Presentation made by Mat Southwell sharing views from the Stimulant Expert Group to the UNODC Pre-CND Consultatation on people who use stimulant drugs and inequalities.

1. Mat Southwell (UK)
The impact of inequalities on the HIV response
with people who use stimulant drugs

2. • A forum for networking and information-sharing among people
with an interest in the field of harm reduction for stimulant use
• Open to people with lived or learned expertise, as well as those
seeking to benefit from expert insight
• Convening for meetings on an ad hoc basis to address advocacy
opportunities
• Operated through an e-list hosted by Harm Reduction International
• Contact stimulants@groups.io or visit https://groups.io/g/stimulants/ to join
Stimulants Expert Group

3. Investment in the HIV
responses with people
who use stimulants
needs extra
investment as part of
global commitment to
close the funding gap
for harm reduction
particularly in LMICs

4. Stimulants are diverse and
present a range of risks and
particular health problem
linked to the added demands
placed on the body and the
challenges of not eating,
sleeping or staying hydrated.

5. Stimulant use impacts most negatively on people living
the margins, living in poverty, and experiencing multiple
levels of discrimination and criminalisation. Responding
to stimulants effectively requires an ability to engage
with this complexity.
Poverty and
Marginalization

6. Plentiful
supply of
sterile needles
and syringes
Silver foil
Meth pipe
Safer
“snorting”
kit
Crack pipe
or stem
* Photographs Exchange Supplies and Nigel Brunsdon UK
There are a core set of harm reduction commodities
that can be deployed and tailored with the advice and
participation of the target community.

8. Global HIV Strategy
commitments for 30% of the
future HIV response to be
delivered by community-led
organisations needs to be
matched with investment.
Stimulants highlights the
pioneering role played by
people who use drugs in
harm reduction innovation.

9. The range of different New Psychoactive Drugs look very similar to
one another and sometimes the same substance may come in a
number of different forms and colours. Drug checking provides a
chance for people who use drugs to test their product so they can
understand what they are using and avoid dangerous substances.
Photo: The Loop
Drug Checking

10. Stimulants are also used by GBMSM and
Trans people are part of the range of drug
used within chemsex settings. GBMSM
and Trans people may find traditional
drug services unfamiliar and targeted at
different populations of drug users. Some
specialist chemsex services exist offering a
range of comprehensive services in a
culturally sensitive way. Targeted harm
reduction &safer chemsex; health
messaging for GBMSM and Trans people
is variable.
Chemsex

11. Stimulants can be used as part of sex work or
stimulants can help people stay up to work in
the night-time economy or people may sell sex
to buy stimulant drugs. The sexualised use of
drugs can bring with it challenges around
consent and coercion. Women who use drugs
are particularly vulnerable to gender-based
violence both from state actors and intimate
partners.

12. Promising use of pharmacotherapies
with people who use stimulants - most
notably dexamphetamine and
methylphenidate.
Many people seeking safe supply
through prescriptions for ADHD, weight
loss and other conditions.
Need to explore both Safe Supply and
drug treatment options for people with
stimulant dependence.

13. Purpose To provide practical guidance to countries on implementing
comprehensive HIV programme for people who use stimulant
drugs, vulnerable to HIV, based on existing UN guidance
documents.
Target audience Programme managers at national and local levels
People who are planning or implementing HIV / HCV programmes
for people who use stimulant drugs, including NGOs and
community-based organizations representing /working with
people who use drugs including men who have sex with men,
sex workers, transgender people & people in prisons