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The Rapid Assessment and Response Guide on Psychoactive Substance Use and Sexual Risk Behaviour

Mental Health: Evidence and Research Department of Mental Health and Substance Dependence Noncommunicable Disease and Mental Health Cluster, World Health Organization

WHO Library Cataloguing-in-Publication Data SEX-RAR guide : the rapid assessment and response guide onpsychoactive substance use and sexual risk behaviour. 1.Substance-related disorders 2.Sex behavior 3.Psychotropic drugs 4.Risk assessment 5.HIV infections – prevention and control 6.Harm Reduction 7.Health promotion – methods 8.Manuals. I.World Health Organization. ISBN 92 4 154558 5 (NLM classification: WM 270) © World Health Organization 2002 All rights reserved. Publications of the World HealthOrganization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to Publications, at the above address (fax: +41 22 791 4806;email: The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps representapproximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capitalletters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use.


Acknowledgements Abstract 1 2 3 4 5 6 Introduction Key concepts Preparation stage Assessment stage Response stage Methods and Tools References Annex 1 Assessment frameworks Annex 2Example RAR report

v vii 1 5 37 53 73 81 121 131 135







This guide was prepared for WHO/UNAIDS by: Tim Rhodes1, Chris Fitch2 and Gerry V. Stimson1

The Centre for Research on Drugs and Health Behaviour, Department of Social Science and Medicine, Imperial College of Science, Technology andMedicine, University of London, UK Department for International Development HIV/AIDS Knowledge Programme, Department of Social Science and Medicine, Imperial College of Science, Technology and Medicine, University of London, UK


Technical contributions and comments on this guide were provided by Professor Moruf Adekan, Dr Andrew Ball, Mr Mark Davis, Mr Martin Donoghoe, Mr Alan Greig, DrSuresh Kumar, Mrs Mwansa Nkowane, Ms Sujata Rana, Dr Shekhar Saxena, Mr Werasit Sittitrai, and Dr Gundo Weiler. The field-testing of the draft version of the guide was carried out by Professors Gabriel Bianchi, Jacobo Schifter-Sikora and Godfrey Woelk and revisions following the field-testing were coordinated by Mr Chris Fitch. The overall management of the project, which included the initial draftof this guide, was undertaken by Dr Andrew Ball and Dr Gundo Weiler from its inception in the late 1997 until November 1999, after which Dr Shekhar Saxena took responsibility with Mrs Annette Nkowane working as the focal person for the project. The layout and presentation design was undertaken by Mr Ian Harris, with editing done by Dr Ali Hussein. The work on psychoactive substance use and...
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