ID: HR19-920

Presenting author: Murtaza Majeed

Presenting author biography:

Murtaza has been working on harm reduction, policy making, advocacy and youth. He has worked with Medicines du Monde in Afghanistan. He advocates for evidence informed harm reduction globally and in Afghanistan and established the Center of excellence for harm reduction and drug dependency in Kabul.

New trends in Kabul’s open drug scene: „Shisha“, new risks and challenge for harm reduction responses

Murtaza Majeed, Jakub Cerny, Katerina Skarupova, Mir Zabihullah Sadat, Roman Hlousek, Barbara Janikova

Background:
Afghanistan has one of the highest population of PWUD in the world (UNODC 2014). The monitoring of the situation and related responses are scarce due to combination of reasons (i.e. security situation, lack of resources). This study aimed to map the current situation and trends in patterns of drug consumption, socio-demographics, treatment experience, behaviour characteristics and prevalence of infectious diseases amongst hard to reach PWDU population in Kabul with the aim to design appropriate responses.

Methodology:
Between 2016-2018 3 studies were conducted using mixed methodology approach. In 2016 five focus groups comprising of total of 56 street PWUD’s were conducted and 87 questionnaires focused on drug history and treatment experience collected. In 2018 two focus groups with clients of mobile harm reduction unit were conducted. We collected 132 questionnaires evaluating drug behaviour and risk potential of PWUD’s in contact with mobile drop-in unit and did 45 follow ups after 4 months period. In addition, 53 PWID were tested for HCV and HIV. All respondents were males in age 18 – 74y.

Results:
Majority (92%) of respondents had experience with methamphetamine use and 70% of them on daily basis. 35% of newly tested respondents were positive on HCV and 6% on HIV. There was very small awareness about risks of methamphetamine amongst PWUD’s who reported absence of harm reduction services, involuntary treatment, forced admissions and unpleasant, painful procedures they did not consent with.

Conclusion:
Sustainable care and adaptation of HR services for the situation based on outreach health and psychosocial work would be needed. Further studies are necessary to monitor new trends and develop appropriate responses.