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Anova Health Institute’s Harm Reduction Initiatives for People Who Use Drugs

Johannes Hugo , Kevin Rebe , Evan Tsouroulis , Anthony Manion , Glenn De Swardt , Helen Struthers , James McIntyre


Background Chemsex is the colloquial term used for a specific pattern of drug use which is increasingly common globally among men who have sex with men (MSM).22% of UK MSM in one published study reported chemsex , while the prevalence of chemsex is unknown in South Africa.Chemsex differs from other patterns of drug use as the recreational substances employed are used specifically in a sexualized context.Drugs used for chemsex vary widely but the most commonly used drugs are: crystal methamphetamine, methadrone, gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL).They can be taken in a number of ways including inhalation, smoking, oral ingestion, anal insertion and there is increasing concern that these drugs are being injected, known among MSM as “slamming”.The World Health Organization (WHO) has provided health guidance to address drug use among key populations such as MSM.Given the lack of access to harm reduction services in the primary care setting, Anova explored harm reduction services at their Ivan Toms Centre for Men’s Health (ITCMH) clinic in Cape Town, South Africa. About the project This project, known as Tikking the Boxes (Tik is a local South African word for crystal methamphetamine), was made possible by a grant from the Dutch organization, Aids Fonds together with the technical assistance of Mainline, another Dutch organization.The objectives were twofold, firstly to reduce HIV and hepatitis B & C transmission among drug using MSM in Cape Town South Africa, and secondly to provide direct harm reduction services to this population.During the grant period, approximately 45 000 MSM were reached with harm reduction and 2260 injecting harm reduction packs and 1119 non-injecting harm reduction packs were distributed. Challenges encountered At the launch of the project in South Africa, the concept of harm reduction was mostly an alien one and easily misunderstood. The way forward JAB SMART is Anova’s new harm reduction initiative.JAB SMART started in May 2017, with support from the City of Johannesburg Health Department, and is the first project of its kind in the city to provide harm reduction services to People Who Inject Drugs (PWID) and their sexual partners.

SH17158  Accepted 18 December 2017

© CSIRO 2017