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From: HIV – Footsteps 98

How to break down stigma, prevent mother-to-child transmission and support people living with HIV

Injecting drug users (IDUs) are one of the groups most at risk of HIV infection. The Freedom Programme is an organisation working to prevent the spread of HIV among IDUs in Egypt.

A health worker carries out an HIV test at a drug rehabilitation centre. Photo: Kieran Dodds/Tearfund

A health worker carries out an HIV test at a drug rehabilitation centre. Photo: Kieran Dodds/Tearfund

Although a relatively low proportion of Egypt’s population is HIV-positive, the percentage of IDUs who are living with HIV is much higher. If IDUs use non-sterile needles and syringes that have previously been used by someone who is HIV-positive, they are at very high risk of HIV infection.

The Freedom Programme

The Freedom Programme was started in 1989 and is now one of the largest drug rehabilitation programmes in the Arab world. They run 28 drug rehabilitation centres across Egypt, as well as an outreach and drop-in centre. They also offer training for people working with those suffering from addictions, and these courses include information on HIV prevention.

A holistic approach

The Freedom Programme runs a range of holistic activities to help prevent HIV among people who inject drugs:

What works well?

The Freedom Programme has found that several approaches are particularly effective in its work with IDUs.


The ethics of harm reduction

Some people might feel uncomfortable at the thought of providing IDUs with sterile needles and syringes. People might wonder: Are we enabling people’s unhealthy behaviour? Is it ethical to provide this kind of help? Might it actually increase drug abuse?

However, many years of research have shown that providing sterile needles and syringes effectively reduces the spread of HIV among IDUs. A World Health Organization (WHO) report has found that these programmes do not increase injecting drug use.

It may take people many months or years to break free from drug addiction and other harmful behaviour. In the meantime, we can protect people from the dangers that they may find themselves in. 

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