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These datasets underpin the analysis presented in the agency's work. Most data may be viewed interactively on screen and downloaded in Excel format. All countries. Topics A-Z. The content in this section is aimed at anyone involved in planning, implementing or making decisions about health and social responses. Best practice. We have developed a systemic approach that brings together the human networks, processes and scientific tools necessary for collecting, analysing and reporting on the many aspects of the European drugs phenomenon. Explore our wide range of publications, videos and infographics on the drugs problem and how Europe is responding to it. All publications. More events. More news. We are your source of drug-related expertise in Europe. We prepare and share independent, scientifically validated knowledge, alerts and recommendations. About the EUDA. The content of this summary does not necessarily reflect the official opinions of the European Union, nor the official opinion of the Republic of Tajikistan, and should be seen as the product of CADAP 5. Updated: August Studies on the prevalence of drug use among the population of Tajikistan were not carried out in In total, 5 respondents were interviewed, of which 2 The study found that the female respondents had a slightly higher awareness of the existence of drugs than the males. Some Among all respondents, Some 1. The survey results showed that However, When asked about drug use, 0. The consumption of inhalants was the most prevalent. According to the responses, 1. The use of marijuana or hashish was second most popular, with 0. The first experience with drugs most often took place at the age of 16 and usually the drug was marijuana, amphetamines, or tranquillisers. In a series of educational, sports and cultural events aimed at promoting a healthy lifestyle were organised. Participants were given information about the problems of drug use in modern society and its consequences. Health bulletins were issued and health information prepared in both the Tajik and Russian languages. Articles were published in newspapers and magazines and awareness-raising programmes were broadcast on three TV channels Channel One, Safina, and Jahonnamo and on the Republican radio. Anti-drug events are also organised annually to coincide with the International Day against Drug Abuse and Illicit Trafficking 26 June. Studies to estimate the population of opiate users, including injecting drug users IDUs , were not carried out in Drug treatment is carried out in the Republic of Tajikistan in specialised drug treatment facilities. The State guarantees anonymous drug treatment. In a total of 1 people received inpatient treatment in substance abuse treatment centres. Of these, The number of drug addicts who received hospital treatment in increased by The main strategic focus of this programme included:. As of 31 December , the country had 3 officially registered HIV cases cumulative number , of which The HIV prevalence rate was HIV cases have been registered in 66 of the 68 districts of the country. The average estimated number of HIV-positive people in the country ranges between 6 —10 Moreover, in recent years, the number of newly reported HIV cases among females has increased almost 2. Thus, in the proportion of women among registered new cases was 8. In , of the total number of registered HIV cases, In the country registered new cases of HIV infection, of which Among the newly registered HIV cases, people The number of reported cases of hepatitis C virus HCV in was According to the Centre for Health Statistics of the Ministry of Health of Tajikistan, in there were cases of syphilis infection among the general population, of which were male and were female. The official data from Tajikistan provide very limited information on the number of deaths related to drug use. Drug treatment is carried out in the Republic of Tajikistan at specialised drug treatment facilities. Services provided by specialised drug treatment agencies in the country include inpatient and outpatient care, anti-relapse therapy, rehabilitation programmes, work with drug addicts and efforts to prevent substance abuse. Treatment of drug dependence in the Republic of Tajikistan is conducted mainly at public drug treatment facilities, including:. The availability of substance abuse treatment beds in the Republic of Tajikistan is 4 per inhabitants. Harm reduction programmes are implemented to minimise the consequences of drug use. Geographically, the HR programme covers almost the whole of the country. In the Government of the Republic of Tajikistan reviewed and supported the letter of the Ministry of Health of the Republic of Tajikistan asking it to consider a pilot implementation of a programme of OST. Up to patients have received OST at this centre. This is the first gender-sensitive project in the Republic of Tajikistan. The centre provided low-threshold services