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2 1 CONTENTS Welcome to Barcelona and to Catalonia Welcome from IHRA and Conference Consortium Conference Staff Executive Programme Committee Barcelona Organising Committee Medical Committee Drug User Committee Governmental Advisory Committee International Programme Advisory Committee Scholarships Awards Conference Programme Programa de la Conferencia Poster Presentations Monday Session Poster Presentations Tuesday Session Poster Presentations Wednesday Session Presentations Index by Presenter Name

3 Harm Reduction 2008: IHRA s 19 th International Conference 2 BENVINGUTS A BARCELONA I A CATALUNYA Celebrem que el 19è Congrés de Reducció de Danys es pugui dur a terme a la nostra ciutat i també que, per primera vegada, aquest concepte no s associï exclusivament a la reducció de danys en relació amb les drogues sinó que s ampliï a altres àmbits relacionats amb la salut. El concepte de reducció de danys, en el tractament de les drogodependències, ha permès donar preeminència a l enfocament de salut pública i a la defensa dels drets i la dignitat de les persones afectades. No cal dir que el nostre darrer objectiu és que ningú no estigui sotmès a cap mena d addicció, però també és cert que per superar una dependència tant les persones afectades com els professionals que les ajuden sovint han de fer un gran esforç i necessiten un cert temps. Moltes persones que han superat la seva addicció tot sovint duen una vida marcada per patologies cròniques o danys psicosocials adquirits durant els seus anys de dependència. La reducció de danys ha sabut donar prioritat a objectius parcials i intermedis per tal que quan s assoleixi l objectiu definitiu i últim, la curació, la persona pugui reprendre la seva vida sense hipoteques per a la seva salut. A més, aquest enfocament, ampli i tolerant, ha permès retornar el protagonisme i el respecte a les persones afectades, atès que els reconeix el valor dels coneixements que els han aportat les seves dures experiències. És bo, doncs, que el concepte de reducció de danys vagi penetrant en altres àmbits de la salut com, per exemple, en els hàbits sexuals, els hàbits i les conductes de risc dels joves, les addiccions no químiques, etc. Desitjo que el treball d aquests dies sigui útil i ens permeti avançar en la promoció del benestar i la salut dels nostres ciutadans i ciutadanes, especialment en la d aquells que encara continuen patint situacions incomprensibles de discriminació i exclusió social. Marina Geli i Fàbrega Consellera de Salut BIENVENIDOS A BARCELONA Y A CATALUπA Nos alegramos que el 19º Congreso de Reducción de Daños se pueda llevar a cabo en nuestra ciudad y también que, por primera vez, este concepto no se asocie exclusivamente a la reducción de daños en relación con las drogas sino que se amplíe a otros ámbitos de la salud. El concepto de reducción de daños, en el tratamiento de las drogodependencias, ha permitido dar preeminencia al enfoque de salud pública y a la defensa de los derechos y la dignidad de las personas afectadas. No hace falta decir que nuestro último objetivo es que nadie esté sometido a ningún tipo de adicción, pero también es cierto que para superar una dependencia, tanto las personas afectadas como los profesionales que les ayudan a menudo han de hacer un gran esfuerzo y necesitan un cierto tiempo. Muchas personas que han superado su adicción, frecuentemente llevan una vida marcada por patologías crónicas o daños psicosociales adquiridos durante sus años de dependencia. La reducción de daños ha sabido dar prioridad a objetivos parciales e intermedios para que cuando se alcance el objetivo definitivo y último, la curación, la persona pueda retomar su vida sin hipotecar su salud. Asimismo, este enfoque, amplio y tolerante, ha permitido devolver el protagonismo y el respeto a las personas afectadas, puesto que les reconoce el valor de los conocimientos que les han aportado sus duras experiencias. Es bueno, pues, que el concepto de reducción de daños vaya penetrando en otros ámbitos de la salud como, por ejemplo, en los hábitos sexuales, los hábitos y las conductas de riesgo de los jóvenes, las adicciones no químicas, etc. Deseo que el trabajo de estos días sea útil y nos permita avanzar en la promoción del bienestar y la salud de nuestros ciudadanos y ciudadanas, especialmente en la de aquellos que aún continúen padeciendo situaciones incomprensibles de discriminación y exclusión social. Marina Geli i Fàbrega Consejera de Salud WELCOME TO BARCELONA AND TO CATALONIA We are happy that IHRA s 19th international conference is taking place in our city and also that the concept of harm reduction is not exclusively being associated with illicit drugs but that it has opened up and embraced other areas related to health. The concept of harm reduction in the treatment of drug addictions has allowed us to give a front-row seat to the public health point of view and the defence of the rights and the dignity of those affected. It is not necessary to tell you that our ultimate objective is that nobody becomes a victim of any type of addiction, but it is also true that in, order to get over a dependency, both those affected by them as well as the professionals who help them often need to make a huge effort and use a lot of resources. A lot of people who have been able to recover from addiction have lives marked by chronic pathologies or psychosocial harms which they developed during their years of addiction. Harm reduction has been able to give priority to realistic and medium term objectives, so that when the final objective - recovery - is reached, the person can re-start his or her life without mortgaging his or her health. Also, the harm reduction focus - open and tolerant - has allowed for the return of protection and respect for those directly affected, valuing the knowledge that they have developed through their difficult experiences. So, it is good that the concept of harm reduction penetrates other areas of health (such as sexual behaviour, young people s habits and risk behaviours, and non-chemical addictions). I hope that the work that will be carried out during these days will be useful and will allow us to advance in the promotion of the health and well-being of our citizens - especially those who still live in unacceptable situations of discrimination and social marginalisation. Marina Geli i Fàbrega Regional Minister of Health of Catalonia

4 3 WELCOME WELCOME FROM IHRA AND CONFERENCE CONSORTIUM Dear Delegate, As Chair of the International Harm Reduction Association (IHRA), it is my great pleasure to welcome you to Harm Reduction 2008: IHRA s 19th International Conference. The first conference was held in Liverpool (UK) in 1990 and, over the last 19 years, it has been held in many different parts of the world. The conference is a major opportunity to exchange knowledge and ideas about harm reduction. It helps to promote the harm reduction approach to politicians, policy makers, frontline workers, police, researchers, educationalists, and drug user advocates. This conference would not be possible without the invaluable contributions of a large number of people here in Catalunya, throughout Spain, and around the world. I would like to take this opportunity to thank everybody who has contributed to this event. IHRA is the leading organisation promoting a harm reduction approach for all psychoactive substances on a global basis. Our work aims to improve public health, protect the human rights of people who use drugs, and reduce the individual and community harms from psychoactive drug use. We work with local, national, regional and international organisations. There are many members of the IHRA Executive Committee and IHRA members of staff at this conference, and they would be all be delighted to tell you more about IHRA s work. I wish you a successful conference. With kind regards, Dr Mukta Sharma Chair of the Executive Committee International Harm Reduction Association Dear Delegate, It is over two decades since the first harm reduction projects started in Europe, Australia and North America. In these two decades, harm reduction has grown in acceptance, implementation and scientific knowledge. Harm reduction programmes now operate in a wide variety of cultural, religious and political contexts. The approach is supported by multilateral agencies, national governments, international and national NGOs, frontline workers, and people who use psychoactive drugs. But much more needs to be done. There are vociferous opponents to harm reduction at both the international and national levels. Many countries have legal constraints on the provision of essential harm reduction medical services and on the ability of NGOs to operate. Harm reduction development has been neglected in South and Central America, and in Africa. Insufficient attention has been paid to the frequent human rights abuses of people who use drugs. We have made a lot of progress on harm reduction in terms of opiate drugs, but much more needs to be done for stimulant drugs and alcohol and tobacco. The reason for this conference is to promote the science, policy and practice of harm reduction on a global basis. I hope that, through your participation in this conference (and afterwards), you can help to push harm reduction Towards a Global Approach. Professor Gerry Stimson Executive Director International Harm Reduction Association Dear Delegate, It s a great pleasure for me to welcome you to the 19th IHRA conference in Barcelona. As an activist, a harm reductionist and a prison reformer, I value the work of IHRA and it s such an honour to be a part of the team who help organise this event. I am very grateful to all the sponsors and exhibitors and other supporting and collaborating organisations for all their help and financial assistance. This is the first time I have been part of the organising team and the second time I have attended an IHRA conference. The opportunity to learn about pushing all the boundaries from policy, to research, to treatment provision from the global community and to be able to network and make friends is just so amazing and valuable and I wish you all a truly wonderful and enjoyable conference experience. James Grieve Chair of National Users Network (U.K.) and of the Conference Consortium Dear Delegate, I would like to take the opportunity, on behalf of the conference team, to welcome you to Harm Reduction Staff from the Conference Consortium and IHRA have worked to ensure that this conference builds on the success of our collaboration last year in Warsaw, with an interesting and exciting conference programme, supported by a wide range of satellite meetings, social events and other networking opportunities. The historic and stylish city of Barcelona provides an interesting and diverse backdrop to the event and we hope that you will have some time during the coming week to sample the cuisine and culture of Catalunya. The whole team, together with a large number of volunteers, are available to you should you have any need for additional information and assistance and will be happy to provide this to you. I look forward to having the chance to meet you during the coming week. Enjoy the conference. Paddy Costall Conference Director Conference Consortium

