With a CVC/COIN Community Grant of US$20,000, Jamaica’s National Council on Drug Abuse (NCDA) trained and employed 10 homeless persons to work as a peer educators from August through November 2012 on a project called Tek it to Dem 2.
Tek it to Dem 2 is a project that trained and employed Peer Educators (PEs) among the ‘vulnerabilized’ population which included the homeless population. With their training and experience, these PEs were able to reinforce prevention and treatment messages about the HIV and substance use. The latest data show that HIV prevalence is 12 percent among all homeless people, 34 percent among homeless women and 8.7 percent among homeless men. Around 79 percent of all homeless people are substance abusers, with 74 percent of homeless women and 80 percent of homeless men being substance users. Around 60 percent of substance users are addicted to crack cocaine and many are addicted to multiple substances. Drug users and sex workers often slide in an out of homelessness. Homeless women and homeless MSM usually support their drug habits with sex work. Some heterosexual male homeless people do the same but most get their money from petty theft, washing cars or ‘hustling.’
The peer educators had the following objectives:
To engage 20 individuals per week during a 16 week programme with substance use and HIV information
To distribute 200 condoms and lubricants per week to peers
To distribute 300 care packages including toothpaste, a toothbrush, a tin of sardines, bathing soap, a washcloth, roll-on deodorant, and lip balm
To co-ordinate persons for HIV testing
The project report indicated that the peer educators reached 1,592 individuals with 2,478 interventions during their 16 weeks of work, thus reaching 318 percent of the targeted 500 individuals. Not all of these individuals were homeless but most had experienced homelessness or were vulnerable to homelessness and mingled with homeless people on the streets, in the crack houses and other locations where homeless people are commonly found.
The peer educators explained that the homeless persons found that the project was beneficial as there was a general distrust of strangers in the homeless community. The use of peers to deliver the message made it more meaningful. They were also grateful for the care packages as it met a fundamental need of the population for personal hygiene. Personal hygiene is major problem for all homeless people because they do not have ready access to running water and they have nowhere to store bathing soap and washcloths. The packages came in bags they could easily store in their bed rolls. They were used to feeling ashamed of their bad hygiene and these products helped them clean up and work up the courage to appear in public. They explained, too, that using crack cocaine gives the body a peculiar odour that marks them as crack users to those familiar with this odour and that also repels people who are not crack users. They appreciated being able to wash off this odour with the soap and washcloths provided. Drug users were made aware of their options for detoxification and rehabilitation but none followed through with referrals because all treatment centres take the “cold turkey” approach and do not offer substitution therapy. However, both of the homeless peer educators who were still drug users said they had substantially reduced their drug use and they believed they were serving as inspiration to other homeless drug users.
The National Council on Drug Abuse is to be congratulated for its innovative approach in reaching marginalized populations with information on substance abuse prevention and treatment.