The Work of General Practitioners among Lithuanian Roma in Vilnius: Incorporating Harm Reduction into Primary Medical Practice

Abstract

We describe the efforts of general practitioners (GPs) in Vilnius working with the Lithuanian-Roma community, the most impoverished and marginalized segment of the city's population. We focus specifically on GPs' efforts to advocate for and implement harm reduction principles and programs to protect and improve the health of Roma drug injectors threatened by HIV. We describe the full range of efforts that GPs have added to their practice beyond “normal doctoring” in order to have a more far-reaching impact on the health of drug users. This includes advocating for and successfully implementing methadone drug treatment and needle exchange services as integrated parts of routine primary medical practice. It also includes the outreach efforts by GPs and nurses to educate many different segments of the larger Vilnius community - law enforcement officials, teachers, and social workers - about harm reduction principles and strategies.