5 Harm Reduction 2008: IHRA s 19 th International Conference 4 CONFERENCE STAFF Gerry Stimson Programme Director Damon Barrett Jamie Bridge Catherine Cook Jennifer Curcio Natalya Kanaef Annie Kuch Rick Lines Andreas Woreth Paddy Costall Conference Director Artur Król Grzegorz Król Simone Leonce Beatrice Martin Magdalena Ruszkowska-CieÊlak Saul Saldivar Joanna Szostakowska Michelle Vatin EXECUTIVE PROGRAMME COMMITTEE The Executive Programme Committee (EPC) is composed of professionals from the drugs, harm reduction, and drug user activism fields. Its members are chosen by IHRA and the Conference Consortium, and come from a variety of backgrounds - including researchers, harm reduction workers, staff of multilateral agencies and funders, people working in criminal justice, and people who use drugs. The role of the EPC is to create the conference programme by organising sessions and (based on peer-reviews by the larger International Programme Advisory Group) selecting the best presentations from the 1,200 abstracts that were submitted this year. The knowledge, experience and complementary skills of the EPC ensure that the highest quality presentations on a wide range of topics are chosen. The Harm Reduction 2008 Executive Programme Committee is composed of: Cinzia Brentari, CONNECTIONS Project (Europe); Jamie Bridge, International Harm Reduction Association (IHRA); Teresa Brugal, Public Health Agency of Barcelona (Spain); Paddy Costall, Conference Consortium (UK); Luis De La Fuente, National AIDS Plan (Spain) Martin Donoghoe, World Health Organization Regional Office for Europe (WHO-EURO); Stijn Goossens, International Network of People who Use Drugs (INPUD); Stephan Ibanez-de-Benito, International Nursing Harm Reduction Network (INHRN); Enrique Ilundain, Grup Igia (Spain); Grzegorz Król, Conference Consortium (Poland); Xavier Major, Generalitat de Catalunya (Spain); Monica Malta, Oswaldo Cruz Foundation (Brazil); Geoff Munro, Australian Drug Foundation (Australia); Tim Rhodes, London School of Hygiene and Tropical Medicine (UK); Eric Schneider, ASUD and ACCES (France) Mukta Sharma, International Harm Reduction Association (IHRA); Beatrice Stambul, Medicins Du Monde (France); Gerry Stimson, International Harm Reduction Association (IHRA);

6 COMMITTEE MEMBERS BARCELONA ORGANISING COMMITTEE / COMITÉ ORGANIZADOR DE BARCELONA SAPS-Creu Roja AEC Gris Sala Baluard Associació de Pacients Dependents a Opiacis Plataforma de persones afectades per les polítiques de drogues Xarxa Sida i Món Local a Catalunya Comitè 1r de Desembre Coordinadora de CAS de Catalunya Federació Catalana d Associacions d Ajuda al Drogodependent Col legi Oficial de Farmacèutics de Barcelona Grup IGIA Conference Consortium Agència de Salut Pública de Barcelona Centre SPOTT- Diputació de Barcelona Departament de Salut. Generalitat de Catalunya Ministerio de Sanidad y Consumo. Gobierno de España MEDICAL COMMITTEE / COMITÉ DE SALUD Joan Colom (Departament de Salut) Jaume Montfort (Sistema d Emergències Mèdiques) Jaume Gil (Sistema d Emergències Mèdiques) Xavier Major (Departament de Salut) Jimi Grieve (Conference Consortium) Saúl Saldivar (Conference Consortium) Béatrice Martín (Conference Consortium) Satxa Rosselló (Grup IGIA) Stéphane Ibáñez-de-Benito (INHRN- Red Internacional de Enfermería en reducción de daños) Carme Guerrero (Departament de Salut) Núria Ribot (Agència de Salut Pública de Barcelona) Carmen Vecino (Agència de Salut Pública de Barcelona) Miguel de Andrés (Grup Igia) Howard Lotsof (INPUD) Francesc David (Plataforma Drets) Stijn Goosens (INPUD) DRUG USER COMMITTEE / COMITÉ DE CONSUMIDORES DE DROGAS Y PACIENTES INPUD FAUDAS APDO Plataforma AUMMO ARSU ARPA GRDB ASAUPAM

7 Harm Reduction 2008: IHRA s 19 th International Conference 6 GOVERNMENTAL ADVISORY COMMITTEE / COMITÉ ASESOR GUBERNAMENTAL Carmen Moya. Government Delegate for the National Plan on Drugs of Spain Teresa Robledo. Secretary for The National Plan on Aids of Spain Joan Colom. Director of the Programme on Substance Abuse of Catalonia INTERNATIONAL PROGRAMME ADVISORY COMMITTEE / COMITÉ INTERNACIONAL ASESOR DEL PROGRAMA Moruf Adelekan, United Kingdom Parviz Afshar, Iran Steve Allsop, Australia Andrew Ball, Switzerland Francisco Bastos, Brazil Ross Bell, New Zealand Joanna Berton Martinez, United States Ricky Bluthenthal, United States Samantha Bowden, Australia María J Bravo, Spain Caryn Bredenkamp, United States Cinzia Brentari, Belgium Jamie Bridge, United Kingdom Robert Broadhead, United States Ernst Buning, Netherlands Scott Burris, United States Waleska Caiaffa, Brazil Patrizia Carrieri, France Walter Cavalieri, Canada Calderon Christine, France Luciano Colonna, United States Catherine Cook, United Kingdom Hannah Cooper, United States Anne Coppel, France Marcelo Cruz, Brazil Sue Currie, United States Matt Curtis, United States Linda Cusick, United Kingdom Pablo Cymerman, Argentina Max Daly, United Kingdom Gerard de Kort, Indonesia Jordi Delas, Spain Vitaly Djuma, Russia Jason Farrell, United States Elvira Filipe, Brazil Jane Fountain, United Kingdom Samuel Friedman, United States Ruth Goldsmith, United Kingdom Irene Lynn Goldstone, Canada Leopoldo Grosso, Italy Paul Hardacre, Thailand Robert Heimer, United States Vivian Hope, United Kingdom John Howard, Australia Catalina Iliuta, Lithuania Kevin Irwin, United States Marianna Iwulska, Poland Adeeba Kamarulzaman, Malaysia Andrej Kastelic, Slovenia Kaveh Khoshnood, United States Trevor King, Australia Suresh Kumar, India Nancy Laliberte, Canada Jeffrey Lazarus, Denmark Simon Lenton, Australia Guy Pierre Levesque, Canada Gregory Lucas, United States Ilham Maerrawi, Brazil Lisa Maher, Australia Melis Martina, Italy Elise Massard, United Kingdom Jane McCall, Canada Hans-Guenter Meyer-Thompson, Germany Warren Michelow, Canada Pete Miller, United Kingdom David Moore, Australia Bijan Nassirimanesh, Iran Patrick O Hare, France Olanrewaju Onigbogi, Nigeria David Otiashvili, Georgia Caitlin Padgett, United States Bijay Pandey, Nepal Lucy Platt, United Kingdom Edoardo Polidori, Italy Robin Pollini, United States Robert Power, Australia Emran Razaghi, Iran Diane Riley, Canada Kay Roberts, United Kingdom Xavier Roca, Spain Acire Roche, United States Diana Rossi, Argentina Cristina Sanclemente, Spain Anya Sarang, Russia Péter Sárosi, Hungary Penelope Saunders, United States Sebastian Saville, United Kingdom Eberhard Schatz, Netherlands Umesh Sharma, Thailand Janie Sheridan, New Zealand Arun Singh, India Natasha Smith, Australia Steffanie Strathdee, United States David Sweanor, Canada Pascal Tanguay, Thailand Roderick Thomson, United Kingdom Abdalla Toufik, France Graciela Touzé, Argentina Carla Treloar, Australia Daniela Trigueiros, Brazil Brian Vandenberg, Australia Annette Digna Verster, Switzerland Dwight Vick, United States Gundo Weiler, Ukraine Lucas Wiessing, Portugal Fiona Williams, Australia Daniel Wolfe, United States Rachel Wotton, Australia Zunyou Wu, China SCHOLARSHIPS Every year IHRA awards full scholarships and other types of financial support to a number of individuals to enable them to attend, participate and present at its conference. This is crucial to ensure that a balance is maintained in relation to representation at the conference and its continued relevance as a global forum to promote harm reduction as both a concept and in practice. To enable us to do this we rely on financial support from a number of organisations. This year we are very grateful to the following for their generous financial contributions to support our efforts: DFID (the UK Department For International Development) IHRA (the International Harm Reduction Association) IHRD (the Open Society Institute s International Harm Reduction Development Program) Schering Plough UNAIDS (the Joint United Nations Programme on HIV/AIDS)

