Availability of Harm Reduction Services in Central Asia

"With financial support from national Global Fund grants and cooperation from international organisations, prevention efforts are scaling-up across central Asia, largely concentrating on IDUs and female sex workers. Harm reduction efforts for IDUs have been impeded by legislative barriers and a lack of strong political support, including hard-line policing and punitive laws on drug use.^34–36 However, Kyrgyzstan has made substantial progress in harm reduction, reflecting the explicit political support received and removal of some legal barriers.^35,43 Some central Asian countries have achieved medium coverage of IDUs with low threshold services, mainly through Trust Points and outreach; for example, coverage has reached 61% in Kyrgyzstan and about 35% in Kazakhstan and services include provision of clean needles and syringes, and condoms and VCT or referral for HIV testing. However, coverage with needle and syringe exchange programmes (NEP) and opioid substitution therapy (OST) remains suboptimum in central Asia (table 4).⁸³ Efforts are ongoing to scale-up harm-reduction activities and Kazakhstan now has a pilot OST programme, with a pilot planned in Tajikistan, although the pilot in Uzbekistan was recently closed by the government.³⁵ In Kyrgyzstan, OST has been available since 2002 and recently became available to prisoners, along with NEP.⁴³ A recent study suggested that awareness of HIV services among IDUs is highest in Kyrgyzstan at 70%, is around 50% in Kazakhstan, and lower than 10% in Tajikistan.³⁴"