International Journal of Drug Policy
Volume 20, Issue 2, 2009, Pages 111-120

A qualitative assessment of injection drug use and harm reduction programmes in Kabul, Afghanistan: 2006-2007 (Article)

Todd C.S.* , Stibich M.A. , Stanekzai M.R. , Rasuli M.Z. , Bayan S. , Wardak S.R. , Strathdee S.A.
  • a Division of International Health and Cross-Cultural Medicine, University of California, 9500 Gilman Drive, Mailstop 0622, La Jolla, San Diego, CA 92093-0622, United States
  • b Division of International Health and Cross-Cultural Medicine, University of California, 9500 Gilman Drive, Mailstop 0622, La Jolla, San Diego, CA 92093-0622, United States
  • c International Rescue Committee, Kabul, Afghanistan
  • d Drug Demand Reduction Directorate, Ministry of Counter Narcotics, Kabul, Afghanistan
  • e German Technical Cooperation, Kabul, Afghanistan
  • f National HIV/AIDS Control Programme, Ministry of Public Health, Kabul, Afghanistan
  • g Division of International Health and Cross-Cultural Medicine, University of California, 9500 Gilman Drive, Mailstop 0622, La Jolla, San Diego, CA 92093-0622, United States

Abstract

Background: The purpose of this paper was to examine the context of injection drug use in Kabul, Afghanistan among injection drug users (IDUs) utilising and not utilising needle and syringe programmes (NSPs). Methods: Following identification of themes from eight focus group discussions, free-lists were used for further exploration with both NSP using (n = 30) and non-NSP using (n = 31) IDUs. Results All participants were male, had been injecting for 5 years (mean), and most (95%) had been refugees in the past decade. Main reasons for sharing syringes were convenience and lack of availability and did not vary based on NSP use. Drug users perceived alienation from the community, evidenced by names used for drug users by the community which convey social stigma and moral judgment. Health risks were the principal stated risk associated with drug use, which was mentioned more frequently by NSP users. Harm reduction services available in Kabul are perceived to be insufficient for those in need of services, resulting in under utilisation. The limited scope and distribution of services was frequently cited both as an area for improvement among NSP using IDU or as a reason not to use existing programmes. Conclusions: While some positive differences emerged among NSP-using IDU, the current context indicates that both rapid scale-up and increased variety of services, particularly in the realm of addiction treatment, are urgently needed in this setting. © 2007 Elsevier B.V. All rights reserved.

Author Keywords

Needle and syringe programme Injection drug user Needle sharing Rapid assessment Free-list Afghanistan

Index Keywords

Afghanistan morality Stereotyping human controlled study priority journal Needle Sharing psychosocial environment qualitative research Young Adult harm reduction health program Humans male preventive health service qualitative analysis clinical article Article Risk-Taking Substance Abuse, Intravenous adult family stress Focus Groups Needle-Exchange Programs intravenous drug abuse Health Services Accessibility Data Collection
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-58849141397&doi=10.1016%2fj.drugpo.2007.11.022&partnerID=40&md5=4c602e8e7fd50d2f18054d99590affa6
DOI: 10.1016/j.drugpo.2007.11.022
ISSN: 09553959
Cited by: 14
Original Language: English