An exploration of best practices of meaningful peer involvement within a harm reduction context with substance users from GHB, MSM, and IDU drug use settings

This study conducted by Mainline focuses on three of Mainline’s target audiences: gamma-hydroxybutyricacid (GHB) users in the Netherlands, men who have sex with men (MSM) and their chemical sex party practices, both nationally and abroad, and injecting drug users (IDU) internationally. These three drug use settings present obstacles for ‘regular’ harm reduction work in that these populations are hard to reach and thus require new approaches for outreach workers. Therefore, we are interested in developing new ways of accessing these populations in order to transmit sustainable harm reduction messages. One way to allow access to these specific population is peer involvement.

The GHB use setting was characterized by practical and ethical issues that made finding the best practices of harm reduction in this setting complex. MSM peers demonstrated a unified network in that there was a strong sense of community and a shared struggle. However the poly-substance use and HIV status associated with this setting complicated how peers went about minimizing risks and connecting with their target audience. The IDU setting appeared to be the most successful with peer involvement in that their networks and partnerships were strong and the peers’ role appeared to be more defined, and their harm reduction agenda tended to be aligned with that of the substance user.

Knowledge and trust are vital components to effective harm reduction and risk communication. Ideally, peer workers and target audiences should share a similar agenda in regards to their ideas on what harm reduction looks like. Peer involvement is largely unexplored and can be complicated, but can also be highly beneficial for both the agency, the peers, and the target group, and thus should be encouraged.

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