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Outreach nurses in Harm Reduction projects: improving acceptability and availability of medical care to drug users

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Author(s): Dvinskykh, Natalya | Shulga, Liudmyla | Botvin, Sergiy

Journal: Tobacco Control and Public Health in Eastern Europe
ISSN 2222-2693

Volume: 2;
Issue: S1;
Start page: 61;
Date: 2012;
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Keywords: injection drug users | medical care | outreach nurses

ABSTRACT
BACKGROUND: Injection drug users (IDU) remain one of the most vulnerable population segments in Ukraine, with HIV prevalence up to 22% among this group. At the same time, drug users lack access to basic health care and reportedly face stigma and discrimination from medical workers. Harm reduction projects in Ukraine partially address this problem by providing regular HIV and STI testing for their clients, and by referring them to medical institutions, where IDU can get free treatment for STI, TB, and ARV therapy for HIV. However, issues of acceptability and availability of medical care for drug users are far from being resolved. METHODS: During 2011, the new approach of ‘outreach nurses’ was piloted by All Ukrainian Harm Reduction Association (UHRA) with support from ICF “International HIV/AIDS Alliance in Ukraine”. The aim of the project was to bring medical services closer to IDU by integrating work of medical professionals into a comprehensive package of Harm Reduction project services. The project employed fifteen nurses from five regions of Ukraine. During the project, nurses provided basic medical services, consultations on health improvement issues and referrals. The services were provided at the places convenient for clients: syringe exchange points, community centers, mobile clinics, and at home. RESULTS: The services of the project were well accepted by the clients. From June till December 2011 the project reached 1703 unique clients, with a total of 4525 visits (300 visits per nurse on average). For comparison, in the HR projects that employed surgeons, on average there were 58 visits per doctor (from 30 to 93) during the same period of time. CONCLUSIONS: To improve access to medical care for the drug using population Harm Reduction projects should consider including work of ‘outreach nurses’ to the package of services they provide.

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