Harm Reduction Unit of the City of Santo André, São Paulo State, Brazil: An Evaluation

Authors

  • Silvia Moreira da Silva Social worker,
  • Cássia Baldini Soares Professor, Master’s Degree from the Department of Nursing in Collective Health,
  • Vilmar Ezequiel Santos Psychologist. Maria Cuzinato dos Santos and Arlindo José dos Santos. Master’s Degree

Abstract

The Harm Reduction Unit (HRU) in Santo André (São Paulo State) was created to improve the health of people who either live or work on the streets: drug users, commercial sex workers (male and female), men who have sex with men, sexually exploited adolescents, transsexuals, transvestites, lesbians, and women working in brothels. This project was undertaken to evaluate the HRU from the perspective of its users. A semi-structured interview was administered to nineteen users from different segments of the populations served by the unit. The major weaknesses of the HRU were felt to be its inconsistent presence in some areas and the absence of psychologists to provide follow-up care. The unit was seen as promoting better health, increased use of condoms, reduction in drug usage, increased access and use of health care services, and less sharing of equipment used in drug consumption. Users see the HRU as a sympathetic presence whose ongoing work provides them with a sense of security and protection. The impact of the HRU went beyond harm reduction; users reported transformative changes such as increased awareness of their social rights and knowledge about how those rights can be demanded. Users had been given new tools to face their problems and seek access to education, work, and housing. Key words: harm reduction, illegal drugs, health service evaluation, social problems

Author Biographies

Silvia Moreira da Silva, Social worker,

SA Physical Anthropology MA Social Medicine PhD Sociocultural Anthropology Full time professor. Research area: Health and society, Graduate Program in Physical Anthropology, National School of Anthropology and History. Member of the Promoting Group of ALAMES in Mexico.

Cássia Baldini Soares, Professor, Master’s Degree from the Department of Nursing in Collective Health,

Associate Professor, Master’s Degree from the Department of Nursing in Collective Health, Escola de Enfermagem da Universidade de São Paulo.

Vilmar Ezequiel Santos, Psychologist. Maria Cuzinato dos Santos and Arlindo José dos Santos. Master’s Degree

Psychologist. Maria Cuzinato dos Santos and Arlindo José dos Santos. Master’s Degree and MD candidate at the Department of Nursing in Collective Health, Universidade de São Paulo.

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Original Research