Apply for Emergency Support Fund for Key Populations! 

Do you work in Armenia, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine or Uzbekistan? Does your organization represent key populations and face an emergency situation in regard to HIV prevention? Are you searching for a funding opportunity? Then please apply to Emergency Support Fund for Key Populations! 

Organisations from Eastern Europe and Central Asia can receive small grants with a maximum amount of €5,000 per grant. With these small grants AFEW International and Aidsfonds will support organisations representing key populations in surviving in emergency situations which they face due to legal barriers, stigma and discrimination, financial challenges and political restrictions. Support will be given to organisations carrying out activities that ensure access to HIV prevention, treatment and/or services for key populations, or projects protecting the human rights of key populations.

Applications from first-time applicants and applications showing innovative approaches to overcome emergency situations are particularly welcome.

The fund is financed by the Elton John AIDS Foundation and Aidsfonds.

Please find details here.

The desire to live

“Thanks to HIV, I plunged into the world of spiritual and moral growth and realized that I am responsible for everything that happens in my life.”

Anton Kutorgin is a volunteer of the Assistance Foundation (Angarsk, Russia), grantor of the Emergency Fund for Key Populations in EECA countries. He told AFEW International about how HIV divided his life into BEFORE and AFTER, and how he came to accept his positive status.

Openly about HIV status

I talk openly about my status because I got tired of being afraid, of feeling inferior or like there was something wrong with me. When I talked to people who didn’t know my status, I felt that I was deceiving them and I thought that they should know. After I discovered my status, it became much easier for me to live. I realized that when you start accepting yourself for who you are, then others begin to accept you in the same way. I call this ‘the law of the mirror’. My openness doesn’t bother anyone and it doesn’t cause any harm; on the contrary, it benefits people with similar diseases. Many people respect me because of this and thank me for it. I hope that in this way I will contribute towards societies being more accepting of this disease, and that the time will come when people talk about HIV as easily as the flu. My work as a volunteer in the “Assistance” foundation contributes to this. We have organized a support group for PLHIV and hold meetings on a regular basis, providing advice on sensitive topics. A support group makes it possible for people who have just received their diagnosis to accept it more easily. At that difficult time it’s very important that a person is in an environment where they can be understood and supported.

BEFORE

From the moment of the diagnosis, my life has been divided into BEFORE and AFTER. Before, my life was completely different. As psychologists say, all problems come from childhood. I am no exception. I am a typical example of someone who came from a dysfunctional family. My father drank, my mother divorced him when I was two years old. She raised me and my sister alone, and naturally she had to work a lot, while we took care of ourselves. When I was 14, I started hanging out with friends in the street. We formed a gang, drank, smoked, mugged people, stole cars, traded drugs, and generally found ourselves in a terrible environment, being influenced by manipulative people who used us to do their illegal deeds. I got infected through sexual contact, since I had never used intravenous drugs. If you ask, do I know who infected me? My answer is no, I don’t know. Over time, I realized that this isn´t so important, because the past can´t be changed.

AFTER

At the beginning it was very difficult. HIV has affected all areas of my social life. I didn´t know how to have a family or where to get a job. Everything I did or wanted to do I looked at through the prism of “I am sick, I have HIV”. But I am very grateful to my illness for the fact that I completely changed my outlook! I was walking a bad path through life, and if it were not for HIV, I would have continued to lead that destructive lifestyle that would eventually have led me either to prison or to the grave. HIV has become a springboard for my spiritual growth! Nobody is the same after such a psychological blow. But there were also many benefits that I found in illness. For example, thanks to HIV, I went to St. Petersburg and met one of my best friends there. Thanks to HIV, I was afraid to get a job and therefore became an entrepreneur. Thanks to HIV, I met my wife, and we got a wonderful girl.

And again, thanks to HIV, I plunged into the world of spiritual and moral growth and realized that I am responsible for everything that happens in my life. My attitude towards life has changed dramatically! I love life in all its forms, for me there are no bad or good people, there are happy and unhappy people, and when you understand this, you stop condemning people, instead there is sympathy and compassion. I call this the Total Acceptance of such a priceless gift as Life. Today I am 100% convinced that it is not the number of years lived that are important, but their quality.

