NSEP AND OUTREACH INTERVENTIONS IN

PENANG ISLAND, MALAYSIA

(Track No: 292)
INTRODUCTION OUTCOME
Penang a northern state in peninsula Malaysia consists of an Ä
Drug users are more aware of the need to use clean
island and mainland with a population of approximately 1.6 needle-syringes; the risks of sharing and the dangers
million. With more than 2 centuries of history and heritage, of discarding used needle-syringes on the streets.
the historic city of Georgetown on the island became a
Ä
Referrals to drug treatment and other service agencies
recipient as a UNESCO World Cultural Heritage Site in July
2008. The state of Penang borders close to Thailand, the - welfare, shelter homes, health services and drug
Golden Triangle of South East Asia. substitution therapy.
Ä
Increased safer sex awareness or less unprotected
There are 4,280 reported cases of HIV/AIDS of which 47 % sex.
is via IV drug use. In 2006, Malaysia launched its National
Harm Reduction Programme begining with 3 implementing Ä
Peer involvement.
sites (NGOs) in Penang, Kuala Lumpur & Johor Baru piloting
Ä
Job placement for drug users
NSEP . Under the purview of Malaysian AIDS Council and
funded by the Malaysian Ministry of Health, Penang
Alternatif Community Center is the first site to launch the
NSEP pilot in Penang Island on 17th February, 2006. LESSONS LEARNED
Ä
Social marketing harm reduction and the benefits of
NSEP in areas where outreach is done, has increased
knowledge of the programme effectiveness as a harm
reduction opportunity for the community, especially
where current local media advocacy is on low profile.

Ä
Street outreach allows outreach workers to interact
with many more clients and it is often easier to
approach groups of drug users hanging out on the
street because of a probable
sense of security and therefore
easier to set up an atmosphere
of trust and build positive
one-on-one rapport by
PROGRAMME being accessible to them
on a regular basis.
Six outreach workers were trained under the Pilot and
subsequently increased to current eight. The programme Ä
Because of the challenges
relies on local drug users and ex-users to serve as outreach
of getting into some
workers, role models, peer educators and advocates.
“ports” and the
changing population
Outreach work covered the North-East, South-East, South-
there, outreach workers often do not see individuals
West districts on the island and areas where clients are not
more than once. It is much harder to hold the attention
able to access services in the DIC. Outreach workers:-
of drug users in “ports” because they are actively
Ä
Provides clean needle-syringes and collects used needle- engaged in getting high. They are more inclined to
syringes for safe disposal entangled in their lifestyle and don't want to stop using
Ä
Distribute condoms and HIV prevention information drugs. The average street outreach encounter lasts
about ten minutes whereas in ports, encounters are
Ä
Refer clients for VCT /drug treatment usually much less than five minutes.
Ä
Build trust with drug users, creating a supportive
environment. Ä
Dealing with agencies who are reluctant to provide
services to drug users, for example, shelter homes
Ä
Address the needs in a day to day situation of drug users -
attending to wound dressings, basic medical and who refuse to accept drug user or service agencies
nutritional needs (vitamin supplements). who feel that drug users do not 'fit the profile of their
client'.

Ä
Anti-Drug operations/raids by law enforcement
resulting in temporary dispersal of the drug scene,
making it difficult for outreach to make contact with
clients.

Ä
Negative reaction from the community – resistance
towards NSEP. E.g. in a fishing village in the North
district of Penang island, outreach workers were
accused of promoting drug use which led to some of
the workers being beaten up.

RESULT
HIV IN PENANG (2006 - 2008)
(Source: Ministry of Health Malaysia) BY RISK FACTOR - IVDU

4000 53.50%
53.00% CONCLUSIONS
3000 52.50%
The benefit of NSEP is evident. Harm Reduction should
52.00% be mainstream thinking. Advocacy is essential to
2000 51.50% bridge gaps with the public and break taboos, including
51.00% partnering with service agencies, communities and
working with law enforcement in a collaborative
1000 50.50%
manner to move NSEP forward as an intervention to
50.00% control HIV prevalence.
0 49.50%
2006 2007 2008 The relationship between NSEP service providers and
H IV 3074 3332 3447 law enforcement agencies can, and should be a bi-
directional initiative. Until then, service providers
H IV via ID U 1630 1724 1755
working with drug users will have to double the effort
% 53.03% 51.74% 50.91%
Contact Authors:
Maryam Wong Abdullah
Email: maryampen@gmail.com SKYPE id: maryampen
NEW CASES OF HIV VIA IVDU
IN PENANG (2006 - 2008) Mohamad Firdaus Zakaria
(Source: Ministry of Health Malaysia) Email: acc.pen@gmail.com SKYPE id: apitacc

Penang Alternatif Community Center,

YEAR NO. OF NEW 28-B Jalan Gurdwara, 10300 Penang, Malaysia.
CASES Tel/Fax: +604 2630839
2006 95
2007 94 Malaysian AIDS Council ¦ Malaysian AIDS Foundation
No 12, Jalan 13/48A, The Boulevard Shop Office,
2008 29 Off Jalan Sentul 51000, Kuala Lumpur Malaysia.
Tel : +603-4045 1033 ¦ Fax : +603-4042 6133 ¦ Website : www.mac.org.my ¦ Facebook Group: Malaysian AIDS Council