How to help migrants?

According to UNAIDS (www.unaids.org)[1], Russia has the second highest number of labour migrants in the world after the USA. Rostov region is one of the areas where this number is constantly growing. One of the reasons is its geographical position – Rostov region has the biggest borderline with Ukraine. Due to this fact as well as certain developments related to the armed conflict in Donetsk and Lugansk regions, many migrants from Ukraine with different statuses are coming to Rostov region, in addition to the labour migrants from Central Asia.

Are there any special services for migrants in Rostov-on-Don? How is HIV prevention implemented among migrants? Where can migrants seek help without endangering themselves? AFEW International asked these questions to Vyacheslav Tsunik, President of Rostov-on-Don Regional NGO “KOVCHEG – AntiAIDS” and Manager of the Project “HIV Prevention and HIV Services for Migrants in Rostov-on-Don”.

Significant financial support to carry out surveys and provide services to migrants within this project was provided by AFEW International, which, in particular, facilitated coordination with the Central Asian organisations to provide effective support to migrants when they leave their countries of origin and come to Russia.

For reference

Labour migrants are one of the populations most vulnerable to HIV in the world, which is explained by a number of factors. The data of numerous studies show that people coming from the Central Asia have a very low knowledge of infectious diseases: HIV/AIDS, hepatitis B and C. The situation is further aggravated with the low social and economic status of the migrants from Central Asia and the neighbouring countries, lack of access to health services, low level of social support and high prevalence of depression caused by such people living away from their families. High isolation of this social group often leads to HIV transmission inside this community, in particular through contacts with female sex workers, who come from the same countries.

Vyacheslav, how accessible is health care for the labour migrants in Rostov-on-Don?

Health care is provided to the labour migrants who officially live in Russia, in particular in Rostov region, based on their insurance certificates, which they buy when registering their patents. Without certificates, people can access health care on a paid basis, while emergency care if a person’s life is under threat in cases of heart attacks, strokes, catastrophes or accidents is provided to everyone, even with no documents, free of charge and is covered by the state.

How well informed are labour migrants about the problem of HIV?

Surveys among the labour migrants showed that they are not well informed about HIV. In our opinion, the reason is lack of preventive information provided to them in educational institutions in their home countries and when they come to work in Russia.

Do migrants practice any risky behaviours?

In fact, the prevalence of risky behaviours among migrants is approximately the same as among all young people. If we talk about the migrants who come from Asia, e.g. from Tajikistan and Uzbekistan, they have less risky behaviour due to their national customs and traditions. They mostly socialize with their fellow countrymen and they also have respect to older people and certain traditions, which restrict their risky behaviours. As for people from Ukraine and Moldova, they are closer to us, Russians, in terms of their culture and so the situation among them is similar to ours. There are young people who practice high-risk behaviour in terms of HIV. Mainly, they represent key populations. Their share in the total number of migrants is not so big, but they exist and some of them are clients of our organisation. They are not ready to quit their behaviour models.

Are there any differences in the behaviours of HIV-positive and HIV-negative migrants?

There is really a difference in the behaviours of migrants with HIV and those who do not have HIV.

Migrants living with HIV are a closed group. They are not ready to talk about their disease with their family members or their countrymen. Usually, they seek help in HIV organisations only in life-threatening situations or sometimes when they need to stock up their ARVs if there is a danger of treatment interruption.

In Russia, if migrants test positive for HIV, they cannot access free antiretroviral (ARV) therapy as they are foreign citizens. How is this issue resolved?

The situation with supply of ARVs is regulated by relevant provisions. In Russia, government covers ARV therapy only for the citizens. That is why migrants are not able to access free treatment as they are not Russian citizens. However, our organisation has contacts with community organisations in a number of neighbouring countries. We can help people who come to us and assist them is getting support services and ARVs from the countries of their origin.

Currently you are implementing the project “HIV Prevention and HIV Services for Migrants in Rostov-on-Don”. Please tell us more about it.

The goal of our project is to slow down the transmission of HIV through raising the awareness of HIV among migrants and creating services aimed at HIV prevention in migrant populations.

