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"They accept me, because I was one of them": formative qualitative research supporting the feasibility of peer-led outreach for people who use drugs in Dakar, Senegal

Research output: Contribution to journalArticle

Camille Stengel, Famara Mane, Andy Guise, Magath Pouye, Monika Sigrist, Tim Rhodes

Original languageEnglish
Article number9
Number of pages12
JournalHarm Reduction Journal
Volume15
Issue number1
Early online date27 Feb 2018
DOIs
Publication statusPublished - 2018

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King's Authors

Abstract

Background: Peer outreach harm reduction initiatives are being developed with and for people who use drugs in
Dakar, Senegal. This is in response to growing injecting drug use across the West Africa region and linked emerging
epidemics of HIV and hepatitis C. We undertook formative qualitative research to explore the feasibility and
potential of peer outreach in this context and in particular how outreach could be linked to fostering communitylevel
processes of change.
Methods: We undertook a total of 44 semi-structured qualitative interviews. Thirty-four interviews were with people
who used drugs (comprised of 25 participants who had injected at least once in their life) and included 11 peer
educators who delivered “awareness-raising” harm reduction activities. We also interviewed 10 service providers
involved in the planning and monitoring of peer outreach initiatives. We used thematic analysis to identify key
characteristics of how peer-led outreach is being delivered, beneficiary need, and the nature of the social networks
in which the awareness-raising activities operate.
Results: Through interviews with peer educators, people who use drugs, and service providers, four main
overlapping themes are identified as follows: peer educators as a bridge to responsibilization through awarenessraising
activities, awareness-raising activities as an enactment of recovery, awareness raising through social network
diffusion, and the contexts and constraints of peer outreach engagement through awareness-raising activities.
Conclusions: The study results suggest that peer education is on a trajectory to develop into a central role for
harm reduction interventions in Dakar, Senegal. This research shows how peer education is bound in processes of
responsibilization and self-change, which link to varying possibilities for risk reduction or recovery. For peer
education to achieve a range of significant goals, broader structural and system changes should be implemented in
the region. We caution that without such changes, awareness-raising activities and the role of peer educators may
instead become part of state- and agency-sponsored processes of seeking to responsibilize individuals for health
and harm reduction.

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