8 7 AWARDS AWARDS Each year IHRA acknowledges those who have made outstanding contributions to the field of harm reduction by presenting a range of awards at the annual conferences. The presentation of these awards will take place during the closing session of the conference, on Thursday 15 th May. A list of previous award winners in each category is printed below. The International Rolleston Award is presented to an individual who has carried out groundbreaking work or excellent service to the reduction of drug and/or alcohol related harm at an international level. Examples of such work include advocating for harm reduction programmes and practice, dedicated delivery of harm reduction teaching and training, advancing scientific research and the evidence-base for harm reduction, or the continued provision of funding or resources for harm reduction initiatives. The winners of this award are chosen by the IHRA Executive Committee. The National Rolleston Award is presented to a group or individual that has made an outstanding contribution to the reduction of drug and alcohol related harm for the nation which is hosting the IHRA conference that year. The winners of this award are chosen by the conference s Local Organising Committee. The Travis Jenkins Award is presented at each conference to acknowledge a current or former injecting drug user who has made an outstanding contribution to reducing drug related harm. The winner of this prize receives a cheque for $500US, which is kindly donated by the family and friends of Travis Jenkins, the late jazz musician who overcame a heroin addiction in order to marry and raise two sons, travel around the world with his anthropologist wife and create his music. The Best in Festival Film Award is given to the best film or documentary on an issue relating to the reduction of drug related harm shown during the conference Film Festival. This award is jointly presented by IHRA and the organisers of the Film Festival the Centre for Harm Reduction at the Burnet Institute, Australia. PREVIOUS INTERNATIONAL ROLLESTON AWARD WINNERS 1992 Dave Purchase on behalf of North American Syringe Exchange (USA) 1993 Ernie Drucker (USA) 1994 Alex Wodak (Australia) 1995 Anne Coppell (France) 1996 Aaron Peake (Nepal) 1997 Luigi Ciotti (Italy) 1998 Nick Crofts (Australia) 1999 Jean-Paul Grund (Netherlands) 2000 Pat O Hare (Italy) 2001 Fabio Mesquita (Brazil) 2002 Ethan Nadelmann (USA) 2003 Ambros Uchtenhagen (Switzerland) 2004 Anya Sarang (Russia) 2005 Zunyou Wu (China) 2006 Robert Newman (USA) 2007 Vladimir Mendelevich (Russia) PREVIOUS NATIONAL ROLLESTON AWARD WINNERS 1992 Les Drew (Australia) 1993 Wijnand Mulder (Netherlands) 1994 Catherine Hankins (Canada) 1995 San Giuliano Unit di Strada (Italy) 1996 The Australian IV League (Australia) 1997 Alain Mucchielli (France) 1998 Tarcisio Andrade (Brazil) 1999 André Seidenberg (Switzerland) 2000 Mike Wavell (Jersey) 2001 Jimmy Dorabjee (India) 2002 Tatja Kostnapfel-Rihtar (Slovenia) 2003 Mae Chan Project (Thailand) 2004 Tony Trimingham (Australia) 2005 Des Flannagan (Northern Ireland) 2006 The Drug User Advisory Group (Canada) 2007 Marek Zygadło (Poland) PREVIOUS TRAVIS JENKINS AWARD WINNERS 2005 Paisan Suwannawong (Thailand) 2006 Jason Farrell (USA) 2007 Alexandra Volgina (Russia) PREVIOUS FILM FESTIVAL AWARD WINNERS 2004 Hi Dad Theresa Wynnyk & Sherry McKibben (Canada) 2005 Mohammad and the Matchmaker Maziar Bahari (Iran) 2006 Worth Saving Gretchen Hildebran & Leah Wolchok (USA) 2007 FrontAids Eugene Zaharov & Sergey Bogatyrev (Russia) ROLLESTON ORATION The Rolleston Oration is delivered at the International Conference on the Reduction of Drug Related Harm by an invited speaker who has played a significant role in the development of drug policy and practice consistent with harm reduction principles. The 2008 Rolleston Orator is Paul Hunt, whose presentation will be delivered as part of the opening plenary session on Sunday 11 May 2008 in the plenary room #7.

9 Harm Reduction 2008: IHRA s 19 th International Conference 8 INFORMATION FOR DELEGATES CONFERENCE PROGRAMME The conference begins on Sunday 11 th May 2008 at 16:30 with the Opening Session including the 2008 Rolleston Oration from Paul Hunt, the UN Special Rapporteur on the Right to Health. This will be followed by an opening reception and networking session. Each full day of the conference (Monday 12 th, Tuesday 13 th and Wednesday 14 th May) will commence at 08:30 with short presentations on Global Issues followed by a Plenary Session (09:00 10:30) on a key conference topic with translation available in English, Spanish, French and Russian. After a short coffee break, there will then be three parallel Major Sessions (11:00 12:30) with translation available in English and Spanish (plus French and Russian in Room 7). These will be followed by a Lunch Break (containing some independently organised Lunchtime Meetings), with food and refreshments provided. Each afternoon will then be devoted to two sets of Concurrent Sessions (14:15 15:45, and 16:15 17:45), two Living Room Sessions (more informal discussion forums on key topics; 14:15 15:45, and 16:15 17:45), and the 5 th International Drugs and Harm Reduction Film Festival. On Monday 12 th and Tuesday 13 th May, there will also be two Six O Clock Shows (18:00 19:30). The final day of the conference (Thursday 15th May) will open with a Keynote Address from Antonio Maria Costa, Executive Director of UNODC (09:00 09:55), followed by three parallel Major Sessions (10:15 11:45) with translation available in English and Spanish (plus French and Russian in Room 7). The programme then finishes with the Closing Session (12:00 13:30) including the 2008 IHRA Awards Presentations and a keynote address from Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. This booklet contains detailed information on all of the conference sessions including times, locations, speakers and presentation titles. Abstracts for each presentation can be found on the accompanying conference DVD. We hope that there is something in the programme for everyone and welcome your comments and feedback now, during and after the conference. OTHER CONFERENCE INFORMATION Exhibitions: These will be located in the coffee and lunch area on level 1 throughout the conference. The exhibitors are key supporters of the IHRA conferences and we would encourage all delegates to take the time to explore the numerous display stands. Poster Presentations: These will take place in three sessions one on each full day of the conference (Monday 12 th, Tuesday 13 th and Wednesday 14 th May). Posters will be in place from the first coffee break (10:30 11:00) to the final coffee break (15:45 16:15), and contributors are asked to stand by their posters during the lunch break (12:30 14:15) to answer any questions from delegates. Posters will be located in the hall on level 3. Film Festival: Film presentations and screenings will take place in Room 3. Please see the separate Film Festival Programme for further information. Languages and Translation: The official language of the conference is English. For some rooms and sessions, simultaneous translation will be available in Spanish, French and Russian. Please see the following table for details. Room 7 Room 6 Room 5 Other Rooms Opening, Closing EN ES FR RU and Keynote Sessions Global Issues EN Plenary Sessions EN ES FR RU Major Sessions EN ES FR RU EN ES EN ES Lunchtime Meetings EN EN Concurrent Sessions EN ES FR RU EN ES EN ES EN Living Room Sessions EN Film Festival Sessions EN Six O Clock Shows EN EN Translation Headsets: Headsets can be obtained outside room 7 on level 3 upon deposit of a valid passport, identification card or credit card, which will be returned in exchange for the headset at the end of each session. Delegates will be charged 320 for lost or misplaced headsets. In order to avoid large queues for headsets, please think ahead and obtain your headset during the breaks before each session. Please return the headset equipment at the end of each day, as it will need to be recharged in order to be used the following day. Delegate Passes: Conference delegates must wear their passes at all times in order to gain access to the sessions and exhibition areas, as well as the conference reception and party. If you have mislaid your delegate badge, please contact the information desk on level 1. Replacement passes will be issued at a cost of 50 each. Speakers Room: Room #2 on level 2 will be available for speakers who need to check or edit their presentations from Sunday 11 th May to Wednesday 14 th May, between 8:30 and 18:00. The room will be equipped with computer equipment and a printer. Refreshments: Morning coffee, lunch and afternoon tea will be served in the exhibition area on level 1 on each full day of the conference (Monday 12 th, Tuesday 13 th and Wednesday 14 th May), as well as morning coffee on Thursday 15 th May. Conference Party: This will take place in Razzmatazz one of Barcelona s premier night clubs on Wednesday 14 th May from 20:00 until 24:00. There will be a light finger buffet and a complementary drink for all delegates attending, and entertainment will be provided by the Harm Reduction All Stars. The conference party is a great opportunity to meet people and renew old acquaintances, and is always one of the highlights of the conference. Razzmatazz is close to the Marina metro station, which is a short ride (5 to 8 minutes) from the city centre. A shuttle bus service will operate from 23:00 until 00:30 that evening to take delegates back to various locations in the city. Details of this service will be available during the conference from the Information Desk. Admission to the party is strictly upon presentation of a delegate badge for the conference. There will be a small number of additional tickets available for delegates to purchase for their guests priced at 25. A maximum of two additional tickets can be purchased per registered delegate. Please see the Information Desk for more information.

