Defining and redefining harm reduction in the Lao context

This was a qualitative study, consisting of in-depth interviews with 27 law enforcement and 8 health officers who work in the fields of HIV and/or drug control about their understanding of HIV related to drug use, and concepts of harm reduction. Content analysis was performed to identify the coding, categories and themes.We found that law enforcement officers in particular had limited understanding about harm reduction and the feasibility and appropriateness of harm reduction services in the Lao context.Harm reduction should be a core element of a public health response to HIV where drug use and IDU exists. Recommendations include the necessity of increasing the awareness of harm reduction among law enforcement officers and providing appropriate evidence to support the needs of harm reduction policy and programs. HIV prevention and treatment strategies should be integrated within existing social and cultural frameworks, working with the task force for HIV/IDU and other government counterparts.The use of illicit drugs is growing throughout South East Asia, including Lao PDR, with negative implications for individuals and public health becoming increasingly apparent [1]. The prevalence of illegal drug use in Lao PDR is not known with any accuracy, but it has been estimated to be higher than 2% [2]. The major substances consumed recreationally in Lao PDR are opium and its derivatives, amphetamine type stimulants (ATS) and volatile substances (glue, petrol). It was estimated in 2004 that there were 8,000 injecting drug users (IDUs) in Lao PDR [3]. A school survey in 1999 found 17% of youth had tried some form of drugs in their life and 7% had used marijuana, hashish, inhalants or amphetamines [4].The prevalence of amphetamine use was 0.7% of the population aged 15–64？years, while opiate use was estimated at 0.5% of 15–64？year olds [5] leading to an assumption that approximately 40,600 people use ATS and 29,000 use opium. Several small studies into ATS use in Laos initia