laundry, showers, communication, leisure, food, sanitary napkins and legal advice and referral to doctors. In this centre, 62 were re-adaptation clients, 40 of whom abstained during the reported period, and two patients were referred for further rehabilitation to the Tangai Republican Rehabilitation Centre. These clients received low-threshold services and advice at the drop-in centre. Five hundred motivational packages were given to the most active clients. Harm reduction programmes were first introduced in the Republic of Tajikistan in in Dushanbe, Khujand and Khorog, mainly in the form of needle exchange programmes NEPs and via the distribution of information materials. In Kulyab a hour drop-in centre for drug users was opened by the non-government organisation NGO Anis. The NGO Volunteer, which implemented a programme in the Gorno-Badakhshan Autonomous Oblast GBAO , provided services 9 times during the reporting period, including services related to: social support 1 ; prevention 2 ; healthcare 2 ; information and counselling 1 ; psychological care and support ; legal services ; and social services The Social Bureau covered 1 clients people injecting drugs, 9 sex workers, 24 people living with HIV, 89 people with tuberculosis, 52 ex-prisoners with HBV and 15 with HCV, 1 minor at risk, and vulnerable women. As part of this programme, one mobile trust point and four NSPs were established, located on the premises of the National Tuberculosis Hospital in urban health centres Nos 2, 12 and During the reporting period, RAN served 1 clients. A total of syringes were exchanged and 23 condoms were distributed. In a total of 4 The steady increase in seizures of cannabis, primarily hashish, continued in , with the result that cannabis comprised This significant change in the type of drug seized was a result of an increase in the areas sown with cannabis in Afghanistan in recent years. The impurities in the samples of heroin that were seized were found to be from the manufacturing process — 6-monoacetylmorphine and acetylcodeine — and cutting agents of extrinsic origin — caffeine, acetaminophen paracetamol and dextromethorphan. No extrinsic substances were found in the narcotic opium seized in Starch-containing substances were found in just a few samples. The physical appearance of the cannabis resin that was seized was either in the form of a rod or of material compressed into rectangular tiles. The dimensions of tiles varied within the following ranges: width 14—16 cm, length 21—23 cm, thickness 2—3 cm. Drug prices in Tajikistan increase in proportion to the distance from the state border. The legislation of the Republic of Tajikistan in the field of drug control is based on the rules and recommendations of the United Nations Drug Treaties and Conventions , , , of which Tajikistan became a signatory in and The main purpose of Law No. Law No. The main objectives of the law are the protection of the rights and legitimate interests of people suffering from substance abuse and addiction, establishing bases and procedures for the provision of substance abuse treatment, and the protection and security of professionals providing drug treatment services. Article 6 of the Constitution guarantees the following types of drug treatment and social protection:. The main objective of this law is the realisation of the national policy and international agreements of Tajikistan in the sphere of licit trafficking of narcotic substances, psychotropic substances and precursors, countermeasures of their illicit trafficking, prevention of drugs and toxicomania and rendering of narcological assistance to people suffering from drug addiction and toxicomania. The main task of the law is to protect the rights and legal interests of people suffering from narcological diseases, establish grounds and a procedure for rendering narcological assistance and to protect the rights of medical and other workers rendering narcological assistance. According to Article 6 of the Law, the Government guarantees the following kinds of narcological assistance and social protection:. Chapter 22 of the Criminal Code of the Republic of Tajikistan effective from 1 September stipulates responsibility for the following violations of the law related to drug issues:. The National Strategy of the Republic of Tajikistan in the field of the control of narcotic drugs is aimed at preventing the use of the territory of the state by transnational organised drug traffickers to smuggle narcotics, international commitments and the establishment of strict control over the licit movement of narcotic drugs, ensuring the effective fight against drug trafficking, guaranteeing the medical care of patients with drug addiction and increasing international cooperation in this area. One of the measures taken by the Government of the Republic of Tajikistan in the field of drug control is the coordination of bodies at all levels of society in order to synchronise the activities of law enforcement agencies in the