FOREWORD

The United Nations Office on Drugs and Crime (UNODC), is a cosponsor of the Joint United Nations Programme on HIV/AIDS (UNAIDS), and is mandated to lead the response for HIV/AIDS prevention and care among injecting drug users and in prison settings.

A consistent body of evidence has established the following fact. Comprehensive HIV prevention programmes which include oral substitution programmes and needle syringe programmes when included as part of a comprehensive package of services reduce drug-related HIV risk behavior such as needle sharing, unsafe injecting, and frequency of injecting. There is also strong evidence that substitution treatment reduces criminal behavior as well as illicit opioid use. We know that it increases retention in treatment and improves the overall health status of drug users infected with HIV. These are outcomes which we all seek to promote.

UNODC's HIV programme in South Asia provides assistance to countries in the region to establish essential interventions that are comprehensive and evidence-informed. One such initiative that our Office supports is a regional project titled "Prevention of transmission of HIV among Drug Users in SAARC Countries" (TD/RAS/03/H13) which is be,ing implemented in partnership with the governments and civil society organizations of the member countries of the SAARC region.

One guiding principle of this project is that successful interventions should be evidence based. In keeping with this, the project carried out a Rapid Situation and Response Assessment in 40 sites across 5 countries in 2005-06 to assess the situation prior to initiating interventions. Extensive training programmes trained peer outreach workers, both male and female, and several of whom were recovering users to carry out this study. The RSRA served as an entry point into communities. It allowed us to reach out to drug users and their sex partner as well as community stakeholders by providing services.

Our RSRA was not an academic exercise. The draft findings have already been used in various forums and helped in designing local level interventions and establishing priority areas for harm reduction interventions. Even though this data has been shared at different meetings, we felt that it would be useful to capture the process and methodology of this immense body of work. We are therefore pleased to present the RSRA outcomes and key recommendations for each of the countries as well as for the region as whole in this report. We also hope that this report will be useful in initiating similar kinds of research, which can contribute to improving the quality of interventions for drug users in South Asia.

Gary Lewis
Representative,
Regional Office for South Asia