Harm reduction initiatives for drug users comprise a range of approaches, including drug-user treatment, advocacy for changes in drug policy, needle exchange programs, bleach distribution, and broad-based interventions that focus on both safer drug use and less risky sexual behaviors. In many developing nations, harm reduction is a relatively new strategy, which focuses almost exclusively on the connections between drug use and the spread of HIV infection. In Brazil, harm reduction programs are few, and little has been documented about their scope, experience, and effectiveness. This paper reviews the status of Brazilian harm reduction initiatives in general, with a specific focus on lessons learned from the conduct of cross-national research in Rio de Janeiro. The study demonstrated the feasibility of implementing a community-based prevention program among an at-risk population of cocaine users in Brazil, and in other countries where there is little tradition of research with out-of-treatment drug users. Finally, the paper addresses aspects of the harm reduction movement that tend to hamper its progress in both developed and developing nations.
|Number of pages
|Substance Use and Misuse
|Published - 2001
Bibliographical noteFunding Information:
This research was supported by PHS Grant No. U01 DA08510 from the National Institute on Drug Abuse.
Despite broad-based support for needle exchange efforts by both federal and state agencies, the implementation of these projects has been slow and difficult (9). The Brazilian Ministry of Health piloted needle/syringe exchange programs at the Salvador and Santos sites in 1995. In Salvador, the program continues to operate, and provides disposable injection equipment, condoms, HIV prevention information, and referrals for medical and social services. The Santos endeavor, however, was less fortunate. Shortly after its initiation, the Narcotics Police of Santos seized the program’s resources and closed it down (10). The project later moved to the neighboring city of São Vicente where a more relaxed political climate made syringe distribution more feasible. More recently, the Ministry of Health and the Federal Narcotics Council of the Ministry of Justice gave joint approval for seven additional needle/syringe exchange programs to be funded by international institutions (11). A number of these were initiated during 1996 and 1997, but they continue to receive opposition from many sectors of the Brazilian community.
- HIV/AIDS prevention
- Harm reduction
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Health(social science)
- Public Health, Environmental and Occupational Health
- Psychiatry and Mental health