( ) 90 03 31 90 04 07 90 04 23
(Community Development for Harm Reduction) UNDCP, UNAIDS
1 2 3..12
(International Harm Reduction Association, IHRA) IHRA IHRA (NGO)
90/3/31(SAT) 11:40 90/4/1(SUN) 14:00 TG-639 14:20 19:50 TG-315 22:25 Hotel Ashok( ) 14:30~17:30 Mini-City Tour 18:00~19:30 19:30~21:30Welcome Reception 90/4/2(MON)8:45~18:30 18:30~19:30IHRA 90/4/3(TUE)8:45~18:30 19:00~21:00 UNDCP Project on HIV & development in South and Southwest Asia 90/4/4(WED)8:45~18:30 19:30~21:30 (Conference Party) 90/4/5(THU)8:45~17:00 90/4/7(SAT) 00:05 17:00~18:00 TG-316 05:40 07:00 TG-634 11:40
Mr. Luke Samson Mr. Shri Raja (World Health Organization, WHO), (United Nations Drug Control Program, UNDCP), (UNAIDS) IHRA Mr. Pat O Hare Mr. Samson ( 12 ) (Community Development for Harm Reduction) Mr. O Hare IHRA IHRA WHO Ms. Maristela Monteiro UNDCP Ms. Renate Ehmer UNAIDS Dr. Werasit Sittitrai (Unprotected Sex) UNDCP Ms. Ehmer (Supply Reduction ) UNDCP (Needle Exchange Program, NEP) Mr. Shri Raja
(Community development and harm reduction) Ms. Jenny Gray HIV Mr. Ernst Buning (Latin American Travelling Seminar, LATS) (tailor-made local solutions for local problems) 2000 Dr. Suresh Kumar IHRA HIV, HBV, HCV (WHO) (Rapid Assessment)
(Asian Multi-City Epidemiology Work Group, AMCEWG) AMCEWG Rapid Assessment WHO Dr. Alfred Uhl Capture-Recapture Approach... Capture-Recapture Approach (Harm Reduction and the Risk Environment) (Physical) (Economic) (Social) (Political) B C Dr. Tim Rhodes (From risk behavior to risk environment) (From risk environment to enabling environment)
(Injecting Drug User, IDU) WHO 1992 IDUs 80 1995 118 1996 1998 1999 121 128 134 IDU HIV 1992 52 1999 114 ( ) IDU HIV UNDCP, UNAIDS, WHO IDU HIV 1992 1995 1996 1998 1999 IDU 80 118 121 128 134 HIV/IDU 52 78 81 103 114 % of Total 65.0 66.1 66.9 80.5 85.1 ( WHO) Dr. Samuel Friedman ( ) ( ) ( ) (Rush)? (Base) Dr. Friedman OTC ( )
IDU HIV B C ( ) WHO, UNAIDS, UNDCP HIV(+) / AIDS WHO (Needle Exchange Program, NEP) IDU HIV NEP IDU 2000 46 NEP NEP IDU/AIDS IDUs 42 NEPs NEP 1000 2001 NEP (Syringe Access Program) (Syringe Vending Machines) 1920 1968 1968 (Home Office) (
) 35,000 (Methadone Maintenance Treatment Program, MMTP) 448 ( ) ( ) ( ) HIV 1992 (Federal Office of Public Health) (Heroin Prescription Program, PEPs 1995 40 FDA (Safe Injecting Room, SIR) NEP SIR ( ) ( ) ( ) ( ) (petty crime) NEP
( ) (salt) (white) (sol. in H 2 O) (decompose) (stable) (base) (brown) / (sol. in fat/alc) (volatile) (unstable) (high melting point) (low melting point) (Recovery ) Recovery (salt) (base) Alone 17% 62% + Caffeine 36% 76% + Noscapine 40% + Lactose 23% + Vitamin C 1% Ms. Kate Dolan ( ) HIV, HBV, HCV ( ) (Overdose)
Ms. Dolan 1996 1999 HIV 33 1993 2001 HCV 17 HBV 26 HIV, HBV HCV 0.4~10% MMTP 19 (7 ) (7 ) (5 Ms. Dolan? Dr. Anagha Kulkarni Dr. Suresh Kumar Benzodiazepines
Benzodiazepine Buprenorphine Ms. Gandhi Dr. Suresh Kumar Mr. Luke Samson Slovenia Slovenia
B C UNDCP, UNAIDS