10 9 PROGRAMME SATELLITE MEETINGS Satellite meetings will take place in the conference venue on Sunday 11th May unless stated otherwise. THE GLOBAL CONTRIBUTION OF NURSING TO HARM REDUCTION Organised by the Nursing Harm Reduction Network (NHRN). University of Barcelona s School of Nursing, Saturday May 10 th 2008, THE UNITED NATION DRUG POLICY REVIEW Organised by International Drug Policy Consortium and supported by IHRA. Hotel Catalonia, Plaza Espana, Saturday May 10 th 2008, 16:00 19:00 3 rd INTERNATIONAL DRUG USER CONGRESS Organised by the International Network of People who Use Drugs (INPUD) Room 3 level 2, 10:00 15:00 4 th INTERNATIONAL CONFERENCE ON ALCOHOL AND HARM REDUCTION Organised by Quest 4 Quality Amsterdam (Q4Q) and IHRA. Room 8 level 3, 10:00 15:00 BUPRENORPHINE-NALOXONE (SUBOXONE): WHAT S NEW? Supported by Schering-Plough. Room 6 level 3, DEVELOPING GENDER SENSITIVE HARM REDUCTION SERVICES AND POLICIES Organised by the International Harm Reduction Development (IHRD) programme and GTZ. Room 4 level 2, 10:00 15:00 HIV PREVENTION INTERVENTIONS FOR INJECTING DRUG USERS: LESSONS LEARNT FROM ASIA Organised by the UN Regional Task Force on Injecting Drug Use. Room 11 level 0, 10:00 15:00 HIV/AIDS AND HEPATITIS C IN PRISON SETTINGS Organised by the Canadian HIV/AIDS Legal Network, the Open Society Institute (OSI) Public Health Program and OSI Justice Initiative, and the International Centre for the Advancement of Addiction Treatment. Room 5 level 3, 8:30 15:30 Sunday, 11 th May :30 18:30 OPENING SESSION Room # 7 Host: Mukta Sharma OS Mukta Sharma Welcome on Behalf of IHRA Gerry Stimson Welcome to the Conference Paul Hunt Keynote Address the 2008 Rolleston Oration Introduction to the Film Festival Opening Ceremony Host: Joan Colom, Department of Health of Catalonia Bernat Soria Minister of Health and Consumers Affairs of Spain Marina Geli Regional Minister of Health of Catalonia Isabel Ribas Councillor on Public Health of the Barcelona City Council Montserrat Ballarin Political Representative of the Social Welfare Area of the Provincial Council of Barcelona Oriol Romaní President of IGIA

11 Harm Reduction 2008: IHRA s 19th International Conference 10 Monday, 12 th May :30 09:00 Global Issues UNAIDS Room # 7 Chair: Rebecca Schleifer Michel Sidibe UNAIDS Director of Country and Regional Support Universal Access, UNAIDS and the UNGASSes GI-1 09:00 10:30 PLENARY Room # 7 Chair: Gerry Stimson The Global State of Harm Reduction La Situation Globale De La Réduction De Dommages Gerry Stimson 1355 The global state of harm reduction (La Situation Globale De La Réduction De Dommages) Louisa Degenhardt 1354 The global state of research (La Situation Globale De L Investigation) Graciella Touze 1358 Harm reduction in Latin America (Reduction De Dommages en Amérique Latine) Lanre Onigbogi 1357 Harm reduction in Africa (Réduction De Dommages En Afrique) Anne Roche 1359 Alcohol harm reduction: A global perspective (Réduction De Dommages en relation avec l alcool: Une Perspective Globale) Milena Naydenova 1356 The global state of drug user activism (La Situation Globale De L Activisme Des Consommateurs De Drogues) P1 10:30 11:00 11:00 12:30 MAJORS Room # 7 M1 Chair: Amparo Sanchez Harm Reduction in Spain Part 1 Réduction De Dommages En Espagne Première Partie Luis De la Fuente 1162 The large decline in drug injection in Spain with continuing geographic differences Francisco José Caracuel 956 The heroin programme in Andalusia: Sanitary problems after heroin dispensation Santiago Rincón Moreno 804 Ten years of methadone maintenance programmes in Spanish prisons ( ) Miguel de Andres 1265 The Latin Alliance : Re-conceptualising harm reduction in the south of Europe Room # 6 M2 Chair: Srdan Matic Hepatitis C Prevention and Treatment Prévention Et Traitement De L Hépatite C Supported by WHO Europe and the London School of Hygiene and Tropical Medicine Holly Hagan 989 What works: A synthesis of research on HCV prevention for drug injectors Amparo González Caballero 1343 Community advocacy in HCV prevention and treatment Margaret Hellard 961 Acute and early chronic HCV treatment responses within a predominantly injecting drug user population: The Australian Trial in Acute Hepatitis C (ATAHC) Thomas Wong 521 Hepatitis C prevention, diagnosis and treatment in indigenous populations: Opportunities for action Discussant: Paulette Tremblay Room # 5 M3 Chair: Tim Rhodes Evidence in Harm Reduction Evidence dans la Réduction de Dommages Don C. Des Jarlais 991 A reduction in HCV among injecting drug users following the large-scale implementation of syringe exchange programmes in New York City Peter Vickerman 1241 Modelling the impact of harm reduction on HIV and HCV in low and middle income settings Maria José Bravo 1205 The evaluation of supervised injection facilities: Evidence from the Spanish experience Thomas Kerr 705 The science and politics of evaluating the Vancouver safer injection facility

12 11 PROGRAMME MORNING P1 The Global State of Harm Reduction It is over two decades since the first harm reduction projects started in Europe, Australia and North America. Since then, harm reduction has grown in terms of acceptance, implementation, and scientific knowledge. Harm reduction programmes currently operate in a wide variety of cultural, religious and political contexts, and the approach is supported by international organisations such as UNAIDS, UNICEF, WHO, UNODC and World Bank. Despite this, obstacles remain to the universal implementation of harm reduction such as resource shortages, re-emerging war on drugs approaches, legal restraints on substitution treatments, and limitations on NGO operations in many developing and transitional countries. In order to overcome these barriers (and the vociferous opponents to harm reduction who still exist at the international level) and move forward, harm reduction must become a truly global approach. This session will launch the Global State of Harm Reduction report the first in a series of major publications from IHRA s new HR2 (Human Rights and Harm Reduction) programme. The report, and this session, will assess the current situation for harm reduction by highlighting a number of key issues, problems and responses. These include the scarcity of harm reduction in many parts of the world (especially Africa and Latin America), the need for improved harm reduction for non-injecting drug use (especially alcohol, SESSION ABSTRACTS marijuana, and cocaine), issues relating to global research on injecting drug use, the need to address human rights abuses of people who use drugs (and the lack of engagement of human rights issues by the international community), and the current state of drug user activism and civil society engagement. As such, this session will introduce and discuss many of the major themes that run though the conference. TEA/COFFEE BREAK M1 Harm Reduction in Spain Part 1 M2 Hepatitis C Prevention & Treatment M3 SESSION ABSTRACTS Evidence in Harm Reduction Spain, like many other southern European countries, has suffered from the serious impacts of HIV/AIDS and hepatitis C infections and overdose deaths especially in the eighties and the early nineties as a consequence of the huge heroin epidemic. HIV/AIDS and overdoses became some of the leading causes of death amongst young people. In Spain, this led to significant efforts to introduce and improve harm reduction strategies encompassing syringe exchange, methadone maintenance programmes (both in the community and in prisons), outreach to hidden groups of drug users, drug consumption rooms, and peer involvement. This session will provide an overview of harm reduction in Spain from different perspectives. It will focus on epidemiological changes in the routes of drug administration (especially how drug injecting has declined in certain regions of Spain, and why this may be the case), research from the heroin prescription trial in Andalusia (a new treatment strategy for long term drug users who have not succeeded with methadone maintenance, and how it has improved their drug consumption, health and quality of life), the impact of methadone interventions in Spanish prisons (including the relevance of a service designed to be easy to access), and, finally, how harm reduction policies have had to adapt to the local cultural and social conditions across Spain and the Latin countries of southern Europe. Globally, it has been estimated that between 123 and 170 million people are infected with hepatitis C (HCV) and that it is the most common cause of chronic liver disease. Morbidity and mortality from HCV infection are increasing and are expected to continue to rise in the coming years. HCV spreads rapidly among injecting drug users because of its high infectivity. International studies suggest that up to 95% of injecting drug users in some countries may be HCV positive (with HCV and HIV co-infection also very common due to the similar transmission routes). Healthcare providers have been slow to provide HCV prevention services that target injecting drug users and despite evidence that treatment is feasible and effective when special needs such as drug dependence are addressed injecting drug users are often excluded from treatment. This epidemic is a significant but poorly addressed public health problem. This session will provide state of the art information on HCV and promote discussion, debate and action on this neglected disease. Under the chairmanship of Srdan Matic (WHO-Euro), four leading experts will address HCV prevention and treatment. Holly Hagan (United States) will provide a synthesis of the latest research on HCV prevention for drug users; Amparo Gonzalez Caballero (Spain) will give the patients view and address community advocacy in HCV prevention and treatment; Thomas Wong (Canada) will focus on the impact of HCV in indigenous populations and examine some opportunities for interventions; and Margaret Hellard (Australia) will present results from a national trial which considers treatment responses to acute HCV infection amongst injecting drug users. This session organised by the Centre for Research on Drugs and Health Behaviour at the London School of Hygiene and Tropical Medicine aims to bring together a number of papers from international researchers on the latest evidence for the harm reduction approach to substance use including some of the challenges facing research in this field. For example, there is only modest evidence linking needle and syringe exchange programmes with reductions in hepatitis C (HCV) incidence among injecting drug users (IDUs) especially compared to the strong (and increasing) evidence regarding HIV. To counter this, the first presentation in this session summarises findings from a New York study which shows reductions in HCV infections among IDUs following the large scale implementation of syringe exchange schemes in the city. The second presentation reports on a mathematical modelling study to map the joint transmission of HIV and HCV among IDU in four settings across Asia and Central Europe and models the potential impact of harm reduction interventions in these four different epidemiological settings, and the levels of coverage that would be required in order to have an impact. The final two presentations focus on supervised injecting interventions providing an update on the ongoing evaluations of supervised injecting facilities in Spain (the findings of which have linked these services with reductions in injecting risk behaviour) and reporting on the science and politics behind one of the best researched supervising injecting facilities (Insite in Vancouver, Canada). These presentations will serve as a potent reminder of how the political environment can shape the interpretation and use of evidence in relation to harm reduction.

