NEEDLE & SYRINGE EXCHANGE PROGRAMME
“The implementation of the Harm Reduction programme through Methadone Maintenance Therapy and Needle & Syringe Exchange Programme has shown positive results, with many kicking drug addiction and leading a quality life. The success of the two programmes reflects the spirit of smart partnership and commitment between the government and private and non-government organisations in reducing the numbers of Malaysians hooked on drugs.”
The Needle & Syringe Exchange Programme (NSEP)remains on the front line of the harm reduction approach to reduce HIV vulnerability among people who inject drugs. Introduced by the Ministry of Health in partnership with the Malaysian AIDS Council in 2006, the NSEP broke new grounds in providing direct community-based health care services for people who inject drugs nationwide. Through 17 NSEP sites, more than 24,000 registered people who inject drugs were served in 2010, with over 300,000 NSEP kits containing fresh needles and syringes distributed. Activities of the NSEP in Malaysia include:
- Exchanging used needles and syringes for sterile ones
- Safe disposal of used injecting materials
- Reaching out and educating PWID on HIV/AIDS and other related health issues
- Providing PWID with referrals, rehabilitation, health and welfare agencies
- Encouraging safer sex practices through education and condom distribution
- Needle exchange
- Light treatment
- Rest place
- Kedah (Cahaya Harapan)
- Penang (AIDS Action Research Group)
- Wilayah Persekutuan Kuala Lumpur
- Chow Kit (IKHLAS)
- Selangor (Insaf Murni)
- Melaka (Kelab Rakan Melaka)
- Kelantan (SAHABAT)
- Terengganu (CAKNA)
- Pahang (Drug Intervention Community)
- Johor(Intan Life Zone)
- Drug users not feel high when using it
- Reduce drug related crime
- Reduce the desire to inject
- Provide opportunities for IDUs to recover and return to work
Community-based outreach and education programmes are key in improving access to HIV prevention and treatment services for key affected populations who are often marginalised due to stigma and discrimination. Outreach workers, a vast majority of whom are members of the key affected populations themselves, are deployed as peer educators to disseminate targeted information, education and communication materials about HIV prevention, sexual and reproductive health, medical and legal aid referral services, as well as safe sex commodities such as condoms and lubricants. This programme also aims to address gender and sexuality issues, and drug use, violence and other compounding factors that intensify HIV vulnerability.
In 2010, approximately 68,000 outreach contacts were made with sex workers (SWs), transsexuals (TSs) and men who have sex with men (MSM) collectively through the work of ten Partner Organisations nationwide, with more than 500,000 condoms distributed.
- Pulau Pinang Community AIDS Services Penang (CASP)
- Kuala Lumpur Dan Selangor Rumah Solehah 1 Rumah Solehah 2 WAKE 1 WAKE 2 WAKE 3 Faith Helping Centre 1 Welcome Community Home
- Johor Darul Takzim Intan Life Zone – Dignity 1 Pertubuhan Harapan Kasih
- Pahang Darul Makmur Casa Villa – DiC Malaysia Casa Harapan – DiC Malaysia Casa Non Kasta – DiC Malaysia Casa Femina – DiC Malaysia
- Terengganu Darul Iman Pertubuhan Komuniti CAKNA
- Sabah Sabah AIDS Support Services Association (KASIH)
HOSPITAL PEER SUPPORT PROGRAMME
Hospital Peer Support
Although the services of treatment, support and assistance were more widespread, but PLHIV are still faced with many challenges and obstacles to obtaining these services, particularly services for financial assistance, social and psychology.
Since some period of years, more attention is given to recognize and incorporating a peer support program to help in the continuum of support and assistance to PLHIV. Involvement and peer approach, particularly in hospitals, and home visits appears more proven its effectiveness in improving adherence to treatment and can also influence behaviour change required to undergo a more positive life.
In the early epidemic of HIV/AIDS in Malaysia, before treatment is given for free, and outreach related services is still not widespread, PLHIV support groups rely heavily on small-scale aid to understand their health condition. Currently, the treatment has been given free, and many programs treatment, care and support that have been implemented. But, as in the early epidemic in ’80s, interest is still strong on support group and cannot be disputed in helping PLHIV, families and their friends in social, education and medication aspects. Support groups can reduce feelings of loneliness often felt by PLHIV – well physically or emotionally, and able to empower them to lead a positive life.
