Harm Reduction

Harm reduction is not an obstacle in reaching the goal of a drug-free world. Drug control authorities need not fear a rise in drug use simply because people are taking steps to protect themselves from HIV and reduce their drug dependency.

Michel Sidibe, Executive Director, UNAIDS (2009)

Methadone treatment is one of the world-widely-adopted harm reduction strategies. The international experience proved that implementation of harm reduction strategy will not increase the number of drug abusers and can effectively control the spread of AIDS.

Harm reduction also means reducing harm caused by drug-abuse and spread of HIV/AIDS disease among drug abusers. It is a strategy aiming at reducing harm to both individual and society at large.

The strategies are as follow:

1. Encourage drug abuser to stop abusing drug and join substitution program like methadone treatment program, the maintenance or detoxification program.

2. If using drug is not avoidable, do not adopt injecting method.


3. If injecting drug is not avoidable, do not share syringe and needle, and use disposable syringe and needle each and every time.

4. If drug abusers cannot have their own syringe, clean the syringe thoroughly to avoid spread of infectious disease like AIDS, Hepatitis B & C and tetanus.

When having sex:

1. Don’t use alcohol and drugs before you have sex. These substances can affect your judgment and put you at a higher risk for getting HIV, STIs and blood-borne diseases.

2.Use condom each time when you have sex.

How to negotiate condom use

A partner might have specific reason for not wanting to use protection for sex. It is important to think about how you might respond if you’re ever with a partner who doesn’t want to use a condom especially if he/she is not the one you know very well at the start of the relationship.

However, it is your right to respect your feeling, protect yourself and your health. It is also your right to demand to use a condom when having sex – it is a way to take care of both of you.


Below are some scenarios if you were pressured to have sex without a condom, and with ideas of how to tackle them:

Scenario 1

I’m [or you’re] on the pill.

But that doesn’t protect us from STIs and HIV. I just want to be safe, for both of us.

My HIV test was negative.

HIV is not the only concern for me. There are several STIs that may not have any symptoms even if you are infected. A condom will protect us both from getting an STI.

Scenario 2

I don’t have any kind of disease! Don’t you trust me?

Of course I trust you, but anyone can have STI and not even know it. Moreover, we may not be able to trust our past partners. This is just a way to take care of both of us.

Scenario 3

Sex with condom doesn’t feel as good. It doesn’t feel the same.

Sex may feel different with a condom, but believe me, it’ll still be good even with protection. If we use condom I’ll feel more secure and relaxed and more focused on each other, and that will make sex more enjoyable for both of us.

Scenario 4

I didn’t bring any condoms.

I have some, right here.

Scenario 5

I love you. If you really loved me, you wouldn’t ask me to use a condom.

HIV is not the only concern for me. There are several STIs that may not have any symptoms even if you are infected. A condom will protect us both from getting an STI.

Scenario 6

Let’s just do it without a condom this time.

It only takes one time to get pregnant or to get an STI. I just can’t have sex unless I know I’m as safe as I can be.

Scenario 7

I don’t know how to use them.

I can show you – want me to put it on for you?

Other tips for negotiation:

Talk this topic over with your partner before you start to have sex. When it’s excited it might be easy to have sex without a condom with the thinking “just this once.”

Find an easy time to talk about this difficult issues. Picking a time when you are both relaxed and ready to talk will make the discussion much easier.

Plan and have condoms with you if you think you might have sex with your partner. Don’t only rely on others to prepare. If they don’t bring it up, make sure you do – it may seem hard at the time, but at least you’ll know that you were protected and safe.