fight against drug trafficking, as well as the relevant ministries and agencies in the control of drug trafficking, psychotropic substances and precursors, and drug prevention. The main body that coordinates ministries, departments and organisations in the prevention of drug abuse, regardless of their form of ownership, is the Coordinating Council on the prevention of drug abuse, approved by Decree No. According to the decree, regional, city, and district councils for the coordination of drug prevention activities were established under republican subordination in the Gorno-Badakhshan Autonomous Oblast, Sughd and Khatlon regions, the city of Dushanbe, and other cities and districts. The Coordinating Council is recognised as the supervisory body of the interaction of ministries, departments and state bodies in the conduct of activities aimed at the prevention of the non-medical use of narcotic drugs and psychotropic and other drugs. Homepage Quick links Quick links. GO Results hosted on duckduckgo. Main navigation Data Open related submenu Data. Latest data Prevalence of drug use Drug-induced deaths Infectious diseases Problem drug use Treatment demand Seizures of drugs Price, purity and potency. Drug use and prison Drug law offences Health and social responses Drug checking Hospital emergencies data Syringe residues data Wastewater analysis Data catalogue. Selected topics Alternatives to coercive sanctions Cannabis Cannabis policy Cocaine Darknet markets Drug checking Drug consumption facilities Drug markets Drug-related deaths Drug-related infectious diseases. Recently published Findings from a scoping literature…. Penalties at a glance. Frequently asked questions FAQ : drug…. FAQ: therapeutic use of psychedelic…. Viral hepatitis elimination barometer…. EU Drug Market: New psychoactive…. EU Drug Market: Drivers and facilitators. Statistical Bulletin home. Quick links Search news Subscribe newsletter for recent news Subscribe to news releases. Breadcrumb Home Publications Tajikistan country overview Tajikistan country overview Contents Drug use among the general population and young people Prevention Problem drug use Treatment demand Drug-related infectious diseases Drug-related deaths Treatment responses Harm reduction responses Drug markets and drug-law offences National drug laws National drug strategy Coordination mechanism in the field of drugs References. Agency on Statistics under the President of the Republic of Tajikistan.

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Metrics details. Tajikistan is one of the most affected countries with high rates of injection drug use and related epidemics. The aim of this qualitative study was to describe drug use practices and related behaviors in two Tajik cities — Kulob and Khorog. Twelve focus group discussions 6 per city with people who inject drugs recruited through needle and syringe program NSP outreach in May Topics covered included specific drugs injected, drug prices and purity, access to sterile equipment, safe injection practices and types of syringes and needles used. Qualitative thematic analysis was performed using NVivo 10 software. All participants were male and ranged in age from 20 to 78 years. Thematic analysis showed that cheap Afghan heroin, often adulterated by dealers with other admixtures, was the only drug injected. NSPs were a major source of sterile equipment. Very few participants report direct sharing of needles and syringes. Conversely, many participants reported preparing drugs jointly and sharing injection paraphernalia. Using drugs in an outdoor setting and experiencing withdrawal were major contributors to sharing equipment, using non-sterile water, not boiling and not filtering the drug solution. Qualitative research can provide insights into risk behaviors that may be missed in quantitative studies. These finding have important implications for planning risk reduction interventions in Tajikistan. Prevention should specifically focus on indirect sharing practices. Injection drug use and related infections represent major public health problems in Tajikistan and other Central Asian republics \[ 1 , 2 \]. As of , 51 harm reduction sites operated throughout the country providing, according to national authorities, HIV prevention services needle and syringe distribution, condom distribution, and voluntary counseling and testing to 11, PWID \[ 5 \]. In , these harm reduction sites distributed 4,, needles and syringes. Tajikistan also has 6 opioid substitution programs two in Dushanbe, and one each in Kulob, Khudjand, Khorog and Kurgan-Tube covering patients with opioid dependence \[ 5 \]. Sharing needles, syringes and other drug preparation equipment is an important route of transmission of both HIV and HCV infection. Increases in prevention program coverage in the region have improved knowledge and reduced risk behaviors \[ 4 , 8 \], however, these changed have rarely resulted in reductions in new HIV and HCV infections among drug PWID. To the