The course of the realization of the Harm Reduction program in the city of Nikolayev

The growth of drug addiction has been noted in Nikolaev. This growth has not been stopped by methods based on the use of force. The results of work in accordance with the program "Harm Reduction" are presented. The program functions on the basis of the Charity Fund "Blahodiinist" and is intended for the prevention of the spread of HIV infection in groups of risk among injecting drug users and in other groups. The realization of the program includes provision of information material, reduction of harm in connection with the use of drugs by injection and the risk of getting HIV and sexually transmitted diseases. The analysis of the results has shown the effectiveness of the program (the frequency of using condoms has increased, the number of sex partners and the number of casual liaisons have dropped, the custom of using sterile syringes has been formed). Considering that during epidemics the coverage of not less than 70% of the representative of risk groups is necessary, the program should be realized on a greater scale to increase its effectiveness.     

The prevention of HIV infection and other blood-contact diseases among intravenous narcotic users in Nizhniy Novgorod within the framework of the Harm Reduction program

The results of the development and realization principles of the project on the decrease of harm, envisaging work in three directions (the determination of the technology of using drugs, the exchange of syringes/needles and other accessories, as well as laboratory examination for the presence of antibodies to HIV, hepatitis B and hepatitis C viruses and consultations of narcologists). 1075 injecting drug users took part in this project. Out of 611 participants filling-in the questionnaires, 338 persons underwent tests for HIV and 3 of them were found to be HIV-infected; out of 305 persons screened for the presence of markers of hepatitis B virus, positive results were obtained in 98 (32% of cases); in 218 (65%) out of 335 persons antibodies to hepatitis C virus were found (49 persons, i.e. 14%, had hepatitis C registered in the medical history and in the rest antibodies were detected for the first time). The preventive program of the decrease of harm was assessed as effective.     

The realization of the concept of Harm Reduction in Russia

By the present moment cases of HIV infection among injecting narcotic users (INU) have been registered in more than 100 countries. To prevent HIV infection, the program "Harm Reduction" has been developed in Britain; the program states that the prevention of HIV infection must be considered more important than the prevention of the use of narcotic drugs, as this infection is a growing danger for both drug users and public health in general. Breaking drug dependence must not be the only aim of services working with drug addicts, because this will exclude persons decisively disposed to the mode of life including the prolonged use of drugs from the sphere of their activity. Active INU having no contacts with organizations which must give them treatment and assistance find themselves in dangerous situations more often than INU maintaining contacts with such organizations. Penetration into such hidden group and its education must be the primary task. Propaganda plays a decisive role in this process, as the only way to penetrate into such group is to develop work in its territory, so that drug addicts, supplied with the necessary means could change their behavior in the desired direction. In the Russian Federation work on the project "Harm Reduction" has been carried out in 50 regions. This work has contributed to conducting teaching seminars, working out teaching programs, as well as to augmenting the interest among specialists of different professions to the problem of decreasing the spread of HIV infection. The importance of information distributed by the narcological service and the probability that very responsible persons take correct decisions on the basis of their understanding the situation have increased. The rating of public organization has risen.     

The results of conducting a rapid assessment of the situation in relation to intravenous narcotic abuse in the city of Rostov-on-Don

The main aspects of the spread and intravenous use of drugs in the city, contributing to the transmission of HIV infection among users of intravenous drugs (UID) have been studied. Anonymous questionnaires were distributed among 61 UID; of these, 50 were males (82%) and 11 were females (18%), mainly at the age of 19-35 years. In addition, sociological study was carried out among 582 persons; 61% of them were under 18 years of age, 18% were aged 19-25 years, 13% were aged 26-35 years. The drug users regarded their individual risk of getting HIV infection as insignificant in 23% of cases, slight in 21% of cases, high in 15% of cases, and 15% believed they were at no risk. As shown by the results of the sociological study, 91% of the respondents believed that the problem of drug addiction was topical in the city. The analysis of data obtained from physicians treating drug addicts and from the Head Office of Public Health made it possible to calculate that the number of UID in the city was about 9,000-10,000 persons. Taking into account the results of the rapid evaluation of the situation, the development of the draft program of "diminishing the harm" of the intravenous use of drugs is now in progress.     