Fear of talks with family

Of course, it was scary for me to open my status to my family and friends! About a year after the diagnosis, I went to live in St. Petersburg with the aim of never returning to my hometown, as I was very afraid that someone I knew would find out. I was afraid of being rejected, but after living in St. Petersburg for half a year, I began to understand that you can´t run away from your problems, or from yourself. On returning to Angarsk, I began to tell first my relatives, then friends, and everyone accepted and supported me! As a result, I realized one wonderful thing: “the fear that everyone will turn away from you” is only in your head! Don’t try to guess what other people will do! And one more important conclusion I made: don´t worry about people who turn their backs on you because of that. They are simply not your people.

To accept the status

There are some things that helped me to accept my status. First, an ordinary and natural desire to live! After all, life is beautiful, no one is in a hurry to leave it ahead of schedule. Although, as an HIV denialist for several years, I could have died. Yes, and thoughts of suicide came to me many times, but I didn´t give up. Secondly, God has always helped, is helping and will continue to, God has always sent me the good people I need. And thirdly, my Mom helped me a lot and continues to help.

HIV denialist

From the very beginning of my diagnosis, I became an ardent representative of the denialist movement. I was fanatic to the point that I even ran a YouTube channel in support of denialism. I didn’t go to the AIDS centre, I didn’t get tested, didn’t take treatment for almost ten years. I watched a bunch of videos on the Internet on this topic and decided that HIV doesn´t exist.

But one day I started having serious health problems. In 2017 I was officially diagnosed with bone and pulmonary tuberculosis due to AIDS (I had about 100 cells). My life from 2016 to 2019 was, without exaggeration, a waking nightmare. As a result, I was so tired of “fighting the system” that in September 2018 I started taking therapy. My condition improved, my cells began to grow, my viral load fell, and the hope for a long and happy life returned. Today I am taking therapy, and personally, it´s helped me a lot. However, I still try to avoid discussions about HIV denialism, since adults must make their own decisions and bear responsibility for their consequences.

Defending the interests of transgender community

Living in society and being a victim of all kinds of violence is unfortunately becoming the norm for transgender people in Ukraine. Stigma and discrimination, as well as police violence at times, restrict transgender people’s access to the law enforcement system and to quality medical services.

Igor Medvid, Coordinator of the Ukrainian organization HPLGBT and a grantee of the Emergency Support Fund for Key Populations in EECA, told AFEW International about the problems that transgender people face in the country, as well as about the ways of solving them.

For reference:

HPLGBT is a public self-organization of transgender people, which has been representing interests of transgender (trans) community in Ukraine for 6 years. HPLGBT is a membership association of a national scope that works in favor of high-risk groups for HIV infection, particularly, transgender people.

Igor, HPLGBT has done some research on transgender people. Could you tell us a little about it?

We are confident that advocating for the rights and interests of key populations is not possible without a thorough study of the situation.

When conducting research, not only we discover the issues that might be hidden from service-providing organizations, but also develop key recommendations for decision makers and service providers.

In 2019, through community efforts, we conducted a monitoring of human rights observance in relation to transgender women involved in sex work. As a result, we put together Alternative report on implementation of the convention on the elimination of all forms of discrimination against women. This report was implemented with the support of the Emergency Support Fund for Key Populations in Eastern Europe and Central Asia region, and it describes 61 cases of the rights violation of trans people, including information on the most common human rights violations. We also studied the specifics of chemical sex and the problems faced by people who practice it.

We hope that the Secretariat of the Commissioner for Human Rights of the Supreme Council of Ukraine will soon include all our recommendations on reforming and humanizing the policies into their annual report. Such actions will help us in advocacy.

In addition to this, we are sending the recommendations to all those who are forming national HIV programs, in order to include important services for transgender people, and we hope that the programs will be changing in accordance with the expectations and needs of those for whom they are implemented.

Financing for non-profit organizations in the EECA region sometimes leaves much to be desired. How do you survive in such conditions?