13 Harm Reduction 2008: IHRA s 19th International Conference 12 Monday, 12 th May :30 14:15 13:00 14:00 Room # 6 UNGASS Discussion Organised by the International Drug Policy Consortium and supported by IHRA. The above session is organised outside of the peer-reviewed programme. Organisers are not responsible for the content. LS-1 14:15 15:45 Room # 7 CONCURRENT C1-1 Chair: Christian Kroll Universal Access To HIV Prevention & Treatment For Drug Users Part 1 Supported by UNODC, WHO Europe, and WHO HQ Martin Donoghoe 503 Setting targets for universal access to HIV/AIDS prevention and treatment for injecting drug users Monica Beg 606 The coverage of HIV prevention for injecting drug users: Country examples Abu S. Abdul-Quader 1302 Increasing coverage for universal access to HIV prevention, treatment and care: Sampling hard to reach populations Tiken Rajkumar 358 The success and challenges of injecting drug users on ART in Manipur, India Room # 6 CONCURRENT C1-2 Chair: Cinzia Brentari Harm Reduction Services in Prisons Sarah Larney 1088 Prison methadone maintenance treatment: An international review of implementation and outcomes for treated prisoners Leah Utyasheva 681 Access to HIV prevention and treatment of injecting drug users and prisoners in Central Asian countries and Azerbaijan: A review of legislation Ventura Ferrer Castro 971 The needle exchange programme in the Pereiro Prison (Ourense): A seven year experience Monica Ciupagea 1128 HIV prevention and drug related services in Romanian prisons Room # 5 CONCURRENT C1-3 Chair: Emran Razzaghi Hepatitis C Treatment & Responses Michael Carden 1324 Treating hepatitis C in people actively using drugs: Using a collaborative, multidisciplinary model of care Simona Merkinaite 1193 Putting hepatitis C on the public health and harm reduction agendas: The EHRN experience Anna Doab 744 Injecting drug users perceptions, knowledge and willingness to participate in clinical trials related to hepatitis C treatment and prevention Lisa Maher 255 Preparedness for candidate hepatitis C vaccine trials in people who inject drugs: Challenges and opportunities Room # 8 CONCURRENT C1-4 Chair: Marcus Day Cannabis Ross Coomber 169 The social supply of cannabis among young people: The case for an alternative conceptualisation of the drug market and for an alternative policing approach Jean-Pierre Gervasoni 1102 Cannabis monitoring in Switzerland: The sentinel system Daniel Abrahamson 730 Implementing medical cannabis distribution in the U.S.: The New Mexico test case 15:45 16:15 16:15 17:45 Room # 7 CONCURRENT C2-1 Chair: Martin Donoghoe Universal Access To HIV Prevention & Treatment For Drug Users Part 2 Supported by UNODC, WHO Europe, and WHO HQ William E. Butler 567 The right to opioid substitution therapy programmes under international law Tim Rhodes 248 Hope, expectation and HIV treatment in a transitional setting: A qualitative case study Donna Higgins 884 Scaling up access to HIV testing and counselling for people who use drugs and for prisoners Annette Verster 920 Improving access to essential medicines for opioid substitution therapy Room # 6 CONCURRENT C2-2 Chair: Fabio Mesguita Beyond Drug Use: Housing, Employment & Law G. Alan Marlatt 1174 Harm Reduction: Innovations from the University of Washington Mar Fernandez Cifuentes 1299 "RECOJE-CAUSAS": A step towards social integration of illicit drug users Lene Tanderup 951 Harm reduction focusing on severe alcohol misuse among homeless citizens in Copenhagen Carmen Romera 900 Drug users insertion into the labour market: A dream made reality Room # 5 CONCURRENT C2-3 Chair: Jordi Delàs Hepatitis C Risk & Prevention Research Pedro Mateu-Gelabert 328 How do long-term injectors avoid hepatitis C? Peter Higgs 538 Hepatitis C sero-conversion in cohort of injectors in Melbourne Noel Craine 246 Hepatitis C virus incidence amongst drug injectors: The effects of opiate substitution treatment and homelessness Room # 8 CONCURRENT C2-4 Chair: Jakob Huber Education & Training In Harm Reduction Strategies & Approaches Ambros A. Uchtenhagen 960 What do we know about needs and opportunities for training in harm reduction strategies and approaches? Gulmira Torokulova 586 Harm reduction education and training: Central Asia experiences Jean-Francois Martinbault 998 Which came first bad rules or bad clients? Joy Barlow 815 How to build an international network for education and training in harm reduction strategies and approaches: Plans for preparing an evidence-based curriculum 17:45 18:00 18:00 19:30 Room # 6 Host: Ernst Buning The Role of New Technology in Harm Reduction Gregory Scott, 629 Using film to promote better health among injection drug users John Fitzgerald, 422 Syringes and culture: Using the web as a window into the everyday construction of the cultural meaning of syringes Carla Treloar, 531 Blood, peers and video tape: Developing innovative blood awareness messages using analysis of video recordings of injecting in a peer education framework Susan Boyd, 525 Visualizing a century of fictional film representations of women and drugs 6PM1

14 13 PROGRAMME AFTERNOON LUNCH BREAK LUNCHTIME MEETINGS Room # 5 LS-2 Pandora s Box: Lifting the Lid on Crystal Methamphetamine and the Gay, Lesbian, Bisexual and Transgender Community Organised by ACON The above session is organised outside of the peer-reviewed programme. Organisers are not responsible for the content. FILM FESTIVAL Room # 3 FILM FESTIVAL 12:30 Cottonland (Canada) 13:25 Getting Out, Staying Safe (Canada) CONCURRENTS FILM FESTIVAL Room # 11 CONCURRENT C1-5 Chair: Vivian Hope Injections & Infections Elisa Lloyd-Smith 1268 Risk factors for abscesses at an injection site Robin Pollini 1289 High levels of abscess incidence and self-treatment among injecting drug users in Tijuana (Mexico) warrant intervention Fortune Ncube 626 First findings from national surveillance of symptoms of injecting site infection or injury: An examination of the extent and associated factors Rohan Sweeney 737 What is the economic burden to the public health system of treating non-viral injecting related injury and disease in Australia? Room # 12 CONCURRENT C1-6 Chair: Jordi Casabona Researching HIV Risk & Prevalence Lucy Platt 1338 Changes in HIV prevalence and risk among new injecting drug users in a Russian city of high HIV prevalence Barbara Tempalski 1046 HIV prevalence among injection drug users in 96 large US metropolitan areas, ( ) Olivier Letouze 1194 Factors that contribute to vulnerability for HIV transmission amongst injecting drug users: The case of two under-researched U.S. / Mexico border towns Emran Razaghi 805 High risk behaviours related to injection drug use in Iran: An 8 year trend analysis Room # 4 LIVING ROOM LIV1 Chair: Rick Swinard Raising Awareness Outside the Bubble Amy Salmon 1050 Beyond plain language summaries: Lessons learned from a community-driven knowledge exchange project to address the health information priorities of women who use drugs Wouter de Jong 921 Harm reduction among active cannabis users in Rotterdam: An evaluation of a prevention programme in coffeeshops Galina Kitsenko 1069 Harm reduction training in law schools in Ukraine Ajianto Dwi-Nugroho 854 Journalists / Activists: Alliances supporting the harm reduction movement through the media in Indonesia Room # 3 FILM FESTIVAL 14:15 Nothing for us, without us Oral Substitution Treatment in India (India) 14:50 Harm reduction video: Cambodia Yama & Ice (Cambodia) 15:05 Access All Areas (Australia) 15:25 The Sleeping Giant (Canada) TEA/COFFEE BREAK CONCURRENTS FILM FESTIVAL Room # 11 CONCURRENT C2-5 Chair: Guy-Pierre Levesque Peer Involvement & Outreach Jim Watkin 955 "Picture as Voice": An exploratory study of street identified people who use psychoactive substances Olena Chupryna 338 Peer groups and HIV theater as a bridge to the incarcerated Morshed Khan 359 Maximising effective peer outreach: An effective harm reduction approach in HIV prevention intervention for injecting drug users Room # 12 CONCURRENT C2-6 Chair: Lisa Maher The Social Context of Risk and Intervention Kevin Irwin 1232 From risk environment to structural intervention: Injecting drug use in Russia Samuel Friedman 523 Devolution and the struggle to avoid infections and social harms: Staying safe in New York City Eugene McCann 443 Urban / Global: A geographical perspective on the role of cities and urban activists in the politics of harm reduction policy Robyn Dwyer 455 Modes of exchange in a local drug marketplace Room # 4 LIVING ROOM LIV2 Chair: Joumana Hermez Opiate Substitution Therapies: Problems & Solutions Vladan Radivojevic 1168 The methadone programme in Nis, Serbia Ante Ivancic 1038 Substitution treatment in general practice: Experiences from Porec, Croatia Aliaksei Aliaksandrau 414 First results of Belarus pilot methadone substitution project Arom Konchom 861 Moving for methadone policy change in Thailand Room # 3 FILM FESTIVAL 16:15 Venopressió (Spain) 16:55 Miradas y drogas (Spain) 17:15 Chew on This (Bolivia) BREAK SIX O CLOCK SHOW FILM FESTIVAL Room # 5 Host: Allan Clear Ibogaine User s Choice session supported by INPUD Howard Lotsof, 559 Ibogaine treatment for substance dependence: Historical and future perspectives Alex Wodak, 1192 The lack of evidence for Ibogaine as a treatment for heroin dependence Alonso Perez, 1351 The safety and screening of Ibogaine in a Mexican clinical setting Dimitri Mugianis, 397 Underground Ibogaine treatment and drug user activism 6PM2 Room # 3 FILM FESTIVAL 18:00 Just Punishment (Australia)

