Harm reduction and mental health - a challenge in center of dependence, São Paulo, Brazil
T. Silva, D. Trigueiros, F. Corregiari, C. Dias, A.L. Bezerra, P. Van Helden
CAPS ad Capela do Socorro, Sao Paulo, Brazil
Issues: Harm Reduction (HR) policy in Brazil shows a challenge to treatment for chemical dependence. Resources are provide from Minister of Health to develop HR in Centers of treatment of chemical dependences (CAPS AD) but there is no clear strategies to how to do in assistance of dependence and investment to training human resources is low. The city of Sao Paulo has 11 million of habitants, the biggest city of Brazil and it counts on 12 public Caps AD that should cover 200.000 habitants per region. Description: Caps AD named “Capela do Socorro” has registered 2100 patients (since November 2008) and around 35 new patients looking for treatment every day. The Caps AD team composition is multidisciplinary, including in a routine the offer of HIV, syphilis, hepatitis B and C testing. This team develops counseling after test, orientation about sexual safe practices, harm reduction to using drugs, beyond lectures about STI/aids/hepatitis inside the center and in the community. Caps AD distribute male and female condoms, teenagers condoms, informative brochures and guiding to specialized public services if necessary. Patients with STI complaint are evaluate and followed to general physician. Lessons learned: preventing HIV/aids among people who are treating dependences is a long process that includes sensibility to health professionals to evaluate risk factors to vulnerability; talk about STI/aids and associate with use of drugs is a possibility to approach difficulties of patients and discuss together strategies to prevent infectious diseases, reducing other harms.
Next steps: Implement new HR strategies to cover women and teenagers; increase the focus to prevent hepatitis B and C and adopt Harm reduction strategies in the community; distribute needles and syringes to injecting drug users; realize HIV/aids and hepatitis counseling for all patients, indifferent of result. More researches should be developed.
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