What do we do? Firstly, we train peer consultants from among migrants. Secondly, we provide medical and social support to HIV-positive migrants, giving them access to health services. Thirdly, we have meetings and negotiations with the representatives of diasporas concerning implementation of the prevention tools among migrants in Rostov region and coordinate service provision with the NGOs in the countries of origin of those people who seek our help.

Our organisation, “KOVCHEG – AntiAIDS”, is a community-based organisation of people living with HIV, representatives of vulnerable populations, PLWH, sex workers, LGBT and migrants. For instance, with our current project we trained a peer consultant from the migrant community. This is a woman from Ukraine living with HIV. Another peer consultant that we have, who works with people who use drugs, is also a citizen of Ukraine. Besides, when we carried out a survey among migrants, we had a volunteer supporting us – Ravshan from Uzbekistan – who is a student of a university in Rostov region.

Within the project for migrants, we organized the process to deliver HIV services. In particular, we have rapid testing, pre- and post-test counselling, if necessary provision of ARVs from our reserve stock, medical assays and support in receiving consultations from infectious disease doctors, tests for immune status and viral load, prescription of medications and treatment monitoring. We also inform migrants about the existing legal opportunities to acquire Russian citizenship with HIV status and facilitate people with HIV in obtaining temporary residence permits and Russian citizenship.

How and where do you share information about the services available?

Migrants can access our informational leaflets in the places, which they visit, such as the migration departments, health institutions, which issue the required health certificates to them, pre-deportation detention centres, and higher educational institutions we cooperate with. We use QR codes, allowing migrants to download any information on their smartphones and use it when necessary. As a result, it brings clients to our consultants, who can provide them with any additional information needed.

Name one of your most important recent activities?

Recently, we appealed to the Public Monitoring Commission and asked it to help us access the migrants in pre-deportation detention centres. The Public Monitoring Commission sent an official request to the Ministry of Internal Affairs. We visited the detention centres, met with the migrants living with HIV who stayed there and agreed with the administration of such centres that we would have further access to such migrants living with HIV. We are planning to seek financial opportunities for people living with HIV to receive consultations from infectious disease doctors, get tested for their immune status and viral load and access ARVs for the period of their stay in such institutions. Besides, we are working on developing an appeal to the government officials about the need to provide this category of people with HIV treatment at the expense of the state.

[1]Migrant populations and HIV/AIDS: the development and implementation of programmes: theory, methodology and practice / UNAIDS, UNESCO.

Prospects for cooperation in the health sector in Uzbekistan

On January 10, 2020, AFEW International, represented by Anke van Dam, Executive Director, and Daria Alexeeva, Program Director, met with Ambassador of Uzbekistan in Benelux countries Dilier Hakimov.

AFEW International is considering possibilities to implement two projects in Uzbekistan. The first one is to develop and improve the quality of HIV testing and prevention services for key populations and support people living with HIV.

The second project, entitled “Strengthening civil society in inclusive health care in Uzbekistan”, is currently under consideration by the European Commission and is on the reserve list of projects.

At the end of the meeting, the parties agreed on a schedule for the AFEW International delegation to visit Tashkent on 15-16 January 2020. AFEW International’s team will have negotiations with the Republican AIDS Center, as well as with representatives of some international organizations, which may act as donors for the implementation of projects of the non-governmental organization in Uzbekistan.

AFEW International already has experience in working in Uzbekistan: the organization supported several projects in the country through ESF, as well as was involved in preparations for the AIDS2018 conference. In addition, representatives from Uzbekistan participated in AFEW International’s community based research education project.

AFEW on AIDS 2018: Session ‘AFEW Network’s experience in strengthening community, Monitoring and involvement in service delivery: From grassroot to policy level’

What: Session ‘AFEW Network’s experience in strengthening community, Monitoring and involvement in service delivery: From grassroot to policy level’

Where: Global Village, Eastern Europe and Central Asian Networking zone

When: July 25, 2018/16:00-17:30

Important to know: Session will be in Russian, translation to English will be provided.

This session, organized by AFEW Network, will offer an opportunity to share experience in strengthening community monitoring and involvement in service delivery: from grassroot to policy level.

During the session we will talk about creating an enabling environment by building the bridge between service beneficiaries, services, policies and successful experiences in meaningful involvement of our service beneficiaries and building strong collaborations between communities of key populations and the public system.

