Increasing Participation and

Accessibility of Services for

People Who Inject Drugs

Overcoming Barriers, Enhancing Incentives and Promoting Healthy Behavior

Change
Nutthinun Yuvasakoonkrai, Punika Seedapongsapunta, Chaiyose Srisongkram, Nattapong Tummachudpong
Bernat Navarro Serer, Daniele Anina, Megan Mueller
 “The und
casually ercover
p la c e to come by police
nt a th
“We wa nd a proper and watc
h us dur e park
g sa worksho in
injec t d r u
o r k s h op” p. This m g the
a ce fo raw environm
ent very
akes the
pl tense”

THE UNHEARD
VOICES
“We felt afraid of g ro u p me
“The art since leader
m
n
bers
o o ne

being caught from d a p ro u p p

e g
It has been happe
police. drift ced the the grou
many years”
ning for repla rganized
o
who ngs”
ti
mee
16 MILLION PEOPLE INJECT DRUGS
WORLDWIDE
PWIDs IN THAILAND AND THEIR RISK
OF CONTRACTING DISEASES
About 40,000 people in Thailand inject drugs.
High risk of contracting blood-borne diseases.
49% shared needles, >50% not tested for HIV.

Overall People Who Inject

Population Drugs Population

HIV 0.89% 25-30%

Hepatitis C 3.2-5.6% ~90%

Outreach Programs for People Who Inject
Drugs

Discourage Needle Prevent Spread Through Encourage Safe Refer to Services

Sharing Unprotected Sex Practices
 Prevent

Educate Encourage
Raks Thai Foundation Provides Services for
PWIDs
Health Drop-In Free
Information Center Supplies
The goal of our project was to
increase the accessibility and
participation of services
offered for people who inject
drugs and provide
recommendations to the Raks
Thai Foundation to overcome
the barriers, enhance
incentives and promote
A model of health
behavior change

“The majority of at-risk populations are not

prepared for action and will not be served
effectively by traditional action-oriented
behavior change programs”
Interviews:
PWIDs and
Staff
Members

Incentives, barriers,
and motivation to
access services
Stakeholder Sample

30 PWIDs 7 Staff Members

 Findings
and
Recommendations
Recommendations and Deliverables

Long Term Program Posters

Staff members and PWIDs perceive peer support,
transportation to RTF and distribution of information as
main incentives
Staff Members
•Free supplies (needles, HIV testing, etc.)
•Ability to talk with peers in group meetings
•Providing a free lunch box
•Having a budget to cover PWID travel
expenses
•Successful distribution of materials
PWIDs
•Short distance to RTF services
•Aware of the RTF
•Staff is friendly and welcoming
•Services are effective and good
•RTF helps the PWID reduce drug usage
•Money is offered at programs
•Concerned about health
PWIDs and staff members have different perceptions
of what is preventing PWIDs to use services
Staff Members PWIDs
•Lack services for women •Not interested
•Fear of police •Afraid of being caught by police
•Lack of awareness of RTF •Insufficient supplies
•No transportation for RTF •Lack information provided
•Insufficient staff •Not a proper place for a workshop
•Lack of physical or outdoor activities

“In the past, there used to be field trips for us, sport “We want a place to
activities, and also planting seed as ways for us to bond. But, inject drugs and a proper place
these have been canceled and no longer happen.” for a workshop”
 Pee
r
sup
po c i al nt
rt Deliverable #1: i n an eme
F a g
n
ma
Long-term Program d a y
Eco n d
no F r ie
mi -a-
zin in g
g B r

Recreational Activities
 Stage 1: Unaware of
behavior
Barriers Addressed
Lack of awareness
Lack of serv Health education counseling
ices for
women
Incentives
a tio n a b o u t d is eases
Info r m
Peer Support
Peer discussion
 Stage 2: Consider accessing
services
Barriers Addressed
Focus groups on
Lack of aw
areness Program Benefits
between PWIDs

Incentives
ormation about diseases Discussion on program
benefits between PWIDs and
staff members: health,
social, professional
r S u p po r t
Pee
Stage 3: Access
services
Barriers Addressed
g for
Lack of programmin
Women’s activities

women Field trips

Lack of recreat
ion
Incentives

Peer Support Recreational Activities

Money Management
Stage 4: Keep using services and change behavior

Barriers Addressed
ser vi ces
t e re st in
Disin Rewards
Lack of recreat
ion
Incentives
t i on ab out
Monetary
incentives Informa es
diseas
Peer Support Recreational Activities
 Stage 5: Maintain the behavior gained
Barrier addressed
Lack of intere
st
Insufficient staff
Incentives
Monetary incentives
Changing activities to keep up
Peer Support interest

Information
about disea Opportunities to become a
ses mentor, volunteer
Deliverable #2:

Advertisement
Promoting RTF to increase awareness
Advertisement on Public Media
Radio / Audio / video advertising
announcing the services offered by RTF

★ Effective in reaching PWIDs

★ Inexpensive
★ Simple, yet effective
 HIV FACTS
POSTER
Where did HIV/AIDS
come from?
Difference between
HIV & AIDS
General facts on health
care for HIV positive
people

Transmission pathway
Contact information &
Address
SAFETY
PRACTICES
Size & Type of needles
POSTER
Suggestion : Prevent
infection by using
clean needle and avoid
sharing needle with Methadone treatment
other individuals

Position of injection
Contact information
and Address
AWARENESS
OF RTF
POSTER Vision statement

Slogan

Contact information
and Address
Future Implications

Increase participation and Increase Reduce spread of

accessibility awareness diseases
 “The und
casually ercover
p la c e to come by police
nt a th
“We wa nd a proper and watc
h us dur e park
g sa worksho in
injec t d r u
o r k s h op” p. This m g the
a ce fo raw environm
ent very
akes the
pl tense”

UN
THE
HEARD g ro u p me
“The art since leader
m
n
bers
o o ne

VOICES
“We felt afraid of
being caught from d a p ro u p p
e g
It has been happe
police. drift ced the the grou
many years”
ning for repla rganized
o
who ngs”
ti
mee
Acknowledgements
Thank You!
Questions?