contrary, in many countries in Eastern Europe and Central Asia HIV incidence has been rising \[ 9 \], and research focusing on in-depth understanding of behavioral risks associated with drug injecting in Tajikistan and other Central Asian countries remains scant. This qualitative study aims to fill this gap by investigating drug preparation, consumption and sharing routines to understand risk factors and previously unexplored aspects of transmission risk that may contribute to the high rates of HIV and HCV among PWID in Tajikistan. We used a purposive and convenience sampling approach to recruit participants. Study eligibility criteria included: a minimum age of 18 years, injecting drug use in the past month and ability to speak Tajik or Russian languages. All participants provided oral informed consent, and received the equivalent of 5 US dollars for their participation. Focus group discussions were held at the NSP site in each city. Two experienced researchers facilitated each focus group, which lasted from 60 to 90 min. Topics covered during the focus groups included detailed descriptions of the drug preparation and consumption practices among PWID in each city. All discussions were audio recorded, transcribed verbatim in Russian or Tajik, translated into English and catalogued in NVivo v. A research staff member, fluent in Tajik, Russian and English, transcribed and translated all of the recordings; the two researchers who facilitated the focus groups discussions compared the English versions with the originals to ensure the accuracy of the translations. The research team used a coding frame derived from the focus group guide to code the transcripts, which were then analyzed thematically for drug preparation and consumption behaviors and factors influencing these behaviors. Coding and analysis were done independently by two researchers in parallel and were later discussed and agreed upon by all research team members. All participants were male and ranged in age from 20 to 78 years with a median age of 43 years. Below we present the results of the analysis in line with the key themes identified - availability and purity of drugs, preparation and injection practices, and injection-related risks. According to focus group participants, a very small fraction of heroin users, mostly beginners, use heroin by smoking or snorting instead of injecting it. Most of those who smoked or snorted heroin when they started reported shifting to injection because of the limited supply of heroin and constantly increased tolerance towards drug. Participants in all focus-group discussions mentioned limited availability compared to previous years of heroin on a local black market. Almost all participants reported that suppliers heavily adulterate heroin available for end users. Most participants believe that drug dealers in Aghanistan and Tajikistan adulterate heroin, with dealers in Tajikistan being blamed the most. According to participants, dealers mix heroin with sugar, medicines such as antihistamines, specifically Dimedrol Dyphenhydramine , non-steroid painkillers Acetaminophen, Analgine, Baralgine , psychotropic drugs Zopiclone , calcium chloride and oral rehydration salts. Some participants reported that drug dealers may use such admixtures as flour, lime powder, alabaster. When heroin is in short supply, drug dealers cut it more heavily. Many participants reported that they usually injected in groups of two or three people, usually the same people and rarely with strangers. They reported preparing heroin in a variety of metal spoons, metal cups from safe injection kits , glass bottles, vials and plastic bottle caps mixing vessels. Many participants mentioned mixing heroin with other medicines. However, some participants reported adding Dimedrol to avoid nausea caused by heroin. Although people usually used Dimedrol tablets, they also use liquid Dimedrol in ampules, which they substitute for water to dissolve the heroin. Although somewhat less common, people occasionally add non-opioid painkillers containing Metamizole Analgin or Paracetamole. Many participants reported injecting with sterile water in ampules provided by NSPs. When sterile water is not available or a person is in withdrawal, people may use water from a tap, river, ditch or a rainwater puddle. People usually use from one-half ml to one ml of water per dose of heroin, using more water when two or more people inject together. Some participants believe that adding more water to the solution makes it less concentrated resulting in weaker effect, while others preferred to add more water making it appear like a larger dose, which is more comforting psychologically. Sometimes, users filter and heat the drug solution but these steps can be skipped when the powder is easily soluble. Some participants reported that boiling causes the drug solution to thicken and gel if it contains certain impurities, making it impossible to inject. Participants reported using filters supplied by the