15 Harm Reduction 2008: IHRA s 19th International Conference 14 Tuesday, 13 th May :30 09:00 Global Issues CND Room # 7 Chair: Marcus Day Damon Barrett Reflections from the 51st Session of the Commission on Narcotic Drugs GI-2 09:00 10:30 PLENARY Room # 7 P2 Chair: Sue Currie What Can Be Done to Ensure Gender Equality in the Field of Harm Reduction? Que peut-on faire pour assurer l égalité entre genres dans le domaine de la Réduction de Dommages? Marina Mahathir 1349 The cultural and religious context of women and drug use (Le contexte culturel et religieux des femmes et l usage de drogues) Kirstie Rendall-Mkosi 1330 The prevention of Foetal Alcohol Syndrome (La prévention du Syndrome Alcoolique Foetal) M. Suresh Kumar 759 Harm reduction programmes for the regular sexual partners of substance users (Programmes de réduction de dommages pour les couples consommateurs de drogues avec des relations sexuelles régulières) Margaret Akan 1255 Using our culture as harm reduction: Addressing the impact of the Residential School System with aboriginal women who use drugs and alcohol in Saskatchewan, Canada (Utilisant notre culture comme réduction des dommages: Abordant l impact du Système d Education Résidentiel dans le cas des femmes aborigënes qui consomment des drogues et de l alcool a Saskatchewan, Canada) 10:30 11:00 11:00 12:30 MAJORS Room # 7 M4 Chair: Stijn Goossens Discrimination Versus Rights Discrimination versus Droits User s Choice session supported by INPUD Pere Martinez 1350 Opiate addiction treatment programmes in Spain: The pilot heroin maintenance project Ekta Thapa Mahat 181 Discrimination versus rights in Nepal Rebecca Brooks 738 Vital voices Fredy 1096 The fight against discrimination through the critical education of people who use drugs Room # 6 M5 Chair: Kasia Malinowska-Sempruch Women, Harm Reduction and HIV: Obstacles and Opportunities Femmes, Réduction de Dommages et VIH: Obstacles et Opportunités Supported by OSI s International Harm Reduction Development Program (IHRD) Peter Meylakhs 988 Barriers to women drug users access to services in St. Petersburg: Preliminary results of a qualitative study Amala Rahmah 840 Do health services address the needs of female drug users?: A qualitative study in 8 Indonesian cities Sophie Pinkham 1210 Obstacles to women s access to harm reduction services in Ukraine and Georgia: New research Wyndi Anderson 391 Uniting harm reduction and women s rights: The U.S. experience and international opportunities Room # 5 M6 Chair: Marjana Martinic Alcohol Harm Reduction for At-Risk Populations Réduction Des Dommages En Relation Avec La Consommation D Alcool Pour Les Populations A Risque Supported by ICAP Arthur W. Blume 417 Harm reduction for alcohol use in colleges and universities: Making programs accessible to all students Alasdair Forsyth 263 Point-of-purchase interventions and their usefulness in reducing the consequences of risky drinking by young adults Dusan Nolimal 860 Dealing with alcohol use disorders in primary health care: combining harm reduction and health promotion. Betsy Thom 339 From lady to ladette? Women as an at risk group

16 15 PROGRAMME MORNING P2 What Can Be Done to Ensure Gender Equality in The Field of Harm Reduction? Women in both industrialised and non-industrialised countries continue to be heavily affected by sex and drug related harms linked to substance use (including alcohol). The marginalisation of women in their communities is extremely complex. Factors that have been associated with sex and drug-related harms have included cultural, religious and indigenous issues, as well as poverty, interpersonal violence, homelessness, sex work, child apprehension and other family-related issues. Despite these issues, there has been limited global attention on harm reduction programmes and M4 Discrimination Versus Rights This session addresses the fundamental and institutionalised injustices against people who use drugs that are the result of drug prohibition. Many people who use drugs face continuous struggles in their everyday lives under inhumane prohibition regimes. They have been killed, harmed unnecessarily, put in jail, depicted as evil, and stereotyped as dangerous and disposable. Prohibition regimes also affect people who use drugs in terms of their relationships with local authorities, policy makers, and service and treatment providers. They are often denied their basic human rights and are often not acknowledged as full citizens. This is a Users Choice session meaning that the topic, themes and speakers have been selected by the International Network of People who Use Drugs (INPUD) to represent the most pertinent issues for its members. The international panel of speakers includes people who use drugs from Spain, Nepal, America and Indonesia. They will present on their own experiences with discrimination, but also on the ways that they dealt with these situations and took action to change things for the better. services for women. In order to develop a truly global approach for harm reduction, it is critical to review and evaluate gender-based inequalities, best practices, programming and needs from around the world. This multimedia session will include expert commentary, current research and best practices in the context of the religious, social, cultural, economic and political issues that affect the negative and positive development and implementation of genderbased harm reduction programmes and services. The session, which has been developed by a special working group of experts from around the world, aims to provide delegates with an improved understanding of the issues relating to gender equality and harm reduction, knowledge about the potential strategies M5 Women, Harm Reduction & HIV: Obstacles & Opportunities In Eastern Europe and Asia, growing numbers of women are in need of harm reduction services, drug treatment, and harm reduction-oriented sexual and reproductive health services. Despite this, women who use drugs are often shut out of mainstream sexual and reproductive health services or women s shelters, and most harm reduction services are designed for a predominantly male clientele. Many pregnant drug users are counselled or coerced into having abortions or giving their children up to the state. They often have little access to accurate information on harm reduction or the prevention of mother-to-child transmission of HIV, and the harsh treatment they receive often leads them to avoid prenatal care altogether. This session will present new data on women drug users access to services in Georgia, Indonesia, Russia, and Ukraine countries where women drug users have traditionally been overshadowed by their male peers. The session will draw on experiences from the USA to discuss how multidisciplinary models of services and advocacy can be used to reduce stigma and protect the rights of women drug users while ensuring that they have access to effective, nonjudgmental care. The session will highlight ways in which the harm reduction, HIV/AIDS and women s rights movements can collaborate to protect women drug users rights and improve their access to care. and best practices to address harm reduction inequalities and barriers, and an understanding of the need for a broader spectrum of harm reduction services in order to address inequalities. By reducing the marginalisation of women, we can ultimately improve the health and quality of life of not only women, but their children, their families and their communities. M6 SESSION ABSTRACTS TEA/COFFEE BREAK SESSION ABSTRACTS Alcohol Harm Reduction For At-Risk Populations Drawing upon experience and best practice, this session aims to identify ways in which harmful social and health outcomes related to alcohol misuse can be minimised for particular at-risk populations. It offers an opportunity to showcase the need for tailored approaches and the advantage of targeted interventions that are responsive to the reality of drinking and the specific problems and risks of individual groups. Taking their cue from the successful approaches implemented in the illicit drugs field, experts in alcohol policy and prevention have increasingly begun to focus on reducing harm. This has placed a greater emphasis on the specific populations and drinking patterns that are associated with elevated risks of negative outcomes. It has also highlighted the importance of targeted interventions that are responsive to specific needs and problems. This session will explore the application of the alcohol harm reduction approach in four areas where particular drinking patterns may increase the risk for harm: heavy drinking among young people (focusing on college students in the USA); public drinking by young people; socially excluded groups (which are often hard to reach through mainstream efforts); and heavy drinking by women. In these examples, carefully tailored policy approaches may need to be considered to ensure that the risk for harm can be minimized.

