We understand that there may be questions around some of our services. Here we answer some of the questions people have asked directly or via media and social media platforms. If you have a question you would like answered, please e-mail our head of communications, Alison Best. [email protected].
We have tried to make the answers appropriate to all settings, but there are cases where different contexts require tailored responses.
We have tried to make the answers appropriate to all settings, but there are cases where different contexts require tailored responses.
- Why are you working in our area ?
- Who gave you permission to provide services here?
- Why do these services exist?
- Is there scientific support for providing syringe service programmes?
- Can you get HIV from a discarded used needle?
- How do you reduce the number of needles in public spaces?
- Are Step Up compliant with the regulations on the disposal of medical waste?
1. Why are you working in our area?
Because our mapping research showed a need for services and an established community of people who inject drugs. Locations are chosen after validation of the findings from the mapping. People who are dependent on drugs like heroin (Unga, Whoonga, Nyaope) need to earn regular small amounts of money to sustain their use and avoid withdrawal. Transport and economic hubs have high foot traffic and offer opportunities for pan-handling, unregulated and regulated employment and related opportunities. Services are establish in areas where injecting drug use has been confirmed and is likely to continue to rise.
For example see Hunter M. Heroin hustles: Drugs and the laboring poor in South Africa. Soc Sci Med. 2020 Nov;265:113329. doi: 10.1016/j.socscimed.2020.113329. Epub 2020 Aug 27. PMID: 32905967.
For example see Hunter M. Heroin hustles: Drugs and the laboring poor in South Africa. Soc Sci Med. 2020 Nov;265:113329. doi: 10.1016/j.socscimed.2020.113329. Epub 2020 Aug 27. PMID: 32905967.
2. WHo gave you permission?
In most cases the authority to provide services is given in terms of the Workplan and Memorandum of understanding with the Provincial and or City Departments of Health. The National Strategic Plan on HIV/AIDS and TB emphasises the need to expand harm reduction services. NSS are a legitimate and essential health intervention, named in several national and provincial policies, and as such are protected by the constitution.
3. Why do harm reduction and Needle & syringe services exist?
Harm reduction programs with agonist maintenance prescribing and NSS are the most effective way of limiting the spread of HIV and other blood borne viruses among people who inject drugs. People who inject drugs have an incidence rate far higher than any other population and without reducing the number of new infections the country will not meet the mandated targets.
4. Is there scientific support for providing syringe service programmes?
YES. A comprehensive list of studies that support Syringe Service Programmes can be found by clicking here: http://www.drugwarfacts.org/chapter/syringe_exchange. Here are a few examples:
US Secretary of Health and Human Services Confirms Effectiveness of Syringe Exchange In 1998, Donna Shalala, then Secretary of Health and Human Services in the Clinton Administration, stated: "A meticulous scientific review has now proven that needle exchange programs can reduce the transmission of HIV and save lives without losing ground in the battle against illegal drugs."
Shalala, D.E., Secretary, Department of Health and Human Services, Press release from Department of Health and Human Services (April 20, 1998).
http://archive.hhs.gov/news/pr...
US Secretary of Health and Human Services Confirms Effectiveness of Syringe Exchange In 1998, Donna Shalala, then Secretary of Health and Human Services in the Clinton Administration, stated: "A meticulous scientific review has now proven that needle exchange programs can reduce the transmission of HIV and save lives without losing ground in the battle against illegal drugs."
Shalala, D.E., Secretary, Department of Health and Human Services, Press release from Department of Health and Human Services (April 20, 1998).
http://archive.hhs.gov/news/pr...
5. Can you get HIV from a discarded used needle?
In theory, it is possible, but in reality there have been no reports of HIV being contracted from discarded needles anywhere in the world. Infections that result from needles are usually in medical settings or through the sharing of injecting equipment. While it is not pleasant to have these syringes inappropriately disposed of in the community, the risk is of contracting HIV from a discarded needle is virtually zero. I would, however, urge anyone who does step on any sharp object, be it serrated edge of a beverage can, a piece of glass from a broken bottle, a rusty nail or a syringe, to consult with a health professional for further advice. For further information click here.
6. How do you reduce the number of needles in public spaces?
The Step Up Project has taken a number of initiatives to reduce the number of needles in public spaces. Service beneficiaries have shown a willingness to co-operate with the project, and are themselves looking for creative and innovative ways of reducing the number of needles that are inappropriately discarded. In one area a beneficiary made a secure lockable box to hold a sharps disposal container. In Pretoria service beneficiaries
asked the project to engage with SAPS on the issue of used needles. This has been done, and rates of return have increased.
In order to reduce the number of needles in public spaces we need to:
you require any further information, or would like to report inappropriately disposed of needles in your area,
please do not hesitate to contact your regional project co-ordinator.
asked the project to engage with SAPS on the issue of used needles. This has been done, and rates of return have increased.
In order to reduce the number of needles in public spaces we need to:
- Work collaboratively, involving all local organisations
- Recognise that certain law enforcement actions could have unintended consequences and seek to address these
- Notify TB HIV Care of needles found in communities and places where they may be found so we can routinely collect these
- Train people in the safe disposal of inappropriately discarded needles
you require any further information, or would like to report inappropriately disposed of needles in your area,
please do not hesitate to contact your regional project co-ordinator.
7. Are you compliant with the regulations on the disposal of medical waste?
Yes, the programme is compliant. We go beyond the responsibilities normally placed on people and organisaytions who supply needles to members of the public for other reasons, such as for insulin dependence.
Many of the needles found in public spaces are not issued by the Step