NSP or using improvised filters from a cotton swab or a cigarette filter. Prior to drawing drug solution into a syringe through a filter, many participants reported removing the needle to reduce the risk of the needle becoming clogged or accidentally jamming it into the cooker and dulling it. Others draw the solution through the needle using a piece of cotton rolled over the tip of a needle as a filter. Filtering the drug solution reduces the presence of solid particles that can clog the needles, which allow people to inject with thinner needles that do less damage to veins. The rules regarding division of heroin purchased by two or more people vary depending upon situational factors. Often, the person who contribute the most money receives the largest share of heroin. In other cases, people apportion the heroin based on individual dosage needs e. Cheating during division of drug is not common and is not tolerated. The rules of drug division are negotiated in advance. Although heroin can be divided either before dissolving the powder is divided or after dissolving the liquid is divided , none of the focus group participants reported dividing powder heroin. When liquid is divided, PWID may prepare the drug in a common container and then take turns drawing it into their syringes. Alternatively, they may draw everything into one relatively large volume syringe and then transfer it into individual syringes by frontloading i. Frontloading may also happen if one of partners accidentally draws more solution than agreed. If the needle hub is translucent, they need to draw less blood; if it is opaque, they need to draw more blood into the syringe. Others may add some more water to the syringe to use the leftover. However, a substantial share of participants, primarily in Khorog, stressed that they do not try to use the drug leftovers because it does not matter much for them. For many heroin users, the amount of money they have strongly determines the number of times that they inject heroin and the amount of heroin in each injection. Some participants mentioned that PWID would inject as much heroin as they can get, up to 3—5 g in a day. Others mentioned that because heroin is heavily adulterated, people needle inject larger amounts of it. When heroin users have trouble obtaining heroin, they often use less, perhaps only a fraction of a gram per day. In general, the most common frequency of injection is 2—3 times per day. Participants reported that as with the daily dosage, the frequency of injection depends on the amount of heroin available. When little heroin can be found, people only inject 1—2 times a day. Many participants said that when plenty of heroin is available, most people will consume it all in one or two days by injecting more frequently, 5—6 times a day or every 2—3 h. Some participants indicated that they have to inject more frequently due to the lower potency of heroin. The choice of source depends on several factors: location and distance, time NSP do not work on weekends or after regular office hours , range and quality of the injecting equipment, and availability of money to buy syringes. In some cases PWID get syringes from a relative or a neighbour who works in a hospital. The main advantages of NSP are free injecting equipment and the possibility of getting many syringes although in Kulob some participants mentioned limited daily quotas of three syringes as well as the convenience of receiving syringes from outreach workers without the need to visit the NSP site. However, NSP disadvantages are limited hours and days of operation and the need to commute to the site if outreach workers are not around. Accordingly, many participants reported that they also buy syringes in pharmacies. This is particularly common if they are experiencing withdrawals from heroin and are unwilling to wait for an outreach worker or travel to the NSP site. Unlike NSP, pharmacies are open for extended hours seven days a week, are located everywhere and can be easily accessed when people need syringes in a hurry. In addition, syringes are relatively cheap 0. Nevertheless, several participants reported that some pharmacists scold PWID who try to buy syringes, and some pharmacists refuse to sell syringes. Pharmacists may suspect that a buyer is a drug injector if the latter asks for both a syringe and Dimedrol. Another concern with the pharmacies is harassment by police who may wait outside of pharmacies looking for potential PWID. Some pharmacists may report suspected PWID to police. The quality of syringes in pharmacies may also be lower as compared to NSP since pharmacists do not take into account specific needs of PWID while ordering syringes. Almost all participants in Khorog and many in Kulob reported using sterile needles and syringes only. PWID appear to have accurate and sufficient knowledge about risks of sharing needles and syringes. Many reported that they had shared needles and syringes before they were aware of HIV transmission