Our main source of income is small grants, which we get intermittently, therefore, unfortunately, our organization most often operates on a situational basis. However, even with the limited means of small grants, we manage to do a lot in strengthening the voice of transgender people. Our work is based on human rights and freedoms, and when planning activities, we try to focus on studying situations with the groups of trans people that are most in need of help. Our main key population groups are transgender sex workers or transgender people who practice chemical sex. Such groups face multiple stigmatization due to their deliberate involvement in sex work, their gender identity, sexual orientation, HIV status, and drug use.

Even though funding is declining, there are still opportunities for receiving money. We approached the Emergency Support Fund several times, and thanks to its grants, we were able to survive during this difficult time. We also transferred our skills to the community, and now the MSM community of sex workers, including those who practice chemical sex, has begun the process of mobilizing and helping each other. We help them with this by providing multilateral support, including technical assistance.

What are your future plans?

As for advocacy goals and objectives, we plan to continue to participate in increasing access to HIV testing, treatment and prevention, including AIDS prevention through interventions focused on commitment, support and care. We plan to promote interventions to suppress HIV replication as a result of ART (viral suppression), as well as participate in the promotion of sexual and reproductive health rights.

What is your most memorable case?

Recently, I was greatly shocked by the incident of rape, robbery and torture of a transgender person in the Zhytomyr region. Six malefactors, one of whom the trans person had met on a dating site, tortured him/her for a long time: having handcuffed the victim, they beat him/her up, threatened with a knife, cut off the clothes and raped him/her. However, the worst thing is that instead of investigating the attack as a hate crime, the police qualified it only as “robbery,” thereby causing the outrage from human rights defenders. We are deeply convinced of the homophobic/transphobic motive of this incident.

What difficulties do you encounter in your work?

The biggest difficulties arise due to the fact that nowadays there are no effective mechanisms for protecting the rights of transgender people in Ukraine. Investigations of crimes like the one I described are not adequate and exclude hate motives. Unfortunately, the Action Plan for the implementation of the National Human Rights Strategy has not been properly implemented.

Also, there is still no direct mention in the list of the Ukrainian Ministry of Health that transgender people are a key population group in the context of HIV. And, of course, the package of services that is provided in HIV prevention programs does not always meet the needs of transgender people. Especially if these people are representatives of sub-groups.

How do community members feel about your activity?

Differently. There are those who are grateful to us and often help the organization. Especially those who have already received help from us, and we have met their expectations.

But there are also those who are dissatisfied. For example, HPLGBT members and I often hear things like: “If you didn’t stick out, nobody would touch us,” or for example, “We were not touched, but now, because of your gay prides, we expect constant attacks by thugs (gopniks) or skin-heads.”

Once again this proves that people have little understanding of the fact that visibility is one of the most important components in protecting and expanding the rights not only of transgender people, but also of all other key population groups. We should make more efforts to educate and inform the public about the importance of visibility for diverse communities, to strengthen the voice of stigmatized and discriminated groups and, overall, to build an open and strong society.

Prevention of HIV and COVID-19 among MSM sex workers

Quarantine and restrictions on movement due to COVID-19 have left most sex workers unemployed and some homeless and at risk of poverty. Throughout the world, sex workers unite to help each other during the #COVID19 pandemic.

“Unfortunately, sex workers were left alone to face the impending COVID-19 pandemic, and not many people were willing to help them, especially to male sex workers. The only possible option we had then was mutual support. At the beginning of the lockdown, we started to raise donations among our group members to buy masks, food, sought shelter for the homeless male sex workers. We have received timely assistance from the Emergency Support Fund for Key Populations. We have been able to create and distribute information brochures on HIV and COVID-19 prevention, as well as to purchase and distribute condoms, lubricants, gloves, respirators and sanitizers. We continue to look for opportunities to buy food, as our resources have already been depleted.” – commented the leader of the initiative group of ChemBrothers.

The project provides HIV and COVID-19 prevention materials to MSM sex workers during the quarantine. MSM sex workers community provides peer-to-peer psycho-social support and assistance in visiting friendly doctors and specialists.

