Advantages and disadvantages of harm reduction: clients prospective Although in the original questionnaire there were questions concerning “advantages” and “achievements” separately while analyzing the transcripts it became clear that in the majority of cases the two terms were confused with each other. The advantages were more clearly identified by the clients as direct beneficiaries of HR programs. At the same time all of the advantages mentioned by IDUs were mentioned as main achievements by those involved in provision of HR services, specially highlighting the advantage of provision of IDUs with blood tests and counseling. Hence it was decided to limit this section only with advantages as viewed by the group of HR clients. Majority of interviewed IDUs marked the following advantages of HR: -
access to medical services
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referrals to narcological dispensaries
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access to anonymous blood tests and treatment. Confidentiality was crucial for IDUs
here: "why would I not trust HRP, if they do not even write down my name" -
possibility to get free syringes that prevent use of non-sterile equipment
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reduction of chances of HIV transmission
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unprejudiced attitude of HR staff toward IDUs
Commercial sex workers (CSW) besides the above mentioned advantages also mentioned the possibility to get consultations, condoms, useful information materials. While ranking and prioritizing advantages of HR projects majority of the HR clients (IDUs. CSWs) spoke about availability of information materials, social support and access to medical services, as well as about the supply of syringes and condoms. Among disadvantages IDUs in some regions listed bad quality of materials distributed and fear of prosecution by the police. Indeed in some regions precedents of purchasing leaking syringes was mentioned by IDUs, so they preferred to inject with a used ones not to loose the narcotic solution. CSW had sometimes complained on poor quality of condoms, which tear, slide, decrease satisfaction for their clients or cause allergies. Besides poor quality of materials, the issue of relevance also was raised by HR users, for instance in some cases the change of the drug used required different size of syringe (e.g. home made opiates require 5 ml. syringe, whereas in case of heroin use “diabetes” ones are needed) In the prison sector among disadvantages inmates mentioned absence of lubricants and syringes and lack of sufficiently detailed information on HIV issues.
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