A harm reduction approach to HIV programming
“Harm reduction” refers to policies, programs, and practices that aim primarily to reduce
the adverse health, social, and economic consequences associated with the use of legal
and illegal psychoactive drugs [7]. A harm reduction approach to HIV programming
includes a set of nine key biomedical interventions endorsed by The World Health
Organization (WHO), the Joint United Nations Program on HIV/AIDS (UNAIDS), and
the United Nations Office on Drugs and Crime (UNODC) [8]. These include the following
(1) Needle and syringe programmes (NSPs).
(2) Opioid substitution therapy (OST) and other drug dependence treatment.
(3) HIV counselling and testing (VCT).
(4) Antiretroviral therapy (ART).
(5) Prevention and treatment of sexually transmitted infections (STIs).
(6) Condom programmes for people who inject drugs and their sexual partners.
(7) Targeted information, education, and communication (IEC) for people who inject
  drugs and their sexual partners.
(8) Vaccination, diagnosis, and treatment of viral hepatitis.
(9) Prevention, diagnosis, and treatment of tuberculosis (TB).
Some advocates have suggested that a comprehensive package representing a harm
reduction approach reaches beyond biomedical interventions to include community-
oriented programs such as livelihood development and access to justice/legal services, as
well as an expanded list of clinical services including sexual and reproductive health and
prevention of mother to child transmission (PMTCT) services [9].
Box 1