The project “Prevention of HIV and COVID-19 among MSM sex workers” is being implemented by the Initiative MSM sex workers group #ChemBrothers with the technical assistance of HPLGBT and financial support from the Emergency Support Fund for Key Populations in Eastern Europe and Central Asia.

Find the leaflet 

Prevention should not be overlooked

After the Global Fund Programme in Russia for 2015-2018 was over, there has been a sharp decrease in the funding of prevention programmes for the key populations. Some NGOs even put their activities on hold. However, others managed to “stay afloat” and continue their work using the available resources. One of them is the Positive Dialogue NGO (St. Petersburg).

To be able to continue its activities for the benefit of the community of men who have sex with men (MSM), in 2019 its President Mikhail Stupishin applied to the Emergency Support Fund for Key Populations in EECA.

About the reason for the growing numbers

In 2012, St. Petersburg AIDS Centre, together with the Red Ribbon NGO, which was actively working back then, carried out a study to assess HIV prevalence among MSM in St. Petersburg, which showed that the prevalence was at the level of 13%. In 2017, within the Global Fund programme Russia conducted another big study, in particular to assess HIV prevalence rates. This new study showed that HIV prevalence among MSM was 22.8%. Such a significant growth was indirectly caused by the high level of migration as St. Petersburg is the second largest city in Russia in terms of population. However, the main reason for such growth, in my opinion, was lack of sufficient HIV prevention programmes for MSM.

About the Emergency Support Fund for Key Populations in EECA

After the GF Programme in Russia for 2015-2018 ended, we found ourselves in a difficult situation as well as many other organisations. We had problems both with funding and with the resources, in particular with condoms, lubricants and tests. At the same time, we realized and were worried about the fact that suspension of our activities and exclusion of the prevention services from our work would aggravate the situation with HIV among MSM and would lead to a surge in HIV cases. Having said that, government contribution to HIV prevention among MSM as well as any other key populations is equal to 0, while business companies usually prefer to stay aside of the topic of HIV and even more so “HIV among MSM”.

Charitable foundations, both Russian and international, are first of all interested in supporting advocacy. Of course, it is important, but I think that prevention, including preventive services, should not be overlooked. So the Emergency Support Fund was founded just on the right time. Moreover, the Fund supports not only advocacy projects, but also prevention activities, allowing the NGOs providing HIV services in the region to continue their work with the key populations, quickly resolve the most pressing issues and look for other funding sources to implement their middle-term and long-term plans.

With the help of the Emergency Support Fund for Key Populations in EECA we procured condoms, HIV tests and lubricants and continued our work to deliver comprehensive prevention services for MSM. Some of the condoms procured were given to the MSM clubs, such as Central Station, Labyrinth, and Priscilla as well as Atlantis sauna for further free distribution among their visitors and to our partner organizations – Hygieia Center and Silver Rose Movement – to implement prevention activities among MSM and MSM/SW.

                About MSM/LGBT community in St. Petersburg

The challenges of MSM/LGBT community in St. Petersburg are the same as in the country as a whole: homophobia of various degrees, stigma and discrimination from the side of society, being outside of the legal environment. In reality, it is only in theory that 50% of people have positive or neutral attitude to MSM/LGBT, when they say, “they can do whatever they want to but… behind the closed doors”. Such “neutrality”, which can turn into strongly pronounced negative attitude or aggression, can make it impossible for the community representatives to express their personality, present themselves as full-fledged members of the society, whose interests are to be taken into account. It all leads to self-stigma, search for the “place under the sun”, while the community itself is “pushed into the corner” so to say. In such circumstances, some people are “breaking bad”, while others are “bottling up”. Both situations are extreme with people having very unstable psychoemotional state. It results in the development of all kinds of addictions, difficulties in finding a regular partner, and risky sexual behaviours increasing the risk of getting infected with HIV and STIs. Meanwhile, members of MSM/LGBT community living with HIV often face double stigma: both from the side of wider society and from the side of community.

One of the growing problems now is the spread of chemsex practices among MSM/LGBT community members in St. Petersburg. The situation is aggravated with economic barriers in access to PrEP and condoms as well as the low level of health care culture. Although in general the frequency of condom use and adherence to safe sexual practices remain quite high.

