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Brazil: Harm reduction for people who use crack cocaine

Mainline has completed the first part of a groundbreaking project in Recife, Brazil, together with the Free School of Harm Reduction (ELRD) and the Latin American and Caribbean Network of People Who Use Drugs (LANPUD). The project expanded harm reduction and HIV care and support for young people who use crack cocaine in an innovative, holistic way.

Crack cocaine use in Recife

Recife is the capital of the State of Pernambuco in Northeast Brazil, with a population of 4.3 million inhabitants. A 2014 national research estimated that 60,000 people use crack across the state. However, current numbers are likely to be much higher. The project focussed on predominantly street-based, young people who use crack in Recife, who are often subject to violence and poverty, and lack access to healthcare and other services.

Innovating outreach strategies

The work of ELRD is heavily influenced by humanistic geography and firmly rooted in social justice. This means that harm reduction at ELRD goes way beyond ‘traditional’ interventions like distributing injection and smoking gear, offering HIV and STI testing, referral to other healthcare providers, and facilitating training for those healthcare providers.

ELRD operates a drop-in centre for people who use drugs and implements outreach work in Recife. Being naturally person-centred, all the work of the ELRD teams seek to increase the autonomy of the person, their families, and their communities. Most notably this was done through six-months “personal and social strengthening courses” for marginalised young people who use crack cocaine. Through weekly meetings, the courses covered topics like sexism, race and gender issues, violence, conflict mediation, financial planning, combined HIV prevention and testing, and harm reduction and survival strategies. The participants of the courses received financial assistance for attending. After the course, participants reported a reduction in homelessness, increased financial stability, increased wellbeing and improved relationships with others.

one of most successfull prevention strategies

The work of ELRD, that was recognised by the Brazilian government as one of the eight most successful HIV prevention strategies in the country, formed the basis for the online course on harm reduction and social justice that is currently available on the Mainline harm reduction school in Portuguese, Spanish and English[AV1] . Mainline is happy to be able to continue collaboration with ELRD for another three year.

Partners and support

This part of the project was a collaboration between Mainline, ELRD and LANPUD and was funded jointly by ViiV Healthcare Positive Action and Open Society Foundations.