HIV/AIDS Asia Regional Program, Thailand.
Int J Drug Policy. 2010 Mar;21(2):134-6. doi: 10.1016/j.drugpo.2009.12.004. Epub 2010 Jan 15.
The response to the HIV epidemics among people who inject drugs in Asia began to emerge in the early to mid 1990s, with the rather hesitant implementation of small-scale needle syringe programmes and community care initiatives aiming to support those who were already living with the virus. Since then Asia has seen a significant scaling up of harm reduction, despite very limited resources and difficult policy and legislative environments. One of the major reasons this has happened, is the utilisation of programme based approaches and the firm entrenchment of harm reduction thinking within national HIV/AIDS programmes and strategic plans--in most cases aided by multilateral and bilateral donors. Several models of scale up have been noted in Asia. The transition away from project based approaches, while on the whole positive, can also have a negative impact if the involvement of civil society and a client focussed approach is not protected. Also there are implications for which models of capacity building can be systematised for ongoing scale up. Most crucially, the tensions between drug policy, human rights and public health policies need to be resolved if harm reduction services are to be made available to the millions in Asia who are still unable to access these services.
亚洲地区针对注射吸毒人群的艾滋病疫情应对工作始于 20 世纪 90 年代早期至中期，当时只是小规模地实施了一些针具交换项目和社区关爱举措，旨在为已经感染病毒的人提供支持。自那时以来，尽管资源非常有限，政策和立法环境也很困难，但亚洲地区在减少伤害方面取得了显著进展。之所以会这样，主要原因之一是采用了基于项目的方法，并在国家艾滋病规划和战略计划中牢固确立了减少伤害的理念——在大多数情况下，这得益于多边和双边捐助者的支持。亚洲地区已经注意到几种扩大规模的模式。虽然从基于项目的方法向整体方法转变总体上是积极的，但如果不保护民间社会的参与和以客户为中心的方法，也可能产生负面影响。此外，还存在着哪些能力建设模式可以为持续扩大规模而系统化的问题。至关重要的是，如果要向亚洲数百万人提供减少伤害服务，就需要解决毒品政策、人权和公共卫生政策之间的紧张关系。