                About the ideal society

Thinking of the ideal society, I always imagine the society, which is understanding and non-judgemental, which does not consider that love between two boys or two girls (and I am not talking about sex here) is a crime; the society where the right of choice is real and is not punished. So if there is a big common problem, especially such as the runaway growth of HIV cases, not only experts should not shed this “uncomfortable” topic, but also people not involved in the epidemic, the decision-makers. I really like the experience of European countries, such as France, Netherlands, Denmark, Sweden and others. They have functioning models of HIV response, where government contribution in the prevention of HIV is significant and covers all the key populations. They have a clear understanding that HIV infection is a socially significant disease, so it should be addressed in coordination with other social problems both in the general population and in the key populations.

                About community engagement

It is an undeniable fact that working with communities with the engagement of communities is most effective. In this regard, the equality principle is key not only in terms of HIV status but also in terms of different key populations. People know what they need because they see the problem from the inside, they realize what their own needs are. Unfortunately, there are no or almost no activities for MSM/LGBT community to develop the capacity of this community and strengthen its positions in the society in response the high prevalence of HIV. There are both social and legal reasons for it. However, we are sure that we should not give up as there are still many things to be done as there are many more MSM/LGBT in our city than 10.5 thousand among five million of St. Petersburg residents (which is the official statistics data presented by the City Health Committee as of the beginning of 2020).

 

The project is supported by the Elton John AIDS Foundation and Aidsfonds.

Don’t blame your status

Reasoning on HIV from Aida, a 13-year-old participant of the project “Mobilization of Adolescents and Young People Living with HIV through Implementing the TEENERGIZER Model in Kazakhstan”. 

Why do you speak openly about your status?

Because I am not afraid of criticism and discrimination from society.

What is HIV for you?

HIV is a human immune virus, nothing more.

What did you feel when you found out about your status?

I was a child, I didn’t get the point of my dialogue with mom. She just told me that I have a virus in my blood. She has the same virus, so we take pills to suppress it.

Your relationships with society

It’s nice! People around me are very accept my status, they see me as a normal person. My close friends in class reacted calmly too. I used to have a fear that my friends would turn their backs on me, but that didn’t happen.

What helped you to overcome that fear?

Teenergizer. Experience with the Teenergizer showed me that most of my fears are an illusion that my imagination draws. Also, this project gave me a lot of familiarity with teenagers with HIV status and the understanding that we are all different and have different points of view about the disease.

Why is it important not to be pessimistic?

By putting your hands down, you deprive yourself of the chance to know if you had the slightest chance of winning.

What would you say to all other teenagers with HIV?

Be happy, because everything depends on your character. Don’t blame your status.

 

 

No One Can Stop Young People Now!

“I thought I’m the only one on this planet, a special child with HIV who takes pills, but it turned out there are many of us. Now I have a lot of friends, with whom I can openly talk about HIV…” This extract from a story of the project “Mobilization of Adolescents and Young People Living with HIV through Implementing the TEENERGIZER Model in Kazakhstan” was cited by Lyudmila Polyakova, Project Coordinator and Executive Director of Peer-to-Peer Plus NGO.

She applied to the Emergency Support Fund for Key Populations in EECA to get financial support for this project and was able to bring together dozens of youngsters with HIV in Kazakhstan!

Lyudmila, what are the special considerations one needs to take into account when working with adolescents living with HIV?

When working with an adolescent living with HIV, it is important to understand how the teenager sees his diagnosis, what he feels about it and if he needs help. He should be explained that it is critical to take the therapy and shown with a personal example that HIV status does not affect the quality of life, teenagers’ self-esteem and the achievement of their goals. It is vital to form a life-affirming scenario and support such adolescents in shaping their personalities. However, the most important thing is to create a team of 2-4 adequately informed adolescents, who will be sharing their experience and providing peer-to-peer consultations to other, less informed young boys and girls.

How did you realize it was necessary to start the project “Mobilization of Adolescents and Young People Living with HIV through Implementing the TEENERGIZER Model in Kazakhstan”?

