Harm Reduction and HIV

 New Mexico AIDS InfoNet

Fact Sheet Number 155

HARM REDUCTION AND

HIV

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• WHAT IS HARM REDUCTION?
• HARM REDUCTION IN ACTION
• HARM REDUCTION AND HIV
• CHALLENGES TO HARM REDUCTION
• IS HARM REDUCTION LEGAL?
• HARM REDUCTION IN NEW MEXICO
• THE BOTTOM LINE

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WHAT IS HARM REDUCTION?

Harm reduction is a way of dealing with behavior that damages

the health of the person involved and of their community. Harm

reduction tries to improve individual and community health.

Much of the work on harm reduction has been in connection with

drug use. This fact sheet focuses on harm reduction applied to

drug use and HIV.

Some key points of harm reduction:

• Drug use won’t disappear but its harmful effects can be reduced.

  Harm reduction should be a goal for service organizations and

  governments.

• Some drugs are safer than others. Some ways of using drugs

  are less harmful than others.

• Drug users can best reduce the harm of their own drug use.
• Abstinence is the ultimate goal. However, it is also good

  to reduce drug use and drug-related deaths, disease and crime.

• The criminal justice approach should not be the only method

  for dealing with drug use. Combining it with a public health

  approach is more productive.

• Services for drug users should be non-judgmental. They should

  not force people to receive services.

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HARM REDUCTION

IN ACTION

Harm reduction related to drug use includes:

• Teaching drug users about the risks of different drugs and

  how they are used.

• Information on using drugs more safely, and reducing the

  harm of overdoses.

• Provide methadone as a substitute for heroin. Offer medication

  to counteract a drug overdose.

• Education and referral to drug treatment opportunities.
• Permit drug users to exchange used syringes for new ones,

  or buy new syringes.

• Outreach services in areas where drug sales occur.

There is research to support several harm reduction approaches,

including methadone maintenance for heroin users and needle exchange

for injection drug users.

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HARM REDUCTION

AND HIV

Some harm caused by drug use is related to HIV. Fact

Sheet 153 has more information on drug

use and HIV.

• Sharing equipment for drug use can spread HIV infection if

  it contains even a tiny amount of infected blood.

• Drug use is linked to unsafe sexual activity. This increases

  the spread of HIV infection.

• It is also related to missing doses of HIV medications (poor

  adherence.) This can make HIV disease get worse.

Harm reduction can include education about the HIV-related

risks of drug use and of unsafe sexual activity. Fact

Sheet 151 has information on safer

sexual activity.

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CHALLENGES TO

HARM REDUCTION

Drug use and its effects are huge challenges. They require the

coordinated efforts of treatment specialists, law enforcement

agents, public health professionals, corrections experts, and

drug users themselves.

Harm reduction says that the best approach to drug use problems

involves public health providers working with drug users. It also

suggests that drug treatment is usually more effective than arrest

and imprisonment. Exceptions would be where drug use results in

criminal activity that harms others, such as theft, violence,

and driving under the influence of drugs.

Many communities combine harm reduction and law enforcement

approaches to drug use. Unfortunately, many debates about drug

policy put public health arguments on one side against morality

and law enforcement on the other.

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IS HARM REDUCTION

LEGAL?

Some aspects of harm reduction are legal. Drug users can get information

on methadone, on using drugs more safely, or referrals to drug

treatment programs. People can get information on reducing the

risk of HIV infection through sexual activity.

Many other aspects of harm reduction require changes in laws

or in law enforcement procedures. For example, syringe exchange

programs operate under specific exemptions to existing laws or

local “emergency” legislation. They require cooperation

from local law enforcement officials.

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HARM REDUCTION

IN NEW MEXICO

In 1997, the legislature passed the Harm Reduction Act. It legalized

needle exchange statewide. A bill passed in 2001 permits pharmacists

to sell syringes to drug users.

These actions put New Mexico among the few states that have

implemented harm reduction approaches to drug use instead of relying

totally on a law enforcement approach.

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THE BOTTOM LINE

Harm reduction is a public health approach to behaviors that harm

individuals and their communities. Harm reduction can be applied

alongside law enforcement activities.

Harm reduction focuses on improving the health of individuals

and the public, more than on eliminating harmful behaviors, although

that is the ultimate goal. Harm reduction principles can be applied

to reducing the HIV-related risks of drug use or of unsafe sexual

activity.

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Revised September 3, 2002

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