17 Harm Reduction 2008: IHRA s 19th International Conference 16 Tuesday, 13 th May :30 14:15 13:00 14:00 Room # 6 Guidelines for Providing Comprehensive TB and HIV Prevention, Treatment and Care Services for Drug Users Supported by WHO Stop TB and HIV Departments, UNODC, and UNAIDS LS-3 The above session is organised outside of the peer-reviewed programme. Organisers are not responsible for the content. 14:15 15:45 Room # 7 CONCURRENT C3-1 Chair: Afarin Rahimi From Implementation to Universal Access Raminta Stuikyte 980 Moving towards universal access in the HIV field in Eastern Europe and Central Asia: Will there be universal access to harm reduction by 2010? Olivier Maguet 935 Implementing harm reduction in Afghanistan Kasia Malinowska-Sempruch 1114 More than needles: Beijing s first needle exchange moves towards comprehensive service provision Gary Reid 602 Assessing advocacy for harm reduction in China and Vietnam Room # 6 CONCURRENT C3-2 Chair: Laura Murray Young People Supported by Youth R.I.S.E Caitlin Padgett 1116 Voices of young women in harm reduction: Improving support and services David Murray 398 Cross-cultural healing: A partnership model Leila Pinto 1053 Mobile Outpatient Unit: A strategy for risk and harm reduction for street children and adolescent drug users in Salvador, Bahia, Brazil Adam Rutherford 1223 RAIN Reaching Adolescents In Need : Utilising a harm reduction framework in adolescent mental health outreach Room # 5 CONCURRENT C3-3 Chair: Susie McLean Women, Risk & Harm Reduction Toby Seddon 623 Women, harm reduction and history Sheryl McCurdy 1311 The need for gendered harm reduction measures in East Africa Benedict Kossi Afasanwo 1171 Gender roles and harm reduction among drug-using women Vicky Bungay 399 Minimising the harms of crack cocaine use: Women s health management strategies Room # 8 CONCURRENT C3-4 Chair: Deborah Coles Overdose Debra Kerr 374 The effectiveness and safety of intranasal naloxone for the treatment of heroin overdose by paramedics Sharon Stancliff 910 Overdose prevention: Building capacity Montse Neira Leon 1207 Lack of preventive behaviours for opioid overdoses among young heroin users in Madrid, Barcelona and Sevilla Traci Craig Green 913 Characterizing the overdose risk environment in St. Petersburg, Russia 15:45 16:15 16:15 17:45 Room # 7 CONCURRENT C4-1 Chair: Bernadette Pauly Healthcare Interventions to Reduce Harm Richard Alan Wood 1246 Socio-cultural, environmental and structural influences on the injection practices of women who use drugs in Vancouver, Canada Anne Fran ois 1004 Syringe exchange for patients in a general hospital: A ten year experience from Geneva Natalia Navarro Gallarda 877 Comprehensive care for users in the "Calor i Cafe" harm reduction programme Patrick Noss 1195 A new approach of the monitoring of opiate addictions: The Network of Medical Mircostructures Room # 6 CONCURRENT C4-2 Chair: Gregorio Barrio Overdose Prevention Programmes Julian Vicente 669 Drug overdose and overdose mortality in Europe: A major health problem needing decided action Kerrstin Dettmer 907 The distribution of naloxone in Berlin, Germany M. Teresa Brugal 1253 Heroin overdose in Barcelona: Evaluating the impact of non-fatal and fatal overdose Jason Farrell 506 Reducing overdose and harm upon release from prison: A prison workshop programme in New York City Room # 5 CONCURRENT C4-3 Chair: Josep M. Suelves Information Systems in Harm Reduction Agencies: Improving Data Collection Abdalla Toufik 280 Monitoring harm reduction: The first French national survey among harm reduction service clients Dagmar Hedrich 619 Monitoring harm reduction: The development of a data collection protocol for specialist harm reduction service providers Paloma Carrillo Santisteve 643 Information System in harm reduction facilities in Barcelona Tara Carney 583 An audit of harm reduction strategies to address drug-related HIV and AIDS in Southern Africa Room # 8 CONCURRENT C4-4 Chair: Shiyan Chao Harm Reduction For High-Risk Groups In East Europe & Central Asia: From Evidence To Action Supported by World Bank Patricio V. Marquez 959 Assessment of best practices in HIV/AIDS harm reduction programs among civilian population and prisoners in the Russian Federation Dorothee Eckertz 1076 Injecting drug use and HIV/AIDS in Central Asia Peggy Millson 1092 Harm reduction in prison systems in the Baltic States and the Commonwealth of Independent States Chinara Seitalieva 1308 Common problems, specific solutions: The Regional AIDS Fund as a means to support partnerships for harm reduction in Central Asia 17:45 18:00 18:00 19:30 Room # 6 Host: Eric Schneider Activism User s Choice session supported by INPUD Pierre Chappard, 587 The e-community (virtual community): A new way for self-support Yvonne Aileen Sibuea, 500 "PERFORMA": People who use drugs making a breakthrough in drug policy advocacy Berne Stalenkrantz, 704 Advocating for the human rights of people who use drugs: SDUU, IHRA and the UN Committee on Economic Social and Cultural Rights Prem Limbu, 333 The social environment of drug users: Stigma and discrimination in Nepal 6PM3

18 17 PROGRAMME AFTERNOON Room # 5 International Network of Drug Related Media Organised by Black Poppy and Auto-Support Des Usagers de Drogues (ASUD) LUNCH BREAK LUNCHTIME MEETINGS LS-4 FILM FESTIVAL Room # 3 FILM FESTIVAL 12:30 Children of Leningradsky (Russia) 13:05 Facing the Habit (United States) The above session is organised outside of the peer-reviewed programme. Organisers are not responsible for the content. CONCURRENTS FILM FESTIVAL Room # 11 CONCURRENT C3-5 Chair: Lucas Wiessing Drug Use Surveilllance Joanne Brady 1039 Estimating the prevalence of injection drug use in large U.S. metropolitan statistical areas from Jane Mounteney 701 Providing an earlier warning of drug related harms: An innovative method for city-level identification and reporting of the illicit use of medicines Ajay Puri 697 Mapping substance use and related harm: An overview of early progress with the BC Alcohol and Other Drug Monitoring Project Benjamin Phillips 742 A global review of the injection of pharmaceutical opioids: Essential treatment and diverted medication Room # 12 CONCURRENT C3-6 Chair: Daniel Wolfe In the Name of Health: Drug Treatment in the Former Soviet Union Supported by OSI s International Harm Reduction Development Program (IHRD) Maria Ovchinnikova 990 Drug treatment in crisis: Rehab and human rights in Russia Nino Balanchivadze 584 In the name of law enforcement: Registration, fines and fees in the Republic of Georgia Sergii Dvoriak 1283 Barriers in drug abuse treatment in Ukraine Inessa Vyshemirskaya 1070 Initiating practical health interventions for injecting drug users in Kaliningrad, Russia: Results of a Rapid Policy Assessment and Response (RPAR) Room # 4 LIVING ROOM LIV3 Chair: Gaspar Fraga Drug Users Magazines: A Voice A View A Vehicle For Change Supported by Black Poppy and ASUD Dirk Schäffer 610 Drogenkurier ("Drug Courier"): A voice for German drug users Fabrice Olivet 1187 ASUD: A voice for drugs users, a view about drugs culture, and a possible vehicle for change Erin O Mara 1173 Drug user magazines: A view ( Black Poppy in the UK) Annie Madden 965 Drug user magazines: A vehicle for change Room # 3 FILM FESTIVAL 14:15 Facing the Dragon With Luck (Australia) 14:55 Harm reduction video: Cambodia Injecting Drug Use (Cambodia) 15:15 Saving Lives with Naloxone (United Kingdom) 15:40 Cactus Blossom on the Sand (Vietnam) TEA/COFFEE BREAK CONCURRENTS FILM FESTIVAL Room # 11 CONCURRENT C4-5 Chair: Annette Dale-Perera Needle and Syringe Programming Norah Palmateer 611 Evidence for the effectiveness of sterile injecting equipment provision in preventing hepatitis C and HIV transmission among injecting drug users: A review of reviews Mingjian Ni 1134 The scaling-up of needle an syringe programmes in Xinjiang, China Steve Hsu-Sung Kuo 847 Harm reduction programmes reduce new HIV infections: The Taiwan experience Xavier Majó Roca 463 Efficacy of needle syringe programmes to reduce risk practices and inadequate disposal of injecting equipment Room # 12 CONCURRENT C4-6 Chair: Bill Stronach Global Efforts on Tobacco Harm Reduction Supported by tobaccoharmreduction.org at the University of Alberta Carl Phillips 1034 Progress in tobacco harm reduction (North America) Karyn Heavner 1219 Smokeless tobacco availability and promotion in Edmonton: Exploring the barriers to, and the opportunities for, tobacco harm reduction Chan Makan 798 Tobacco-related harm reduction: A public private partnership in the making in South Africa Campbell Aitken 756 The health perceptions of illicit tobacco (or chop-chop ) smokers Katherine Sykes 394 The impact of smokeless tobacco (or Snus ) in South Africa Room # 4 LIVING ROOM LIV4 Chair: Jim Peters Alcohol & Managing Night-Life Supported by the Global Alcohol Harm Reduction Network (GAHR-Net) Gerard Vaughan 1077 Can education change a drinking culture? James Lange 985 Restaurant server-based intervention to promote designated driver use. Jochen Schrooten 806 Risk reduction in night-life: An example of an integrated alcohol and drug policy in practice at the I Love Techno festival in 2007 Ronni Abergel 596 Alcohol and the City : Developing a local intervention to reduce alcohol-related harms in Copenhagen Room # 3 FILM FESTIVAL 16:15 The Lovers, The Victims (Iran) 16:50 Brothers of Kabul (Afghanistan) 17:10 Santi, Lucy, and Thoibe (India) 17:35 You, Me and Hep C (United Kingdom) BREAK SIX O CLOCK SHOW FILM FESTIVAL Room # 5 6PM4 Host: Ingrid van Beek Drug Consumption Rooms & Supervised Injections Javier Rio, 657 Introducing the International Network of Drug Consumption Rooms (INDCR) Allison M. Salmon, 284 The impact of the Sydney Medically Supervised Injecting Centre (MSIC) on ambulance attendances at opioid overdoses Kora DeBeck, 1052 Police and public health partnerships: Evidence from the evaluation of Vancouver s supervised injection facility Andrea Krüsi, 690 Supervised injecting within a day health programme for HIV-Positive injection drug users Room # 3 FILM FESTIVAL 18:00 Waiting to Inhale (United States)

