Anova Health Institute’s harm reduction initiatives for people who use drugs
Johannes M. Hugo A B D , Kevin B. Rebe A B , Evan Tsouroulis A , Anthony Manion A , Glenn de Swart A , Helen Struthers A B and James A. McIntyre A CA Anova Health Institute, 12 Sherborne Rd, Parktown, Johannesburg 2193, South Africa.
B Department of Medicine, Division of HIV and Infectious Diseases, University of Cape Town, Rondebosch, Cape Town 7700, South Africa.
C School of Public Health, University of Cape Town, Rondebosh, Cape Town 7700, South Africa.
D Corresponding author. Email: hugo@anovahealth.co.za
Sexual Health 15(2) 176-178 https://doi.org/10.1071/SH17158
Submitted: 21 August 2017 Accepted: 18 December 2017 Published: 21 March 2018
Journal compilation © CSIRO 2018 Open Access CC BY-NC-ND
Abstract
Chemsex is the colloquial term used for a specific pattern of drug use that is increasingly common among men who have sex with men (MSM) globally. The recreational substances employed are used specifically in a sexualized context. The reasons for chemsex among MSM are complex. The Anova Health Institute (Anova) provided harm-reduction services in Cape Town, South Africa in 2013 and 2014. This project, known as Tikking the Boxes had two objectives: first to provide direct harm-reduction services to drug-using MSM in Cape Town, South Africa, and second, to reduce HIV and hepatitis B and C transmission among this population. This was done by identifying drug-using behaviour among MSM and linking them to harm-reduction services. Employing people who were currently using drugs was a novel aspect of this program, and successfully facilitated access to MSM drug-using networks. At the launch of the project, the concept of harm reduction was easily misunderstood by MSM. Another challenge was that the harm-reduction service, encompassing needle exchange, excluded opioid substitution therapy. People who use drugs were employed as outreach workers, requiring the project to be very flexible and adaptable to sometimes complex lives and difficult-to-reach peers. JAB SMART is Anova’s new harm-reduction initiative and 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.
References
[1] Sewell J, Miltz A, Lampe FC, Cambiano V, Speakman A, Phillips AN, Stuart D, Gilson R, Asboe D, Nwokolo N, Clarke A, Collins S, Hart G, Elford J, Rodger AJ, Attitudes to and Understanding of Risk of Acquisition of HIV (AURAH) Study Group Poly drug use, chemsex drug use, and associations with sexual risk behaviour in HIV-negative men who have sex with men attending sexual health clinics. Int J Drug Policy 2017; 43 33–43.| Poly drug use, chemsex drug use, and associations with sexual risk behaviour in HIV-negative men who have sex with men attending sexual health clinics.Crossref | GoogleScholarGoogle Scholar |
[2] Scheibe A, Makapela D, Brown B, dos Santos M, Hariga F, Virk H, Bekker LG, Lyan O, Fee N, Molnar M, Bocai A, Eligh J, Lehtovuori R. HIV prevalence and risk among people who inject drugs in five South African cities. Int J Drug Policy 2016; 30 107–15.
| HIV prevalence and risk among people who inject drugs in five South African cities.Crossref | GoogleScholarGoogle Scholar |
[3] Pakianathan MR, Lee MJ, Kelly B, Hegazi A. How to assess gay, bisexual and other men who have sex with men for chemsex. Sex Transm Infect 2016; 92 568–70.
| How to assess gay, bisexual and other men who have sex with men for chemsex.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC28bit1amsw%3D%3D&md5=e78b9cfc517b261a4300614a2f56375cCAS |
[4] Bourne A, Reid D, Hickson F, Torres-Rueda S, Weatherburn P. Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study. Sex Transm Infect 2015; 91 564–8.
| Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC28%2FitlWgtA%3D%3D&md5=e3b0e09b147c5d8fbad362b4be4a0facCAS |
[5] Giorgetti R, Tagliabracci A, Schifano F, Zaami S, Marinelli E, Busardò FP. When “Chems” meet sex: a rising phenomenon called “ChemSex”. Curr Neuropharmacol 2017; 15 762–70.
| When “Chems” meet sex: a rising phenomenon called “ChemSex”.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2sXhtFSlsr3J&md5=111096346462431563f0ce655da8c77bCAS |
[6] Plüddemann A, Parry CD, Flisher AJ, Jordaan E. Heroin users in Cape Town, South Africa: injecting practices, HIV-related risk behaviors, and other health consequences. J Psychoactive Drugs 2008; 40 273–9.
| Heroin users in Cape Town, South Africa: injecting practices, HIV-related risk behaviors, and other health consequences.Crossref | GoogleScholarGoogle Scholar |
[7] Semlyen J, King M, Varney J, Hagger-Johnson G. Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys. BMC Psychiatry 2016; 16 67–75. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0767-z
[8] Tucker A, Liht J, de Swardt G, Jobson G, Rebe K, McIntyre J, Struthers H. Homophobic stigma, depression, self-efficacy and unprotected anal intercourse for peri-urban township men who have sex with men in Cape Town, South Africa: a cross-sectional association model. AIDS Care 2014; 26 882–9.
| Homophobic stigma, depression, self-efficacy and unprotected anal intercourse for peri-urban township men who have sex with men in Cape Town, South Africa: a cross-sectional association model.Crossref | GoogleScholarGoogle Scholar |
[9] Rebe KB, De Swardt G, Struthers H, McIntyre JA. Towards “men who have sex with men-appropriate” health services in South Africa. SA HIV Med. 2013; 14 52–7.
| Towards “men who have sex with men-appropriate” health services in South Africa.Crossref | GoogleScholarGoogle Scholar |
[10] Stoloff K, Joske JA, Feast D, De Swardt G, Hugo J, Struthers H, McIntyre JA, Rebe KB. A description of common mental disorders in men who have sex with men (MSM) referred for assessment and intervention at an MSM clinic in Cape Town, South Africa. AIDS Behav 2013; 17 S77–81.
| A description of common mental disorders in men who have sex with men (MSM) referred for assessment and intervention at an MSM clinic in Cape Town, South Africa.Crossref | GoogleScholarGoogle Scholar |
[11] Rhodes T, Abdool R. Drug harms and drug policies in Sub-Saharan Africa: implementation science and HIV epidemics. Int J Drug Policy 2016; 30 1–6.
| Drug harms and drug policies in Sub-Saharan Africa: implementation science and HIV epidemics.Crossref | GoogleScholarGoogle Scholar |
[12] World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations (2016 update). Geneva: WHO; 2014. Available online at: http://www.who.int/hiv/pub/guidelines/keypopulations/en/ [verified 2 Aug 2017].
[13] World Health Organization. Guidance on prevention of viral hepatitis B and C among people who inject drugs. Geneva: WHO; 2012. Available online at: http://apps.who.int/iris/bitstream/10665/75357/1/9789241504041_eng.pdf?ua=1 [verified 2 Aug 2017].