Gayane has 12 years of experience in HIV/AIDS and international development sector. Her expertise includes harm reduction, human rights, gender programs, community empowerment, and advocacy for domestic funding for key populations. Passionate about inclusive health systems, she has community-led initiatives amplifying the voices of people who use drugs globally.

Abstract co-authored and co-presented by Gayane Arustamyan and Alla Bessonova

Background:
In recent years, Kyrgyzstan has witnessed a sharp increase in New Psychoactive Substances (NPS) use, posing serious challenges to public health and harm reduction efforts. As of January 2024, 51% of all HIV cases in Kyrgyzstan involve people who use drugs, with HIV prevalence in this group at 16.5%—over 70 times higher than the general population. Although no data exists on the exact number of NPS users, their use is strongly linked to high-risk behaviors like unprotected sex, which contributes to rising HIV rates. This evolving drug landscape calls for a community-led assessment to better understand NPS users’ needs and service gaps, informing more targeted harm reduction interventions.

Methods:
In 2024, the national drug user-led organisation Attika, in collaboration with INPUD, conducted a study using a mixed-methods approach. Surveys were administered to 100 NPS users and 30 healthcare workers across three regions (Bishkek/Osh/Chuisk). The study assessed the adaptability of current HIV prevention and treatment services, identified challenges, and proposed solutions to improve harm reduction for NPS users.

Results:
The study found a significant shift from traditional drugs like heroin to synthetic cannabinoids such as mephedrone and alpha-PVP. There was a notable increase in women switching to NPS use, with rising cases of mental health crises and hospitalisations. Many participants reported discrimination and inadequate support from healthcare professionals. Young users emphasised the need for expanded online harm reduction services, especially web-based tools to engage youth.

Conclusions:
The study underscores the urgent need for gender-sensitive harm reduction approaches and interventions for NPS users. Recommendations include public education campaigns, stronger collaboration between healthcare providers and communities, more peer-led initiatives, and improved service accessibility. Addressing these gaps is crucial to curbing HIV rates and improving overall public health outcomes in Kyrgyzstan.