We often organized various events for teenagers within the projects of our Peer-to-Peer Plus NGO. Sometimes they met each other but were not really close. In spring 2019, the Spring Leadership School was organized, bringing together 80 teenagers from all over Kazakhstan. We invited Danya and Lera, leaders of the Ukraine-based project TEENERGIZER, to be trainers at our school. The participants became real friends, they wanted to continue spending time together and hanging out. They wanted to have TEENERGIZER in their country!  That’s where the idea to mobilize teenagers came from. However, back then we had nothing apart from the willingness to improve the lives of our adolescents and show them that dreams come true. We had some ideas on how to develop the teens community, but they could not be implemented without financial support, so I decided to apply to the Emergency Support Fund for Key Populations in EECA. Our love and commitment to our cause brought us positive results!

How did this grant help you?

Thanks to the funding received from the Emergency Support Fund, we were able to ensure sustainability to the TEENERGIZER movement. We are greatly thankful to AFEW International and the Elton John AIDS Foundation for their support.

At the same time, we received significant technical support – Baurzhan Bayserkin, Director of the Kazakh Scientific Centre of Dermatology and Infectious Diseases, gave us a great office in the centre of the city. Mentorship offered by TEENERGIZER allowed us to bring together 34 adolescents living with HIV and engage with 17 adolescents vulnerable to HIV. We started a messenger chat, where teenagers share information. They also have meetings in our youth centre. We covered over 190 young people and, importantly, 50 teachers of educational facilities with our workshops to prevent HIV and form tolerance to PLWH among students.

How did the young people change?

The changes are unbelievable! Now they have a much higher self-esteem, an experience of public speaking and more confidence when speaking in front of cameras. This project helped us to unite them, form a team and facilitate their growth. When they are together and do something, you can see how they complement one another.

No one can stop young people now! When implementing the project, we allowed teenagers to offer the topics and ideas they were interested in. When they became closer, they were able to build trust and team spirit. It turned out that, apart from HIV, they are interested in many other topics, such as domestic violence, bullying at school, career guidance, prevention of risky behaviours among adolescents and many other things. With their youthful exuberance, they organized theatrical performances against violence, wearing face paint and white clothes, with musical background, at several venues of our city. Besides, they went to Arbat on December 1, 2019, wearing white coats with red ribbons on their chests, asking people questions about HIV, giving them awareness-raising brochures and telling about the routes of transmission and prevention measures.

What do you remember most from your work with young people?

In fact, I have many interesting stories to tell about how we trained our teenagers in street orientation skills, how they organized their first workshop, but the story of one boy raised by his grandmother really thrilled me. We had a new off-site Winter School with some new boys and girls. They all knew about their HIV status, at least from their parents and doctors of the AIDS Centre. During our class, the teenagers were asked if they took ARVs, at what time and how many times a day. So everybody started telling what pills they take and at what time. This boy was so surprised, that it touched me to the heart: “I thought I’m the only one on this planet, a special child with HIV who takes pills, but it turned out there are many of us. Now I have a lot of friends, with whom I can openly talk about HIV. Let’s meet more often.”

What does the society think about your work?

It depends. Older people still have this stereotype in their heads that HIV is the twentieth century plague. As for the young people, they know almost nothing about the disease and its ways of transmission. There are no events organized for youth, if not to count one dull 40-minute lesson. All the knowledge just flies away as soon as the lesson is over. For many years, it was considered a shame to talk about HIV/STI prevention and sex education in our country. Besides, it was seen as a propaganda of sex and risky behaviours. In the recent years, the situation has slightly improved, but even now, when we prepare our proposals, we are asked not to use the word “HIV”, but to wrap it up in some nice packaging.

 

The project is supported by the Elton John AIDS Foundation and Aidsfonds.

ATTENTION! GRANTS!

Emergency Support Fund for Key Populations continues accepting applications for small grants to overcome emergency situations.

Organisations from 10 countries in Eastern Europe and Central Asia can receive grants with a maximum amount of €5,000 per grant.
 