Experience in realizing the Harm Reduction program in Moscow

The data on the realization of the program of the prevention of HIV infection among intravenously injecting drug users in the South-Western administrative district of Moscow are presented. In the course of the realization of the project drawn up in accordance with this program the information package permitting the collection, analysis and transmission of the necessary information on the epidemic situation and leading risk factors in the zone of the action of the project has been compiled, and on the basis of this information the tactics and strategy of preventive measures have been worked out. The main advantage of the information system thus developed is the possibility of its use in computers of any class, in any operational system, as well as its use in Internet.     

The introduction of the concept of Harm Reduction in the city of Cherkassy

The introduction of the concept of Harm Reduction into the practical work of the narcological survive confidence relations with injecting drug users were established, which resulted in the possibility to carry out information and educational, as well as preventive work. In addition, there occurred changes in public opinion with respect to the problems of drug addiction (a drug addict was now regarded as a sick person) and AIDS (HIV infection was considered to be a problem, topical for wide strata of the population). The creation of a dedicated team comprising medical personnel, psychologists, representatives of the clergy, volunteers from drug addicts contributed to successes in this work. The work on the correction of negative manifestations, carried out by the organs of law protection, also contributed to the creation of balance between the strategy of Harm Reduction and the strategy of the reduction of need in narcotic drugs.     

The effect of a syringe-exchange program on a decrease in the risk of HIV infection among intravenous narcotic abusers in the city of Rostov-on-Don

The necessity and effectiveness of introducing the program of the exchange of syringes for intravenous drug users as a preventive and antiepidemic measure are discussed. Preventive and antiepidemic measures within the concept of harm reduction are described. The comparative analysis of materials obtained as a result of two sociological questionings, carried out in 1997-1998 among the representatives of the community (random nonrepeating choice) and in the middle of 1999 among the participants of the program revealed that the participants of the program had statistically significant changes in risky behavior patterns during the use of injection drugs.     

The results of sentinel epidemiological surveillance on the level of HIV prevalence among injection narcotic abusers in the city of Poltava

The sentinel epidemiological surveillance on the level of spread of HIV infection among injecting drug users in Poltava, taking part in the program of harm reduction, was carried out. The results of the surveillance revealed that the level of HIV infection among drug users was 37.8%, the level of HIV infection among females being higher than that among males. These data indicate that the level of HIV infection rises with the increase of age and the time of drug consumption. Still in the age group of 30 years and older and among drug addicts using drugs for 7 years and longer the lowest level of HIV infection was noted.     

The prevention of HIV/AIDS among injection narcotics users in the city of Odessa

Since August 1996 the realization of the first Ukrainian Project "HIV/AIDS Preventive Maintenance among Injecting Drug Users", based on the strategy of harm reduction, has been started in Odessa with a view to the effective counteraction to the spread of HIV/AIDS among injecting drug users (IDU). The project is being realized with the advisory and financial support of UNAIDS, UNICEF and USAID. The basic organization for the realization of the Project is the Public Movement "Faith, Hope, Love". The Project is aimed at decreasing the rate of the spread of HIV infection in cases of the non-medical use of narcotic drugs by the elaboration and adoption of measures conductive to changes in hazardous behavior. The realization of the project includes the following stages: the rapid evaluation of the situation with the injecting use of drugs in Odessa, the elaboration and adoption of preventive measures.     

The effects of narcotic analgesics and narcotic antagonists on ganglionic transmission in the rat.

The effects of narcotic analgesics, narcotic-antagonist analgesics and narcotic antagonists on ganglionic transmission in the superior cervical ganglia of the rat were studied $\text{in}$$\text{vivo}$ and $\text{in}$$\text{vitro}$. $\text{In}$$\text{vivo}$ administration of morphine, meperidine, methadone, pentazocine or naltrexone blocked ganglionic transmission. Levorphanol, cyclazocine, nalorphine and naloxone had no effect on ganglionic transmission in this procedure. $\text{In}$$\text{vitro}$ studies confirmed the $\text{in}$$\text{vivo}$ results with the exception of levorphanol, cyclazocine and nalorphine, which were also found to block ganglionic transmission $\text{in}$$\text{vitro}$. In both preparations, naloxone did not antagonize the effect of morphine, suggesting that the effects of morphine and the other opiates were nonspecific. Similar potency of $\text{d}$- and $\text{l}$-isomers of pentazocine and cyclazocine support this conclusion. The observation that naltrexone blocked ganglionic transmission, but the other pure narcotic antagonist, naloxone, was inactive is somewhat unique to this test procedure and possibly significant.     