risks and before sterile instruments were widely available through NSPs. Participants reported that PWID rarely share syringes anymore and generally only in situations when someone is in acute withdrawal and sterile syringes are not available. Some participants mentioned replacing the needle and injecting with a shared syringe. A number of participants mentioned that many young injectors lack awareness and knowledge regarding injection risk behaviors. Consequently, young injectors may share syringes and engage in indirect sharing practices. Although PWID rarely engage in direct syringe sharing, sharing other injection equipment e. Several participants report that many PWID use a shared container to prepare heroin. However, participants did not perceive any transmission risks because each person uses his own sterile syringe. Moreover, a number of respondents reported on injecting equipment being re-used. According to the participants, after the injection they may rinse their own used syringes and hide them in some places to use later when no clean syringes are available. They would be there for 10 days, 20 days. When syringes are reused, repeated rinsing with water is a common practice. Some participants reported using alcohol swabs provided by NSP for superficial cleaning of syringes when no water is available. The setting in which PWID inject plays an important role in the process of drug preparation and injection. Many PWID prefer to inject in their homes due to perceived safety, and, in most instances, access to new injection equipment or their own equipment as well as sterile or boiled water. However, due to withdrawal symptoms or fear of arrest, PWID may decide to prepare the drug solution and inject on the street or in a secluded location e. In these cases, users often hurry and skip boiling water and filtering the drug solution, and use tap water or water from a ditch to prepare their drugs. Some participants mentioned that PWID in withdrawal prepare the solution right in the syringe, by pouring the drug into the syringe barrel, adding water and shaking it to dissolve the drug mixture. We did not identify any important differences in drug injection practices and risk behaviors between the two cities. Our findings provide additional support for findings from previous studies, which suggest that access to sterile injection equipment and a safe place to inject are key to reducing injection risk behaviors \[ 10 \]. It appears that most PWID understand the risks of direct sharing, and direct needle and syringe sharing has become fairly rare. In contrast, the risks associated with indirect sharing through use of common drug injection paraphernalia are poorly understood, and Tajik PWID continue to engage in these behaviors. This is consistent with findings from other studies that found sharing drug preparation equipment was more common than sharing syringes \[ 11 — 13 \]. In many drug injecting populations, recognition of HIV transmission risks and scaling up prevention interventions have led to sharp declines in syringe sharing but not in sharing drug preparation equipment. In many locations, users continue to engage in drug preparation and apportioning processes including use of shared cookers, containers, water, syringes for division of solution, front- and backloading, that may introduce contamination with HIV or HCV \[ 13 — 15 \]. Our findings provide support for current recommendations regarding access to sterile injection equipment and safer injection education programs. However, apart from broadly defining safe injection principles, the focus of such education should be on specific risks associated with different stages of drug preparation and division, and with use of injection paraphernalia. This might be particularly important for HCV prevention since evidence suggests that HCV transmission risk associated with paraphernalia sharing can be comparable to the risk associated with sharing needles and syringes \[ 11 , 17 \]. Several studies have linked HCV transmission to indirect sharing practices in addition to direct sharing of syringes \[ 11 , 17 — 19 \]. The risk of transmission of HIV through sharing injection paraphernalia seems to be lower compared with the risk of HCV transmission \[ 20 \]. However, due to the higher prevalence of, indirect sharing practices in many locations, these practices may be of equal or greater importance than direct needle and syringe sharing for both HIV and HCV transmission among PWID. Our findings suggest that injecting in an outdoor setting and injecting while in withdrawal both contribute to unsafe injecting practices. In these situations PWID, who inject safely in most situations, are more likely to engage in risky practices such as borrowing syringes, sharing preparation equipment, using non-sterile water, and not boiling the drug solution. The presence of withdrawal symptoms and injecting on the street or in a public place have both been reported with unsafe injecting practices