Guide to Developing and Managing Syringe Access Programs by Harm Reduction Coalition

M od u l e 4 : E x t e r n a l Iss u e s O U T RE A C H TO IN J ECT IO N DRUG USER S Outreach can be a valuable tool for expanding the reach of SAP services and ensuring that IDUs have access to sterile injection equipment when they most need it. It can also be an effective way of reaching IDUs who are less likely to visit an SAP onsite. Determine the purpose of specific outreach and identify which services, if any, will be able to be delivered based on capacity, resources and need.

There are several methods of outreach that can be implemented. In some cases, staff will simply travel around to areas where drug users may be in order to inform people that an SAP exists and provide more information about the services that are available. This can be done by visiting community-based or AIDS-service organizations and doing scheduled presentations or by going to parks, single-room occupancy hotels and shelters and other public places where drug users congregate. Results from any preliminary needs assessment can be useful for identifying targets for outreach.

Street outreach can also be a means of providing syringe access and other supplies to different locations. Backpacks can easily transport syringes, other sterile injection equipment, condoms, educational materials and disposal containers for distribution. Some programs set up a table on the sidewalk to attract people. In cases where staff and volunteers will be traveling with sterile injection equipment and collecting used syringes for disposal, it is important to inform local law enforcement of outreach activities. In addition, an SAP will need to develop policies and procedures specifically for outreach teams in order to protect the safety of outreach teams and participants. The following recommendations ought to be taken into consideration: • Street outreach may be safer if conducted in pairs or small groups, taking gender into consideration to account for safety. Exceptions may be made in cases involving peer or secondary distribution or under other circumstances. If outreach is done alone, extra communication and safety planning may be necessary.

• The outreach team should be familiar with the area where outreach will be conducted.

• Suitable outreach attire should include comfortable shoes and conservative or subtle and weather-appropriate clothing.

• Proper training on outreach regulations, methods, confidentiality and safety is essential.

• Outreach workers should carry identification at all time and whenever possible, provided with documentation from the program about their relationship to the SAP. • Follow procedures for safe disposal of syringes and carry sharps containers that are small enough to transport, but large enough that they will accommodate several transactions.

• Avoid carrying valuables such as jewelry, money and electronics while on outreach.

• Do not carry weapons or drugs on outreach.

• Outreach workers should be trained in overdose prevention, recognition and response.

• Develop simple tools for documenting outreach activities.

• Log books are useful for recording any important incidents and/or other information from outreach shifts.

• Develop educational materials and program advertisements specifically for use on outreach; this can be used to begin conversations and to distribute to people who can’t stop.

Both hours and location influence the success of outreach. Choose times when drug users will both be present at a location, and available to stop and engage with workers for a brief conversation. For example, mornings may be a bad time to engage IDUs because they may be primarily concerned with avoiding withdrawal sickness. In addition, while weather and seasonal changes may be cause for shifts in outreach schedules, every attempt should be made -60-