潍坊市儿童11种国家免疫规划疫苗接种率抽样调查

目的了解潍坊市11种国家免疫规划疫苗的接种状况,比较常住儿童与流动儿童的接种率水平。方法采用分层随机抽样方法对2005年1月1日—2010年12月31日出生的儿童进行抽样调查。结果调查的常住和流动儿童2 160名,建卡、建证、卡证相符率均>95%,差异无统计学意义(P>0.05);BCG、HepB、OPV123、DPT123、MV或MR、MenA、JE-I 1、MMR、DPT4、HepA-I、JE-I 2、OPV4、MenAC1的接种率,常住儿童为95.63%～99.44%,流动儿童为93.89%～98.89%,差异无统计学意义(P>0.05);HepB首针、MV初种及时率常住和流动儿童均>95%,差异无统计学意义(P>0.05);6岁年龄组MenAC2、DT、MV3常住儿童分别为92.15%、91.11%、93.33%;流动儿童分别为86.25%、85.00%、87.08%,差异有统计学意义(χ2=18.89、18.42、23.48,P<0.01)。结论潍坊市4岁以下常住和流动儿童疫苗各剂次接种率差异无统计学意义,6岁年龄组MenAC2、DT、MV3疫苗接种率常住儿童高于流动儿童,差异有统计学意义(P<0.01)。     

Development of HIV infection epidemic among intravenous drug users in the Sverdlovsky region

The Sverdlovsky region takes the fourth place among the 89 subjects of the Russian Federation by the number of registered cases of HIV infection. Drug addiction has reached an excessive scale in this region: according to the data of express evaluation carried out by the Regional Narcological Hospital and the Regional AIDS Center, not less than 7-8% of persons aged 15-30 years constantly use injection drugs. The large-scale epidemic of injection drug addiction has led to the rapid spread of HIV among addicts. The first penetration of HIV into this population took place in 1996 and, starting from the year 2000, rapid, development of the epidemic began, taking the character of an avalanche. The peak of new cases of HIV infection fell on 2001 (9,230 cases were registered). The concentrated stage of the epidemic development is observed in the region at present, the prevalence of HIV infection among drug addicts being 13.8%. Children born from HIV-infected drug addicted mothers now represent a new risk group due to great difficulties in the prophylaxis of the vertical virus transmission.     

The antimeasles immunity in infants in the 1st year of life

The serological survey of 138 infants aged 8 months and 138 mothers having had protective titers of specific antibodies to measles during pregnancy was made. The study revealed that passively transferred antibodies to measles circulated in infants for a longer time and were detected more frequently under the conditions of breast feeding by mothers having had measles (up to 93.7% of infants). In artificially fed infants, born of mothers having had no measles, but previously vaccinated against this infection, antibodies to measles were detected in rather rare cases (only in 7.3%). In infants, artificially fed, but born of mothers having had measles, the level of antibodies to measles was practically unchanged (81.6%).     

Efficacy of a complex program for controlling influenza in a large industrial city

The epidemiological and economic effectiveness of the realization of the complex three-year (1980-1982) program for the control of influenza in Perm is shown. The coverage of 46-51% of the city population, including working people, pensioners and children, with immunization carried out with the use of live and inactivated vaccines made it possible to decrease morbidity rate 2.12 times in comparison with the average data for many years. The greatest effect was achieved at large industrial enterprises where, simultaneously with vaccination covering 90% of the employees, urgent prophylaxis with remantadin and the early treatment of influenza patients were carried out. Due to these measures the morbidity rate and the number of disability days per 100 employees decreased 3-6 times.