For many PLHIV, a peer support group is the first place where they can share with others their status, and meet with others PLHIV. When a group of PLHIV can share the anxiety, fear and any other question, it is able to empower themselves, respectively, because they then realize that many PLHIV who have been through the same process, have been overcome successfully.
Among the topics are often discussed in the support group are about the ways of HIV transmission, treatment options, treatment side effects, hospitals and clinics that offer treatment and methods of safer sex practices. Most of PLHIV, the support group is the safest place for them to discuss the topic with more openly.
Support groups are often seen as one method of treatment for PLHIV – without prescription! This is because the support group members will obtain more benefits together only with other PLHIV, and thus can control and manage their health more effectively. The value of support groups cannot be trivialized and set aside.
- Giving moral support to patients who come to the clinic for treatment
- Provide information and explain the guidelines and policies related to the clinic, the patient or client and also a support group to help patients do not feel afraid or awkward to get treatment, help and support from hospital
- Provide basic information about HIV/AIDS, safe sex, sexual reproductive health and opportunistic infections
- Complement the counseling services offered at the hospital
- To assist the clinic staff to ensure that the needs of patients/clients and matters that affect patients
- Improve information on treatment/adherence HAART medication
- Number of patients receiving HAART treatment is growing rapidly and will continue to increase
- Adherence to HAART intake was complex accomplished through by own self
- Staff at the hospital are not enough to meet the needs of patients to HAART treatment adherence and support to them
- A person living with HIV (PLHIV) for effective sharing of positive life
- Responsible for the work done
- Be open, no prejudice to entertain all the PLHIV
- Sincere and honest in work responsibilities
- Good and calibre personal lives and can be seen as a role model to the patient/client
- Be patient to help PLHIV according to their own step
- Able to pay attention to the PLHIV client
- Very concerned in maintaining the confidentiality of client
- Knowledgeable and able to assist clients with a network of related support
Responsibilities of a peer support
Drop-in Centers (DICs) are an extension to outreach activities with the aim of providing direct services for key affected populations in a non-judgmental environment. The services differ from one setting to another dependent upon the key affected populaton served, but chiefly include facilities for maintaininig personal hygiene and basic healthcare, warm meals, peer education, support groups, as well as referrals for voluntary HIV counselling and testing and legal aid.
The DIC in Penang provides the opportunity for people living with HIV (PLHIV) and their family members to participate in peer education sessions and support group activities. In Melaka, sex workers (SWs) may benefit from the sexual and reproductive health education as well as HIV and STI services offered through the DIC. Meanwhile, the DIC for women in Pahang catering to spouses and intimate partners of Injecting drug users (IDUs) enables them to access services such has peer counselling, support sessions and referrals.
SEXUAL REPRODUCTIVE HEALTH AWARENESS
MAC through its Partner Organizations delivered targeted community based interventions encompassing promotion and provision of preventive tools, behavior change communication materials and effective linkages to clinical services within an enabling environment amongst the sex workers, transgender and men who have sex with men communities.
CONDOM USE POLICY
CONDOMS AND HIV PREVENTION
Position statement 2009 – UNAIDS
[Originally published in 2004 updated in 2009]Condom use is a critical element in a comprehensive, effective and sustainable approach to HIV prevention and treatment
Prevention is the mainstay of the response to AIDS. Condoms are an integral and essential part of comprehensive prevention and care programmes, and their promotion must be accelerated. In 2007, an estimated 2.7 million people became newly infected with HIV. About 45% of them were young people from 15 to 24 years old, with young girls at greater risk of infection than boys.
- The male latex condom is the single, most efficient, available technology to reduce the sexual transmission of HIV and other sexually transmitted infections.
- Condoms must be readily available universally, either free or at low cost, and promoted in ways that help overcome social and personal obstacles to their use.
- HIV prevention education and condom promotion must overcome the challenges of complex gender and cultural factors.
- Condoms have played a decisive role in HIV prevention efforts in many countries.
- Increased access to antiretroviral treatment creates the need and the opportunity for accelerated condom promotion. Read