„ Roma and Drugs in Figures – the Czech Republic“ Budapest, 29-30 October 2004

1. „Roma and Drugs in Figures – the Czech Republic“Budapest, 29-30 October 2004 Czech National Focal Point for Drugs and Drug Addiction Office of the Government of the Czech Rep. tel. +420296153222 fax +420296153264 Pavla Lejckova

2. Content • Roma population in the Czech Republic • Drug use among Roma • Roma population surveys • Pattern of drug use among Roma • HCV seroprevalence study • Roma and treatment • Gravity of drug problem in Roma communities

3. Roma Population in the CR • evidence of Roma population? • 11 746 Roma in the CR in 2001 according to Census – based on their own declaration • 32 903 according to 1991 Census • 145 738 according to municipal authorities in 1989 • estimate: 160 – 200 thousand(based on demographic projections) • no evidence of Roma population • civic approach: equal approach to individual with no regard to nationality or ethnicity • protection of personal data (nationality/ethnicity = personal information) • fear of accusation of discrimination • demographic and social characteristics • high fertility, higher number of children in families, less favourable health status (influenced by extent of smoking and alcohol) • lower level of education, low qualification, high level of unemployment (long-term, social support), low quality of housing

4. Roma Population Surveys • Roma Out-Reach and Battery Project, 2003-2004 • NGO project focusing on extent and pattern of drug use in Roma population with the help of Roma out-reach workers • 2003: research model proposed, pilot testing, focus groups • 2004: research realization • Specifics of Roma Drug Users Compared to Majority PopulationUsers, 2002 - 2003 • NGO in Prague • non-standardized questionnaire in low-threshold centre • sample: 30 Roma respondents (29 aged 15 – 25, 1 older), 30 non-Roma respondents (24 aged 15 – 25, 6 older) • questions on drug used, frequency, age at first use, route of administration, needle sharing, treatment • Out-Reach Programme in Socially Excluded Roma Communities, 1999 - • Council of the Government for Roma Community Affairs • situation analysis in Roma communities: assessment of unemployment, housing, truancy, illiteracy, criminality, prostitution, gambling, drug use – in the beginning and at the end of year • 81 Roma communities observed, gravity of the problem assessed

5. Prevalence of Drug Use among Roma • Roma and Drugs, 2004 (school survey realized by A Kluby Society in Brno) • 200 respondents (aged 12 – 16); 96 students of Roma community schools • drugs = tobacco, alcohol, illicit drugs Prevalence of drug use First drug used • age at first drug use: non-Roma 88 % at the age of 12 and older Roma 53 % at the age of 11 and younger

6. Pattern of Drug Use among Roma • Specifics of Roma Drug Users in Comparison to Majority Population Users, 2002 - 2003 • 30 Roma and 30 non-Roma low-threshold centre/out-reach programme clients Primary drugRoma population: - 63 % combine heroin and pervitin - all combine main drug with inhalants and sedatives - 43 % use daily TreatmentLow-threshold centre - Roma 30 % vs. 73 % non-Roma

7. HCV Seroprevalence Study 1 • HCV Seroprevalence Study, NMC • September 2002 – December 2003 • multi-site cross-sectional study • 12 centres involved: low-threshold incl. out-reach programmes • study goals • identify prevalence of HCV antibodies (seroprevalence) among injecting drug users • identify predictive factors influencing the prevalence • evaluate level of knowledge on hepatitis C and the methods of prevention applied among injection drug users • identify sources of instruments for injecting and attitudes to the acquisition of clean instruments and identify factors influencing these practices • 760 clients tested, 226 HCV positive results = 29.7 %

8. HCV Seroprevalence Study 2 • main findings by ethnic groups • Roma: younger with shorter period of drug injecting • higher M/F ratio (3:1) than in the major population (2:1) • higher frequency of opiates as main drug than in major population (36% vs. 27%) • higher frequency of drug injecting than in major population • lower knowledge and information about drug-related infectious diseases, risk factors, harm reduction measures (e.g. testing) • no significant differences in: • sharing of needles • imprisonment (Roma slightly more frequently) • sex for money or drugs

9. Roma and Treatment • insufficient data in general • according to treatment demand register: • 2000: 60 Roma clients out of 9 237 all treatment demands • 2002: 54 Roma clients out of 4 148 first treatment demands (1.3 %) • substitution treatment is the only attractive modality for Roma community (high ratio of Roma clients in substitution centres esp. in Usti nad Labem, Ostrava, Brno) • exchange programmes are acceptable • low number in contact with low-threshold centres • very low interest for psychotherapy

10. Drug Problem in Roma Communities • Out-Reach Programme in Socially Excluded Roma Communities, since 1999 (data for 2003) • 81 Roma communities observed, gravity of problems assessed Prevalence of drugs in communities • substantial problem in 11 communities (13.6 %) • correlation with the extent of gambling (59), prostitution (28), criminality (67), usury (35), low education

11. Thank you for your attention • Contact: Czech National Focal Point for Drugs and Drug Addiction National Drug Commission Office of the Government of the Czech Republic Nabrezi Edvarda Benese 4 118 01 Prague 1 Pavla Lejckova tel: +420 296 153 349 lejckova.pavla@vlada.cz