Harm Reduction: A Public Health Response to HIV Epidemic among Injecting Drug Users in Indonesia Patri Handoyo Indonesia HIV Prevention and Care Project – Australia Indonesia Partnership

Source: MoH RI, 2006

HIV Prevention and Care to IDU Needle and Syringe Program (NSP) Methadone Maintenance Treatment (MMT) HIV Care, Support, and Treatment (CST)

Needle and Syringe Program (NSP)

Methadone Maintenance Treatment (MMT)

HIV Care, Support, and Treatment (CST)

No. of article found: Google Scholar

First NSP in Indonesia 1999, by an NGO in Bali Encountered by law enforcement (police) Project based program

1999, by an NGO in Bali

Encountered by law enforcement (police)

Project based program

First MMT in Indonesia Jakarta and Bali, 2003 Two hospitals Evaluation result: decrease in criminal activity and drug injecting behavior

Jakarta and Bali, 2003

Two hospitals

Evaluation result: decrease in criminal activity and drug injecting behavior

CST for IDU Stigmatization for ART adherence Adherence can be improved by access and integrating it with prevention program

Stigmatization for ART adherence

Adherence can be improved by access and integrating it with prevention program

Considerations to Scale up Program To cover as many IDU as possible Cost Sustainability Legitimacy

To cover as many IDU as possible

Cost

Sustainability

Legitimacy

Primary Health Center At least one in each sub-district Health workers Well known health institutions in community Part of public health system

At least one in each sub-district

Health workers

Well known health institutions in community

Part of public health system

What We Have Done Capacity building of health workers for program implementation Hospital as primary health center and prison’s program supervisor Local and national authorities involvement for the integration to existing health system Clients and community involvement to HIV prevention and care program Establishing national policy for production, distribution, dispensing, and monitoring

Capacity building of health workers for program implementation

Hospital as primary health center and prison’s program supervisor

Local and national authorities involvement for the integration to existing health system

Clients and community involvement to HIV prevention and care program

Establishing national policy for production, distribution, dispensing, and monitoring

NSP Indonesia, 2007 65 primary health centers, incl. CST for IDU 1 hospital

65 primary health centers, incl. CST for IDU

1 hospital

MMT Indonesia, 2007 7 hospitals 9 primary health centers 3 prisons

7 hospitals

9 primary health centers

3 prisons

Lesson Learnt Program should integrate to existing public health system National policy should be made Involvement of local and national authorities Involvement of client and community to the program

Program should integrate to existing public health system

National policy should be made

Involvement of local and national authorities

Involvement of client and community to the program