NEEDLE AND SYRINGE PROGRAMMES MONITORING IN LITHUANIA

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1 NEEDLE AND SYRINGE PROGRAMMES MONITORING IN LITHUANIA Dr. Audronė Astrauskienė Drug control department under the Government of the Republic of Lithuania

2 Harm reduction services development in Situation in 2004 Changes in Harm reduction services development Harm reduction services were not organized, was no legal acts regarding service provision; Services did not ensure quality control Individuals infected with HIV by drug use to 74 percent legally regulated drugs and psychotropic substances harmreduction programs, Increased availability of these services Individuals infected with HIV by drug use declined by 44 percent. 2008, but increased again to 65 percent in support for Harm reduction In Lithuania, the implementation of syringe/needle exchange programs for injecting drug users were started a decade ago. A legal basis for these programs was established in Decree No. V-584 of July 5, 2006, of the Minister of Health of the Republic of Lithuania On Approval of Profile of the Implementation Procedure of Drug and Psychotropic Substance Drug Reduction Programs (Žin., 2006, No ). This legislation establishes the mandatory package of services for injecting drug users: syringe/needle exchange, distribution of disinfecting tools, distribution of condoms, health education to reduce risk behaviour, providing of information and counselling. This legislation seeks for attraction of drug users and their partners to institutions and organizations providing health and social services, services of adequate quality and qualification, and their integration into the society. This legislation is expected to facilitate development of harm reduction services in Lithuania.

3 Drug use indicators and drug use situation in Lithuania INDICATOR 1. Drug use in General population and various groups (GPS) Data LTP (2008) 12% LTP (2004) 8,2%, School children (15-16 years) LTP (2007) 20% LTP (2003) 15,6% 2. Problem drug use (PDU) ~5500 persons. ( ) 3. Drug-related infectious diseases (DRID) (HIV, HEPATITIS B and C) 4. Drug-related deaths and mortality (DRD) 5. Treatment demand indicator (TDI) 8-11% IDU are infected by HIV (2009) New HIV cases (of them infected using ID %) pers. (65%) pers. (44%) 68 pers. (2009) 60 pers. (2008) New cases 345 pers. (2009) 10,4 cases / All pers. (2009) 178,9 cases / Within the period since 1988 when the first HIV case was diagnosed in Lithuania to January 1, 2010, 1314 HIV infected individuals were diagnosed, 1145 persons (72,4 percent) were infected HIV by using injecting drugs.

4 Reported rates of new HIV infections among IDU per million population, B e lg iu m B u lg a r ia C z e c k R e p u b lic D e n m a r k G e r m a n y E s to n ia Ire la n d G r e e c e S p a in F r a n c e Ita ly C y p r u s L a tv ia L ith u a n ia L u x e m b o u r g H u n g a r y M a lta N e th e rla n d s A u s tr ia P o la n d P o r tu g a l R o m a n ia S lo v e n ia S lo v a k ia F in la n d S w e d e n U n ite d K in g d o m C r o a tia T u r k e y N o r w a y Source: EMCDDA, 2010

5 New HIV diagnosis in Lithuania (disaggregated by sex) female male Source: S. Čaplinskas, 2010

6 New HIV diagnosis (by transmission mode) Source: S. Čaplinskas, 2010

7 Harm Reduction strategy in EU In 2009, in Lithuania 12 (in units) harm reduction services units (incl. syringe and needle exchange) were available in Vilnius, Kaunas, Klaipeda, Siauliai, Panevezys, Alytus, Mazeikiai, Druskininkai, Kedainiai. in 2009 One harm reduction services unit was closed in Visaginas city (re-opened in 2010) and one in Klaipėda city. The staff of these units includes social workers, health care specialists, trained street workers who visit gathering palaces of drug and psychotropic substance users, look for contacts with them and inform them of the opportunity to get help.

8 Needle and syringe programmes in Lithuania supported by UNODC

9 Needle and syringe programmes (NSP) coverage Estimated number of PDU (in 2008) In 2005 (Dr. Gordon Hey study) IDU- 3200; PDU In 2006 PDU 5699 In 2007 PDU 5800 Regular clients (1 per 3 monds) of NSPs ~ Number of syringes per IDU per year Peer-driven intervention in 2010: During the last year, have you received clean syringes from NSP, outreach workers? Yes % (N=324)

10 NSP funding ? Drug Control Department, LT Municipalities, LT nd UNODC, nd

11 Monitoring of Harm reduction programmes 1.Harm reduction units provided services monitoring (annual data collection) a)number of provided services b) Number of clients visits, number of regular clients, number of new clients 2. Monitoring of Harm reduction programmes clients (client s questionnaires)

12 Harm reduction services activities in Services Distributed needles Distributed syringes Collected needles Collected syringes Disinfections, distribution of condoms Distribution of condoms Health teaching and education Providing information Counselling Personal hygiene and care services Providing of dressing Wound dressing Taking samples and sending them for tests Catering services Transport services Facilitation and representation Number of clients visits

13 Monitoring of Harm reduction programmes clients 1. Drug control department collects data about Harm reduction clients Data providers harm reduction units financed by the Drug control department 3. Data collection is based on Client self reporting data collection form / questionnaire 4. Collected data about client - IDU characteristics (total 35 questions): a) General client characteristics (gender, age and etc.) b) Social-demographic characteristics (nationality, living status, education level and etc.) c) Drug use patterns and experience (used drug type, use frequency, age of first time use and etc.) d) Risk behavior characteristics (use of sterile injection equipment, needle and syringes sharing, risky sex, use of condoms, use of harm reduction services and etc.) e) Infection diseases (testing for HIV and Hepatitis C, tests results)

14 Harm reduction clients database

15 Problems Funding Unification of code Training Information system

16 Thank you for your attention