Song Dep SW-IDU Educational Session Brief: Ladder of Risk – PlanningAhead

Theme / Mark Relevant Theme (1 only)
1 CCU: Consistent Condom Use
2 SI: Safer Injecting / X
3 DDR: Drug Demand Reduction
4 VCT: VCT Promotion
5 STI: STI Testing/Treatment Promotion

Key Messages:

  • Use a sterile needle/syringe every time and to ensure that they keep their injecting equipment separate from others.
  • Always reserve a new needle and syringe for the next injection!

Narrative: (Includes sample text, as long as the GAPMOP guidelines are followed, the OW can adjust as s/he gets more experience with it.) Also: Don’t forget to collect the UIC!

Greet, introduce, and make comfortable“Hi, my name is <Name>, I am part of the Song Dep team working on women’s health issues. My job is to support you as you make healthy decisions and any conversation we have is private. May I take 15 minutes of your time to talk about some easy steps you can take to protect your health?”

Attract/Make Initial Impact(Show “Ladder of Risk”)“Let’s imagine there are 6 sex workers. They all use drugs, but they practice differently. You can see their behavior in these cards.

Prompt TG to personalize: Now could you please put the cards into different levels of the ladder shelf in right order from the first step to the 6th step (the first step is no risk, the 6th step is highest risk). Why some behaviors are less risky and some are more risky than others? (For example, why sharing N/S with people you know well is more risky than keeping your own N/S?) What level you think you are now?

Make the connection to the problem:“Please think back to the last time your shared? Can you tell me what happened?” (If they haven’t, ask them to talk about a friend who shared). “Almost all IDUs know that sharing needles/syringes can transmit HIV and try not to share. But sometimes, they find themselves in emergency situations where they feel they have no choice.

Offerdesired behavior/action as thesolution; sell the benefits“By planning ahead you can avoid these “emergency situations” and protect yourself from HIV. It is important that you always use a new, sterile needle and syringe. We can sit down together and put together your plan to avoid emergency situations (use “planning ahead” form). Let’s talk about an emergency situation you are most concerned about. Perhaps it is when the pharmacy is closed, or when the weather is too bad to go out and get a needle/syringe. What is the emergency situation you most often encounter?

Prompt TG to take actionThere are many ways to plan ahead. What is the best safety plan for you?

You buy a number of syringe/needles to keep at home or at your injection place in case of emergencies when you run out of needles/syringes and cannot get more.

If you cannot go the pharmacy for syringes/needles, you can buy it at a tea stall or xe om place. Many tea stalls or xe om also provide syringes/needles (normally in higher price).

Call a peer educator for free needles/syringes. Usually, peer educators come to your injection place; however, you can go to see her/him at her/his house or to her/his groups.

Drop-in centers or IDUs club also provide syringes/needles free of charge.

Buy syringes/needles from drugs sellers. Make sure the needle/syringe is still in the original packaging and has not been tampered with.

Never use a needle/ syringe that has been used by someone else.

Desired Action: TG uses sterile (new!)needle/syringe every time and with the help of the “plan ahead” sheet, plans ahead to avoid reusing and sharing injecting equipment.

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