19 Harm Reduction 2008: IHRA s 19th International Conference 18 Wednesday, 14 th May :30 09:00 Global Issues Civil Society Room # 7 Chair: Monica Gorgulho Raminta Stuikyte NGO Accountability: The NGO HIV/AIDS Code of Practice and Harm Reduction Self-Assessment Tool GI-3 Alex Wodak Nothing About Us Without Us: Greater, Meaningful Involvment of People who use Drugs 09:00 10:30 PLENARY Room # 7 Chair: Deborah Small Criminal Justice, Human Rights and Drugs Justice Pénale, Droits Humains et Drogues Gemma Calvet Barot 1336 Drug policies: justice, security and human rights (Politiques sur les drogues: Justice, sécurité et droits humains) M. Ravi 1140 Criminal justice, the death penalty and drugs (Justice pénale, la peine de mort et les drogues) David Otiashvili 581 The Georgian drug war: Ignoring evidence and neglecting human rights (La guerre Georgienne des drogues: Ignorant les faits et négligeant les droits humains) Scott Burris 859 Policing and harm reduction: An overview (L intervention de la police et la réduction de dommages: une perspective générale) P3 10:30 11:00 11:00 12:30 MAJORS Room # 7 M7 Chair: Jimi Grieve The Harms That Harm Reduction Forgot Les Dommages oubliés par La Réduction De Dommages Eric Schneider 324 The hidden harms of prohibition: A user s view Marta Torrens 501 Psychiatric comorbidity among substance users: Differences by substances and settings? Jim McVeigh 493 Anabolic steroids and associated drugs: Public health implications and harm reduction Sebastian Saville 362 Harms and challenges: toward a post drug-using identity Room # 6 M8 Chair: Mauro Guarinieri Moving Towards Universal Access to Prevention and Treatment in Prisons En Se Dirigeant Vers Un Accés Universel Pour La Prévention Et Le Traitement Dans Les Prisons Supported by OSI s International Harm Reduction Development Program (IHRD) James Motherall 633 Giving a voice to prisoners and former prisoners in the debate on prisoners health and harm reduction Carmen Archanco 869 A pragmatic and rights-based approach to HIV and injecting drug use in prisons: The reduction of drug-related harm in Spanish prisons Inang Winarso 1122 Moving towards universal access to prevention and treatment in Indonesian prisons Ralf Jürgens 691 Scaling up harm reduction and treatment in prisons in the Former Soviet Union Room # 5 M9 Chair: William E. Butler Human Rights and Harm Reduction Droits Humains Et Réduction De Dommages Supported by HR2 IHRA s new programme of work on harm reduction and human rights Rick Lines 310 Complicity or abolition?: UNODC and the Death Penalty for Drug Offences R. Douglas Bruce 1256 Ethical and human rights imperatives to ensure medication-assisted treatment for opioid dependence in prisons and pre-trial detention Ann Fordham 667 Positioning human rights at the centre of harm reduction for injecting drug users in the context of HIV prevention, treatment and care Rajesh Khongbantabam 409 Is this harm reduction or harm maximisation?

20 19 PROGRAMME MORNING P3 Criminal Justice, Human Rights & Drugs Law enforcement approaches dominate the response to illicit drug use, both at the domestic and international levels. In many cases, these punitive responses and harsh enforcement practices have negative consequences for human rights protections. Law enforcement activities can result in undermining health interventions for people who use drugs, such as deterring people from accessing harm reduction services. They can also lead quickly to serious human rights abuses, such as police brutality or the use of the death penalty for drug offences. This session will examine some of the negative human rights impacts of criminal justice approaches to drug use. Through a mixture of international, regional and national perspectives, the session will highlight key issues for future action by both harm reduction and human rights advocates. SESSION ABSTRACTS M7 The Harms That Harm Reduction Forgot During this session, four presenters from Europe will present overviews of four key areas which have been frequently neglected by harm reduction. These are issues which remain very real for people using drugs, but are rarely taken into account by professionals from the field (or, at least, not in a satisfactory way). The session will be chaired by James Grieve Chair of the National Users Network in the UK. Firstly, Eric Schneider (France) will present on the harms caused by prohibition itself, and what the implications of this are for people who use drugs, their environment and the broader societies. The presentation will suggest that prohibition can only impede global approaches to social work and care. This will be followed by a presentation by Marta Torrens (Spain), who will outline some of the issues in psychiatric co-morbidity including diagnosis and responses to treatment. This presentation will be based on peer-reviewed studies which have been published in several leading journals in the field (including the Lancet). Jim McVeigh (UK) will then present an overview of contemporary issues relating to performance enhancing drugs (and, in particular, anabolic steroids) in both elite sport and the general public. The presentation will outline the work and research that has already been done, as well as the difficulties in engaging and maintaining interventions with this often ignored group of people who use drugs. Finally, Sebastian Saville (UK) will present a largely autobiographical case study of accessing and managing HCV infection, the barriers for people who use drugs, the side effects of such treatments, drug use and the experiences of imprisonment in three continents. M8 Moving Towards Universal Access To Prevention & Treatment In Prisons Despite the extensive and growing evidence of the effectiveness of harm reduction programmes in prison settings, the vast majority of prison systems around the world continue to deny prisoners access to such programmes. This is all the more concerning considering that the international community has committed to the goal of universal access to HIV prevention, treatment, care and support by This session, organised by the International Harm Reduction Development (IHRD) programme of the Open Society Institute, will showcase best practice harm reduction programmes from prisons around the world. It will highlight the results from their evaluations, and demonstrate that such programmes can be introduced and scaled-up successfully within prison settings. The session will also introduce a voice that has thus far been strikingly absent from the debate on harm reduction in prisons that of the prisoners themselves. A presentation from a former prisoner will demonstrate that these individuals are essential allies in identifying what works and what does not work in terms of HIV prevention in prisons. M9 TEA/COFFEE BREAK SESSION ABSTRACTS Human Rights & Harm Reduction All over the world, people who use drugs (and communities affected by problematic drug use, drug production and drug trafficking) face abuses of their human rights in the name of drug control. Despite their central position in the Charter of the United Nations, the guarantees in the Universal Declaration of Human Rights (and the binding nature of the core international human rights treaties), drug control measures have, in many cases, taken human rights discourse off the agenda at both the national and international levels. There is a conspicuous lack of top-down policy guidance on human rights and drug control from the United Nations. The UN drug control bodies rarely discuss human rights. The UN human rights bodies rarely discuss drugs. The result is a policy environment in which human rights abuses may take place with little international oversight. This session will look at the responsibilities of the international drug control system in relation to human rights and the need for accountability. It will also consider the roles of civil society and the harm reduction movement to advocate for the human rights of people who use drugs (as well as public-health interventions), and also for their right to participate in the policies and decisions that affect them. The presentations will highlight some of the specific human rights violations that have come from drug control including the denial of opioid substitution treatment in prisons, and abusive practices against people who use drugs. The session will consider both top-down and bottom-up approaches to human rights protection and will highlight the need to document and publicise those human rights violations against people who use drugs that are so often hidden or not discussed.

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