Problem: With the begining of the COVID-19 pandemic, the harm reduction program had to adapt to the new conditions of the overall functioning of the community. Namely, the drop-in centers could not work due to preventive measures for protection against COVID-19 virus, which measures prohibited the grouping of people indoors and outdoors. Also, police curfew and quarantines were in force, which enormously restricted the movement of people.

Solution: In order to meet the daily needs of the clients of the program, very soon after the declaration of the pandemic, the activities were shifted to out-reach work, online counseling and information sharing through social media. During last year, with our out-reach teams we managed to rich almost 80% of our regular clients, but also, with our visibility on-line, we riched to new clients as well.

Protective equipment (СOVID protective suits, protective gloves, visors and medical masks) was procured for the members of the field teams in order to safely conduct contacts with the clients. Additionally, medical masks and disinfectants were distributed to our clients because some of them couldn’t afford protective material against COVID-19.

Results: Injection equipment was constantly available to customers, distributed by the our-reach teams, as well as social service services available 24/7. Additionally, the clients were offered online services from the legal and psychological service, as well as educational information for protection against COVID-19.

The social work centers were closed for clients and access to the social services offered by state social protection system was restricted. Government measures to protect vulnerable categories of citizens were also unavailable to our clients because they did not meet the necessary conditions / criteria. Due to that, HOPS -Healthy Options Project Skopje distributed food packages and hygienic materials to everyone who needed them the most, especially to the Roma population. Totally HOPS distributed more then 400 humanitarian packages, of whitch at least 150 were distributed among Roma PWUD.

A positive example was that the Daily Hospitals for the prevention and treatment of addictive diseases during the pandemic were open every day and there was no interruption in the substitution treatment with methadone and buprenorphine. The situation with the pandemic and especially the measures that restricted movement were the reason for buprenorphine supstitution therapy to be widely distributed throughout the country, unlike before when patients from all over the country had to come to the only buprenorphine center in Skopje. This is a great positive benefit for patients from other cities who are being treated for opiate addiction.

All of this has contributed to HIV prevalence remaining low and we have had almost no covidue-positive clients.