With these small grants AFEW International and Aidsfonds will support organisations representing key populations in overcoming emergency situations which they face due to legal barriers, stigma and discrimination, financial challenges and political restrictions.
Support will be given to organisations carrying out activities that ensure access to HIV prevention, treatment and/or services for key populations, or projects protecting the human rights of key populations. We particularly welcome applications from first-time applicants and applications showing innovative approaches to overcome emergency situations!

“Sex workers – a real power in curbing the HIV epidemic”

“Just imagine – every sex worker has from 3 to 15 clients every day. She works 10 to 30 days a month. There are about 45 thousand of such women in St. Petersburg. If we empower those women with HIV knowledge, skills and rights, each of them can become an “agent of change” for the general population, in particular for the men who use her services,” says Irina Maslova, head of the Silver Rose movement of sex workers and their allies in St. Petersburg.
To continue implementing her project to prevent HIV and STIs among sex workers in St. Petersburg, she applied to the Emergency Support Fund for Key Populations in EECA.

About the scene of sex services
We started our activities in 2012. It was so-called HIV and STI prevention “behind closed doors.” Since then, the scene of sex services has changed greatly not only in St. Petersburg, but also in Russia in general.
For instance, there are more women migrating from the post-Soviet countries as well as from Nigeria. Many of them are engaged in sex work. Besides, there has been a sharp decrease in the prices for sex services, so today girls have to work more to earn their living. Another driver of change was the global crisis, resulting in many women losing their jobs. Today we see many women over 35 years of age who come into sex work. Taking into account all those changes, we realize that there is a high demand for prevention services. As we know, sexual route of HIV transmission is one of the main ones and is currently prevailing over the injecting route of transmission. In the first 6 months of 2019, sexual contacts accounted for 80.4% of new HIV cases registered in St. Petersburg.

About funding
In June 2018, the Global Fund wrapped up its programme in Russia and all the projects among the key populations, including sex workers, were closed. The experience shows that the contacts built throughout the operation of such programmes fail within 2-3 months and the results are lost. I felt it would be a shame to lose everything that the Silver Rose was able to achieve in six years. That is why I started looking for some new sources of funding. I conducted a research study, which showed that thanks to our projects HIV rates among the sex workers in St. Petersburg decreased by 3%. In 2012, this rate was almost 13%, and we were able to bring it down to 10% by 2018. This fact proved the importance of continued efforts, evidence-based approach and peer support both to us and to the government.
Within the project implemented with the help of the Emergency Support Fund for Key Populations in EECA, we were able to maintain evidence-based HIV/STI prevention services for sex workers in St. Petersburg. Moreover, this project served as the basis for launching HIV prevention among sex workers in a number of regions of the Russian Federation – Voronezh, Orenburg, Kaliningrad, Moscow region, Yekaterinburg, Rostov-on-Don, Krasnodar and Perm. In those regions, such activities are funded from the municipal budgets.

About numbers and quality
There are 1,652 people already covered with the services of our project. All quantitative and qualitative indicators were fully performed and even exceeded. Among the clients of the Silver Rose, 1,015 people are migrants, with 72% of them coming from the neighbouring countries and 11% – from the African countries. Three persons tested positive for HIV. Apart from direct HIV prevention services, 1,415 women were tested for HIV, 619 women visited friendly doctors (gynaecologists and STI doctors), and 138 people received legal advice. Besides, 12 people received free post-exposure prophylaxis of HIV within the project implemented in cooperation with the AIDS centre.

About public opinion
So far, not everybody understands that sex workers are a real power in curbing the HIV epidemic. Apart from the fact that this group is understudied and unpopular in terms of funding, it is also the most mobile and unstable.
Nevertheless, gradually we were able to reverse the situation in terms of the negative attitude among government officials to the idea of implementing HIV prevention projects among sex workers. Now health professionals understand that our work is necessary and important. However, criminalization of sex work in Russia still limits the possibilities of receiving support and funding from the government.

About love and safety
Sex workers are eager to use the services of our project. It is important for us to make any person coming to us feel that she or he is accepted and not judged. In our office, we have an atmosphere of love, kindness, and acceptance. It is a safe space. The main barrier for sex worker is the time that they have to spend to come to our office, but we were able to eliminate it by organizing outreach visits “behind closed doors” to the venues, where sex workers provide their services.

