HKIER

Abstract

Traditionally, therapeutic communities (TCs) have focused on providing abstinence-based treatment. However, with the emergence of HIV among injecting drug users, some TCs have evolved to include risk management or harm reduction strategies into their previously abstinence-based programs. We Help Ourselves (WHOS), a group of TCs in Australia, integrated harm reduction into their services in the 1980s. WHOS passed through a series of stages as it moved from a goal of “abstinence only” to one of “abstinence eventually.” Following these changes, client retention and length of stay increased and HIV risk behaviors decreased. The process by which WHOS integrated harm reduction into their services while maintaining a commitment to abstinence is outlined and a guide for TCs interested in adopting harm reduction is provided.

摘要

過往，治療社區（therapeutic communities）的治療計劃都以禁制為本。然而，隨着注射毒品者感染愛滋病毒，有些治療社區已把危機管理或緩害策略結合於「禁制為本」的服務內。「我們自助」是澳洲的一組治療社區，於20世紀80年代已把緩害策略結合於其服務內。「我們自助」的目標由最初的「只有禁制」發展至「最終能自我克制」，當中經歷了多個階段。因應策略的轉變，受助人留在治療社區內的時間多了，而感染愛滋病毒的高危行為減少了。本文概述了「我們自助」在堅守禁制理念下結合緩害策略的過程，並向有意採取緩害策略的社區給予指引。