Harm Reduction in an Open Drug Scene

A harm reduction approach in an open drug scene is described. The effectiveness of a needle exchange scheme can be increased if it is part of primary medical care. Besides the basic documentation on services provided through various studies, data on the population of an open drug scene were obtained. Viroepidemiological studies showed a 100–300 times higher prevalence of hepatitis A, B, and C compared with the Swiss population in general. A downward tendency of HIV prevalence could be demonstrated. An overall reduction of needle sharing between 1989 und 1992 was noted. However risk behaviour still exist in some subgroups of intravenous drug users, especially in beginners, where a high prevalence of hepatitis B was found. Methodological considerations of research in open drug scenes are discussed.