Mohammad Shoriful Alam (MPH), native of Bangladesh working around seventeen years as an activist in the area of HIV Intervention program among PLHIV and PWID.

Issue:

Bangladesh has been one of the early adopters of harm reduction measures in Asia. Despite being a matured Syringe-Needle (SN) program, it has been identified that there is a procedural service gap in outreach field in Dhaka. Peer Outreach Workers (POWs) are not on field 24 hours. Besides, POW roams around the spots approximately two-square Kilometers area, so PWID can’t find POW sometimes when necessary. Thus, new initiative was required in SN distribution modality.

Setting:

Total thirty-five depot holders (Pharmacy-26, Ragpicker-09) were recruited in Dhaka city under the Global Fund NFM3-grant started from 01 April 2021 for syringe distribution alongside with conventional outreach modality.

Project:

Comprehensive service package for PWID is provided from this project. POWs act as a link to biomedical services with outreach activities. During unavailability of POW or early morning or evening, PWID are provided syringe by the depot holders. In return, depot holders are getting one taka (USD 01 cent) from this project as incentive. To protect the depot holders, a support letter was taken from government authority. Safe disposal campaign, setting drop-box, orientation to the depot holders and information dissemination among the PWID were conducted by POW. Network of People Who Use Drugs (NPUD) monitored and supported the whole process.

Outcome:

• Syringe distribution per PWID per year increased from 260 (July 20-June 21) to 310 (July 21-June 22).
• Local leaders/elites are engaged in the process who are now promoter of harm reduction services.
• Average 91% of mother-listed PWID reached in every month which was only 63% in previous year.
• 75% of distributed syringe from depots are collected through drop-box.

“DEPOT” is very effective for reducing outreach service gap where PWID are hard-to-reach. Drop out of POW is a challenge but continuous capacity building of new POW can overcome this challenge.