in previous studies \[ 13 , 21 \]. In other countries, situational factors contributing to sharing also included perception of safety associated with particular sharing partners, and fear of police and reluctance to carry syringes \[ 13 , 15 , 22 , 23 \]. In contrast to other regional research we found no elements in drug sharing which would act as a ritual to make friendships closer or strengthen bonds between users \[ 15 \]. We also found no references to places where many drug users would gather to buy and inject heroin yama , the Russian word for a pit — an analogue of a shooting gallery , which may increase risks for the spread of HIV among PWID. Our research suggests that the group nature of drug acquisition, preparation and injection in Tajik settings is not a result of these activities being perceived by many drug users as a social activity, but rather is a pragmatic response to the illegality of drug use and is often driven by economic and logistical rationale \[ 12 \]. For example, the preference for splitting liquefied drug solutions rather than powder arises because it is virtually impossible to split a small amount of powder accurately, while liquefied drug solutions can be divided very accurately using the calibrations on a syringe barrel \[ 12 , 24 \]. Our findings emphasize the need to improve access to sterile injecting equipment. Tajikistan reported distributing syringes per PWID in \[ 4 \], thus exceeding targets recommended by the UN technical agencies \[ 25 \]. Furthermore, given limited geographical coverage and hours of operation existing NSPs alone are unlikely to meet PWID needs, and therefore, should be complemented by pharmacy-based harm reduction services \[ 26 \]. Last but not least, since withdrawal was cited as the main reason for using non-sterile equipment, expanding opioid substitution therapy OST services and lowering their threshold is another viable strategy to reduce risky injection practices \[ 27 \]. Finally, other authors suggested that in the absence of a needle and syringe, some users might snort or smoke heroin \[ 30 \]. However, our results point to injecting as the sole route of administration among drug injectors in Kulob and Khorog. PWID who do not obtain syringes from NSP may be less knowledgeable regarding safe injecting practices, have less access to sterile injection equipment, and may engage in risky behaviors more frequently. The absence of women in the sample may further reduce the generalizability of the findings. In a sample of PWID in Kulob and Khudjand 27 females and males HIV prevalence and rates of risk behaviors in women were significantly higher than among men unpublished data. This raises the possibility that our findings may have been different if our sample had included females who inject drugs in addition to males. Despite these limitations, our research adds to the scant literature on injection risk behaviors and associated environmental factors among PWID in Tajikistan. We identified no observable differences in drug injection practices and risk behaviors between two cities, which suggests that the results may be generalizable to the population of NSP clients in other cities in Tajikistan. This information could prove useful for developing more focused harm reduction interventions to reduce injection risk behaviors among PWID in Tajikistan. This study highlighted important issues for further research and planning risk reduction activities in Tajikistan. Of particular concern is the limited access to sterile equipment in remote areas and the lack of awareness among PWID regarding risks of indirect sharing e. Future harm reduction interventions will need to focus on the different stages of drug preparation and injecting processes, improve access to new needles and syringes and promote safer injecting practices that incorporate current knowledge about the spread of disease through the sharing of drug paraphernalia. The study also underscores the importance of qualitative research in understanding the social, cultural and economic contexts in which drug use occurs and behavioral norms are shaped. This research helps to identify and interpret risk behaviors associated with injecting drug use and to inform prevention program development and implementation, so that the planned interventions are meaningful and useful to drug users themselves. It is imperative to incorporate qualitative research into design and evaluation of interventions targeting substance-using populations. Oral informed consent was obtained from the study participants for publication of this report and any accompanying images. Ancker S, Rechel B. Glob Public Health. Article PubMed Google Scholar. Drug scene, drug use and drug-related health consequences and responses in Kulob and Khorog, Tajikistan. Int J Drug Policy. Ministry of Health of Republic of Tajikistan. Dushanbe: Ministry of Health of Republic of Tajikistan; Google Scholar. Report on the results of bio-behavioral surveliance survey among people who inject drugs in Republic of Tajikistan in Drug situation in the Republic of Tajikistan in World Bank. New Country Classifications Accessed 15 Aug Astana: Ministry of Health of the Republic of Kazakhstan. Modelling an optimised investment approach for Tajikistan. Dushanbe: UNDP; Interventions to prevent HIV and Hepatitis C in people who inject drugs: a review of reviews to assess evidence of effectiveness. Risk of transmission associated with sharing drug injecting paraphernalia: analysis of recent hepatitis C virus HCV infection using cross-sectional survey data. J Viral Hepat. AIDS Behav. Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliatti City, Russian Federation: a qualitative study of micro risk environment. Soc Sci Med. Risky injecting practices associated with snowballing: a qualitative study. Drug Alcohol Rev. BMC Public Health. Article Google Scholar. The growing popularity of prescription opioid injection in downtown Montreal: new challenges for harm reduction. Subst Use Misuse. Meta-analysis of hepatitis C seroconversion in relation to shared syringes and drug preparation equipment. Addiction Abingdon, England. Safer and unsafe injection drug use and sex practices among injection drug users in Halifax, Nova Scotia. An exploratory look at community and interpersonal influences. Can J Public Health. PubMed Google Scholar. Risk of hepatitis C virus transmission through drug preparation equipment: a systematic and methodological review. Harm Reduct J. Prescription drug misuse and risk behaviors among young injection drug users. J Psychoactive Drugs. Syringe-mediated drug sharing among injecting drug users: patterns, social context and implications for transmission of blood-borne pathogens. Technical Guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. Harm reduction among injecting drug users - evidence of effectiveness. Harm reduction: evidence, impacts and challenges. The impact of needle and syringe provision and opiate substitution therapy on the incidence of hepatitis C virus in injecting drug users: pooling of UK evidence. A review of the effectiveness and cost-effectiveness of needle and syringe programmes for injecting drug users. Hepatitis C avoidance in injection drug users: a typology of possible protective practices. PLoS One. Download references. UI transcribed and translated data collected during focus groups. IK and UI performed qualitative content and thematic analysis. DO developed the first draft of the manuscript. All authors participated in the review and revision of the first draft of the manuscript. All authors read and approved the final manuscript. You can also search for this author in PubMed Google Scholar. Correspondence to David Otiashvili. Reprints and permissions. Otiashvili, D. Drug preparation, injection, and sharing practices in Tajikistan: a qualitative study in Kulob and Khorog. Subst Abuse Treat Prev Policy 11 , 21 Download citation. Received : 25 January Accepted : 26 May Published : 02 June Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Download ePub. Methods Twelve focus group discussions 6 per city with people who inject drugs recruited through needle and syringe program NSP outreach in May Results All participants were male and ranged in age from 20 to 78 years. Conclusion Qualitative research can provide insights into risk behaviors that may be missed in quantitative studies. Background Injection drug use and related infections represent major public health problems in Tajikistan and other Central Asian republics \[ 1 , 2 \]. Interviewing Focus group discussions were held at the NSP site in each city. Qualitative analysis All discussions were audio recorded, transcribed verbatim in Russian or Tajik, translated into English and catalogued in NVivo v. Preparation of drug solution Many participants reported that they usually injected in groups of two or three people, usually the same people and rarely with strangers. Drug division and injection The rules regarding division of heroin purchased by two or more people vary depending upon situational factors. Dosing and frequency For many heroin users, the amount of money they have strongly determines the number of times that they inject heroin and the amount of heroin in each injection. Unsafe injection practices Almost all participants in Khorog and many in Kulob reported using sterile needles and syringes only. Discussion We did not identify any important differences in drug injection practices and risk behaviors between the two cities. Conclusions This study highlighted important issues for further research and planning risk reduction activities in Tajikistan. References Ancker S, Rechel B. Google Scholar World Bank. Competing interests The authors declare that they have no competing interests. View author publications. About this article. Cite this article Otiashvili, D. Copy to clipboard. Contact us General enquiries: journalsubmissions springernature.

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