The project is supported by the Elton John AIDS Foundation and Aidsfonds.

Help Here and Now

“If you can help someone Here and Now, you should do it without postponing it or thinking what other people can do,” says Ekatherina Rusakova, Director of Sverdlovsk Regional Charitable Organization “Malaxit” supporting people in difficult life situations. “If every one of us helps at least one person, maybe it will drive changes in the society.”

To support these words, Malaxit implements the project “Social and legal support of people who use drugs in Yekaterinburg” with financing and support of the Emergency Support Fund for Key Populations in Eastern Europe and Central Asia (EECA).

Ekaterina how does your organization help people who use drugs in Yekaterinburg?

Ekatherina Rusakova, Director of Sverdlovsk Regional Charitable Organization “Malachite”

Mainly we provide social and legal support to clients to eliminate regulatory and discriminatory barriers, help them to get fair court decisions and access to free rehabilitation. Besides, we provide our clients with referrals to healthcare and social support institutions of the city. Our social worker makes outreach visits to families with small children. He provides consultations on HIV and treatment, helps clients to make appointments with specialists, assists them in re-issuing documents and receiving temporary registration in the city as clients are not able to receive medical or social services without registration.

Why did you decide to apply to the Emergency Support Fund for Key Populations in EECA?

We applied to the Emergency Support Fund because the situation of PUD in our city is difficult. Many people still do not recognize that substance use is a disease. However, this condition needs comprehensive treatment, including medical assistance, psychological and social support. Moreover, efforts should be aimed not only at the person using substances, but also at such person’s family as substance abuse is a systematic, family disease.

Of course, current situation contributes to the growth of HIV and other socially significant diseases (tuberculosis), while people who use drugs remain outsiders and the society prefers not to notice them. However, it is not possible to solve this problem pretending that it does not exist, after all sooner or later it will manifest itself and, most likely, in a very negative way. That is why, in our opinion, enough attention should be paid to secondary prevention and working with the “risk groups”.

What case from your practice do you remember best of all?

Andrey, a representative of the Rehabilitation Center, Dmitriy Kadeikin, consultant, and a social worker of the project, after a lawsuit in Revda, Sverdlovsk Region

That’s a story of one of our clients. Andrey came to our project when he learned about it from his friends. Back then, there was an investigation against him based on part 2 of article 228 of the Russian Criminal Code. Our staff members signed a social support agreement with him, drafted procedural requests and collected all the necessary documents. Social worker of the project acted as a community advocate in court. A person from the rehab also took part in the court hearings. As a result of our joint efforts, Andrey got a suspended sentence with a course of rehabilitation.

What does the society think about your work?

It depends: some people support us, some don’t and it’s fine! All people cannot think the same and have the same “view of the world”. We are all different, with various views, values, attitudes, and that’s the beauty of human beings – in their differences…

Have you ever faced any challenges working with the key populations?

Speaking about the members of key populations, our target groups, they are all positive about our activities, they trust our staff members and our experience. We mostly see challenges related to new psychoactive substances, which our clients still use. That is why they can have unpredicted behaviours, treatment interruptions, etc.

How does engagement of the key populations in your activities help you in your work?

I think that when implementing such projects it is very important to engage members of the key populations. Without such engagement, it is not possible to reach PUD, who are a very closed target group, especially considering that in this group there is a very low level of trust to people.

Your example of a perfect society.

I don’t think I could give you an example of a perfect society. I tend to be realistic when looking at things, not losing myself to illusions. I do not like it when people say that somewhere there is a perfect country and a perfect society, where everything is fine, which we should strive to achieve. There are some pitfalls everywhere. It is important to realize that there are good things everywhere and we need to learn to notice and appreciate them. I am sure that we have to always start with ourselves and you can of course feel offended and be angry at our country and our authorities, but it does not bring any results. Speaking about a specific country with the approach to working with key populations that I like, for me it’s Portugal.

The project is supported by the Elton John AIDS Foundation and Aidsfonds.