THE POWER OF PARTNERSHIP: PRIORITISING HARM REDUCTION AND HEALTH RIGHTS AS WE EMPOWER ADOLESCENTS IMPACTED BY DRUGS
Adolescent girls and young women in Nigeria and across wider regions of Africa continue to be disproportionately impacted by HIV, an issue which is compounded by criminalisation laws around drug possession and use. As of 2024, 145 countries still criminalise the possession of small amounts of drugs, including 46 countries that implement compulsory detention if an individual is found with drugs on their person. In 2019, nearly half a million people worldwide died from drug-related or drug-use causes – 15% of these deaths were attributed to HIV.1
Despite an abundance of evidence on the importance of a health-based approach, punitive and coercive policies and practices continue to dominate global drug policy. 1 The nature of Nigeria’s country response to drug use contributes to the spread of misinformation, leading to stigma and feelings of shame and isolation, which ultimately impact an individual’s willingness to seek out essential healthcare services – further compounded by the punitive nature of Nigeria’s drug laws. 2This can lead to delays in diagnosis and treatment initiation and ultimately impedes global progress in preventing HIV transmission and meeting the UNAIDS goal of ending HIV by 2030.3
Created in response to growing drug use and incidence of HIV among people who use/inject drugs in Nigeria, YouthRISE has been at the forefront of advocating for evidence-based policies and harm reduction programming since 2012. With an emphasis on policy reform, YouthRISE aims to shift the narrative around drug use from a criminal justice response to a public health response – with a specific focus on the unique needs of women who use drugs.4
I feel a sense of duty to advocate for gender-responsive approaches that address the challenges that women face by promoting health equity and social justice. In Nigeria, adolescent women experience a high rate of unintended pregnancy, often compounded by drug use and a lack of education around safe sex practices - leading to an increased risk of acquiring HIV. At YouthRISE, through the support of Positive Action, we’ve been able to deliver a range of sexual and reproductive health services via drop-in centres, alongside pre-and post-natal care for pregnant women administered by primary health workers. This allows us to address an individual’s needs across the base of the pyramid while helping to minimise barriers to care.
Implementing a community-centred approach
One of the ways we reach people who use drugs, especially adolescents, is by actively engaging with and involving them in the design and implementation of our harm reduction programmes. In doing so, we’re able to tailor our approaches to the unique cultural, societal and economic contexts of each community, helping to create sustainable interventions. Not only does this improve programme engagement and retention, but it can help build trust within the community, establish rapport and gain insights into specific needs and challenges.
Reaching young people who use drugs through peer-led initiatives
At YouthRISE, we aim to empower the individuals we work with, allowing them to act as advocates for their peers and communities. Once embedded within our programmes, we’re able to train participants to become peer facilitators, leveraging their education and lived experiences to support adolescents facing similar challenges associated with drug use. Through this peer-led model, facilitators are able to foster a sense of belonging, solidarity and promote resilience.
Our peer-support programmes are a proven method of changing the lives of adolescents in Nigeria. One woman we worked with had her life changed for the better after joining one of our peer-support sessions. When we first met her, she faced uncertainty and misinformation around reproductive health and had navigated her early adolescent life without support and guidance around her menstrual cycle, and measures that can be taken to prevent unplanned pregnancies. Following her attendance at our peer support sessions, she learned how the power of knowledge can transform your life as she became empowered to manage her own sexual health responsibly. She found a community that supported her and is a testament to the benefit of peer-support groups to help young women navigate the changes in our physical and sexual health and wellbeing.
Creating positive change to improve the lives of people impacted by drug use
For me, it’s all about seeing the tangible impacts of our work. It inspires me and drives me to expand and scale the reach of our programmes so we can reach more individuals who are underserved and underrepresented. My work has been inspired by true evidence-based interventions and rigorous research that has demonstrated the effectiveness of harm reduction initiatives, allowing us to address the complexities of vulnerable populations.
We can also leverage evidence-based research to inform our own decisions, actions and programmes. One example of this was when our needle-syringe exchange programme was first piloted - women were not participating. With support from Positive Action funding, we are able to identify the gender disparity and ensure women gained equal access to our services.
Through YouthRISE, I’ve been able to help more than 700 individuals, but there’s more that needs to be done. We must advocate for policy change, to ensure access to services without judgement and reclaim lives – by taking the results to legislators, to the ministry of health, we can showcase the benefits of our interventions to create positive change across the country.
Shifting the focus from punishment to public health
One of my priorities within the harm reduction response is to address legislation around drug use by highlighting the transformative power of our programmes. Without policy change, communities will continue to face barriers to access and care – further exacerbating the risk of acquiring HIV.
The success of evidence-based interventions plays a key role in shaping national public health priorities, and advocating for policies that support harm reduction. If we can collectively shift the national drug response from an issue of criminalisation to that of public health, we can help reduce stigma, remove legal barriers that prevent people from seeking help out of fear, and improve access to healthcare services.
We as advocates are leading the charge to reform antiquated criminalisation laws, pushing for approaches that look at the individual and their experiences, ultimately helping to reduce the number of incarcerations of underserved.
Through my work with YouthRISE, I will continue to push boundaries, advocate against stigma, and ensure communities can access the services they need.
Together, we can change the lived experiences of young women and adolescents, show up to better their lives and ensure no one living with HIV is left behind.
References:
- UNAIDS. Global AIDS Targets 2025 for people who use drugs. Where are we now? Available at: https://www.unodc.org/documents/commissions/CND/CND_Sessions/CND_67/Stakeholder_Contributions/HIV/UNAIDS_Drug_Policy_Fact_Sheet_v2.pdf. Last accessed: April 2024
- United Nations Office on Drugs and Crime. National Drug Control Master Plan. Available at:
https://www.unodc.org/conig/uploads/documents/NDCMP_2021-2025_Advance_copy.pdf. Last accessed: April 2024 - UNAIDS. Fast-Track - Ending the AIDS epidemic by 2030. Available at:
https://www.unaids.org/en/resources/documents/2014/JC2686_WAD2014report. Last accessed: April 2024 - YouthRISE Nigeria. About us. Available at:
About Us – YouthRise Nigeria (youthriseng.org). Last accessed: April 2024
NP-GBL-HVX-COCO-240023 | May 2024
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