Ml. Adelekan et Gv. Stimson, PROBLEMS AND PROSPECTS OF IMPLEMENTING HARM REDUCTION FOR HIV AND INJECTING DRUG-USE IN HIGH-RISK SUB-SAHARAN AFRICAN COUNTRIES, Journal of drug issues, 27(1), 1997, pp. 97-116
The use and misuse of a broad spectrum of psychoactive substances, inc
luding heroin and cocaine, is of growing concern in many African count
ries. Approximately one-third of global HIV and AIDS cases are reporte
d from Africa but injecting drug use has not yet been documented as a
causative factor. The drug supply control strategy has recorded only l
imited success in Africa, and the currently adopted demand reduction p
rograms are beset with many problems. In this paper we review possible
constraining and facilitating factors in the adoption of harm reducti
on approaches in high risk sub-Saharan African countries. We conclude
that appropriate needs assessments are urgently required to establish
the extent of problem drug use and of injecting. This exercise may ide
ntify clinical and psychosocial problems that could benefit from an in
tervention approach based on a combination of the principles of harm r
eduction and demand reduction.