| To maximize the reach and impact of the core services, the
Drop-in Center will seek to establish a positive, healthy
environment – a safe haven for current and former drug users
where they can support each other to adopt and maintain healthier
life styles. To foster this positive environment and ensure
that clients feel at home, the Drop-in Center will provide
an array of support services, both educational and recreational,
including a media center equipped with television, VCD and
Karaoke; a computer center with internet access; a fitness
center; a reference library and reading room; a lounge area
for board games; and a self-service kitchen, snack bar and
tea room. |
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| 云南省药物滥用和艾滋病感染现状
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• 云南省药物滥用和艾滋病感染现状
• 新策略的必要性
• 减少危害的理念
• 目标及目的
• 一套完整的主要服务
• 中心里的辅助活动
| 云南省药物滥用和艾滋病感染现状 |
| 云南省是我国药物滥用泛滥猖獗的主要地区之一，也是HIV/AIDS感染和传播的高发区之一。静脉注射毒品和共用针具是导致该地区HIV/AIDS传播的主要途经。据估计，云南省有70%的吸毒者是由于注射毒品而成为HIV/AIDS病毒携带者。滥用毒品，不仅严重危害吸毒者本人，也影响了他们的家庭，社区和整个社会的安宁。持续滥用毒品的高危趋势引发了日趋严峻的诸多健康问题，这不仅加剧了HIV/AIDS的传播，也给有限的医疗资源增加了沉重的财政负担。
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| 新策略的必要性 |
| 滥用毒品不仅仅是一个法律问题，它已经成为一个日益严重的公共卫生和社会问题。在中国，强制戒毒和自愿戒毒的方法是目前解决毒品滥用问题的标准手段。尽管通过戒毒所戒毒取得了一定的成效,
但从戒毒所释放后吸毒人员的高复吸率仍然是社会关注的焦点。在诸多因素里，
社会隔立和缺乏一个支持他们戒毒的健康环境是导致复吸发生的原因。吸毒者和戒断人员都成为社会歧视和排斥的目标。正是由于这些偏见，很多戒断人员很难找到固定的工作。以往戒毒所提供的各种辅助服务,
例如心理咨询和就业指导，难以满足他们的需求。由于现有的服务没
有正视由吸毒者带来的问题，吸毒人员几乎丧失了获取医疗服务和医疗资讯的途径。作为边缘人群的药物滥用者也根本无法接近这些服务领域。因而，能够提供减少吸毒人员负面健康问题的重要资讯和服务，包括媒体对HIV/AIDS感染者的曝光，都未能及时解决那些最具有危险性和最需要得到帮助的人群的需求。
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| 减少危害的理念 |
| 减少危害是一系列无偏见的、可行性策略,旨在使吸毒者和他们周围的人能够减少药物滥用所带来的负面影响。减少危害始于70年代初期,
经过20多年的不断实践，已经在欧洲、美国及若干发展中国家成功地降低了药物滥用带来的负面影响。
目前中国政府已经将减少危害的策略纳入其五年计划中。
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| 目标及目的 |
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为了减少由个体吸毒和群体吸毒所带来的不良后果，遏制HIV/AIDS的传播趋势，国际人口服务组织
(PSI) 已经为吸毒人员和戒断人员成立了一个活动中心。国际人口服务组织建立该吸毒人员活
动中心(云南省第一家吸毒人员活动中心)的目标为：通过推广健康的生活方式和安全性行为，以减少HIV/AIDS的传播及降低戒毒后的复吸率。
为达到上述目标，活动中心将提供一套完整的服务项目，目的在于：
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教育吸毒人员懂得并认识到高危行为的危险性，例如共用注射器和针具，多个性伙伴和没有保护措施的性行为；
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推动采用安全、健康的行为； |
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增加社会心理和同伴教育活动以确保健康的行为； |
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提高生存和就业技能，为重返社会做准备。 |
| 一套完整的主要服务 |
| 活动中心将提供一系列主要服务以鼓励吸毒人员采取健康的行为。这些活动将以咨询员的询问为切入点，他们使用个案工作的方法来确定每位来访者的需求，并引导他/她获得适当的内部服务和外部服务。活动中心里的主要服务将包括同伴教育，多媒体宣传教育节目，个人及家庭咨询，为戒断人员和吸毒人员开展的自助小组活动，及有关药物滥用和预防HIV/AIDS知识的热线咨询。还将提供一些必要产品，其中包括交换注射器和发放安全套项目。短期职业培训和社会服务活动有助于培养吸毒人员的自尊意识，以促使他们与社会的融合。外展活动将向社区宣传相关信息，并可介绍吸毒人员到活动中心参加各项活动。在最大限度地利用活动中心现有服务项目的同时，一套数据服务和转诊服务系统将确保来访者获得恰当的外部服务。
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| 中心里的辅助活动 |
| 为尽量达到并使主要服务产生影响，活动中心将寻求建立一个积极、健康的生活环境为吸毒人员和戒断人员提供一个健康向上的活动场所，他们在这里能够相互支持去采纳并保持健康积极的生活方式。为促进这种健康环境并确保来访者有一种回到家的感觉，活动中心将提供一系列辅助的活动：有教育和娱乐活动，还包括配备有电视、VCD和卡拉-OK设备的媒体中心；因特网网吧；健身中心；图书阅览室；活动大厅；自助厨房；饮料台和茶室。
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A computer center with internet access is one of the supporting
services available at the drop-in center.
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