What Works for Women and Girls

attributed to …swift introduction of needles and syringe programmes when HIV infectionwas first noted in the 1980s (Mathers et al., 2008: 1743). (Gray III) (needle exchange,drug use, Australia, New Zealand)A harm reduction program by CARE SHAKTI in Bangladesh which instituted a harmreduction program for IDUs found that early intervention is more cost-effective thandelaying activities, although this should not preclude later interventions. Economic costdata were collected and combined with impact estimates from a model the project wasestablished in 1995. Data were collected between 1997 and 2002. In 2001, 66% of theIDUs were married. Interventions consisted of increasing the number of IDUs contactedthrough clinics or outreach workers; needle exchanges. Needles sharing dropped from62% in 1997 to 18% in 2001. Condoms, STI services, and needle exchange were alsopart of the program. The cost per HIV infection averaged among IDUs and their partnerswas US$110.40. Cost-effectiveness increased based on increasing number ofyears of the program (Guiness et al., 2009). (Gray III) (harm reduction, IDU, needles,Bangladesh)In 2006, Taiwan instituted a harm reduction program for IDUs, including methadonetreatment, syringe exchange, and VCT, along with educational campaigns. By 2007,3,299 IDUs (no sex given) were enrolled in methadone programs and 109 stationsprovided no cost needle exchange and counseling. In 2006, the number of new HIVinfections decreased by 43% in comparison with that in 2005; and decreased 44% in2007 compared to 2006. In addition, crime events related to drug use dropped significantlyfrom 2005 to 2007 (Sheue-Rong et al, 2008). (Gray III) (IDU, needles, HIVtesting, harm reduction, Taiwan)A 2008 study of IDUs (no sex disaggregated data provided) in Taiwan compared aregion that instituted harm reduction with a region that did not institute harm reductionand found a statistically significant reduction in HIV prevalence in the region thatinstituted harm reduction. In the region with no harm reduction measures, HIV prevalenceincreased from under 2% to over 3%; in the region with harm reduction, HIVprevalence was reduced from over 37% to fewer than 19%. In-depth interviews andquestionnaires were collected from 3,740 IDUs attending detention centers (Lan andChen, 2008). (Gray III) (IDU, harm reduction, Taiwan)A harm reduction program in Salvador, Brazil that focused on sexual and drug riskreduction among females for 12,198 IDUs in 2002 or 70% of the IDUs in the cityresulted in a decrease of contaminated injection equipment from 60% to 18% duringthe 1990s. Condom use by IDUs increased from 3% to 30%. HIV prevalence amongIDUs fell from 50% in 1996 to 7% in 2001. IDUs receiving health services increasedfrom 28% to 68%. The program provided outpatient drug treatment, prevention educationand care provided by community outreach workers, needle syringe programs, drugprevention programs in schools and mobile vans (PHR, 2007b). (Gray III) (IDU, harmreduction, condom use, drug treatment, Brazil)WHAT WORKS FOR WOMEN AND GIRLS95