Through exchange and panel discussion we aim to:

  • Demonstrate the double win (for both the public system AND the communities served) when communities and service beneficiaries are involved in service delivery and policy making;
  • Share strategies and best practices from the AFEW network members that use innovative methods of information through online media that hands bigger autonomy to the service beneficiaries;
  • Share strategies and best practices to form mechanisms of community monitoring.

This session is prepared and presented in the framework of the program ‘Bridging the Gaps: health and rights for Key populations’, through the regional EECA approach by AFEW International and AFEW Network.

Agenda

3 Session of 30 min each to share and discuss experiences.

Session 1: ‘Meaningful involvement of service beneficiaries in planning, designing and monitoring of services’ experiences within the AFEW Network

  1. Creation key populations’ advisory councils in Tajikistan: Dilshod Pulatov, project manager, AFEW-Tajikistan
  2. Involving adolescents in service delivery and monitoring of services in Ukraine: Daria Kopiyevska, activist, NGO “Return to Life”, Kropyvnitsky, Ukraine
  3. Initiative groups in the provincial steering committee of Kakheti region in Georgia: Davit Kazaishvili, Public Union “Bemoni”, Georgia
  4. Supporting community steered service delivery by key populations in Kazakhstan: Roman Dudnik, Executive director AFEW Kazakhstan, Rosa Oleynikova,  Director NGO “Doverie Plus”, Sergey Schetnikov,  NGO “Answer”
  5. Discussion

 

Session 2: ‘Building equal access to prevention, treatment and care for HIV’, experiences within the AFEW Network

  1. New digital approaches to support adherence to treatment in Kazakhstan: Yagdar Turekhanov, Program technical advisor, AFEW Kazakhstan
  2. On-line consultations in Tajikistan: Zarina Davlyatova, Project specialist of AFEW-Tajikistan
  3. Interactive prevention methods for working with young drug users in Ukraine: Aleksander Mohylka, NGO “Blago”, Kharkiv, Ukraine
  4. Discussion

 

Session 3: ‘Building bridges, connecting people’, experiences within the AFEW Network

  1. Community-based participatory research: Daria Alexeeva, project manager, AFEW international       
  2. Сoordination mechanisms on HIV in Kyrgyzstan: Ulan Kadyrbekov, Director, Republican AIDS center, Kyrgyzstan
  3. Key populations platform in Ukraine: Vielta Parkhomenko, Club Eney, Kyiv, Steering Committee of the Country Key Populations Platform
  4. Discussion and closing of the session

Communities in Kyrgyzstan Explore their Needs for the First Time

Community research provides an opportunity to objectively assess the existing services. Focus group in the office of Ulukman Dariger NGO in Issyk-Kul area

Author: Olga Ochneva, Kyrgyzstan

Sex workers over the age of 30 desperately need employment; women living with HIV have a need for women’s dormitories – these are the preliminary conclusions of two different studies conducted in Kyrgyzstan. The complete results of the needs’ assessment and HIV prevention programs in the country will be presented at the 22nd International AIDS Conference (AIDS 2018). The research is conducted by these communities for the first time. AFEW International provided this opportunity for key populations in Kyrgyzstan and other countries of East Europe and Central Asia (EECA) within the Small Grants Program.

New and unexpected discoveries

International AIDS Conference is a platform for the community to express their voices. Currently, community organizations from the EECA countries supported by AFEW International are carrying out the research, the results of which will be presented at the International AIDS Conference in July 2018 in Amsterdam. There are two research teams in Kyrgyzstan.

“Our organization has wanted to conduct a similar assessment for a long time. This is the first full-scale study among sex workers in the country,” Ulan Tursunbayev, the director of Ulukman Dariger NGO says. His organization assesses the effectiveness of HIV/AIDS prevention program with the help of the sex-workers themselves. “The preparation of the research and data collection took us four months. We traveled the country – four people, two of which being consultants. First, we tested our questions in mini sessions, so that they were clear to the community members and could open them up for the dialog.”

Another organization from Kyrgyzstan – PF Prosvet – conducts research work among women living with HIV. They study the impact of HIV-positive status on women’s lives.

“Community representatives are the main executors of the project,” Margarita Sabirova, a psychologist at Prosvet is saying. AFEW International has provided all training opportunities: trainings, online modules, technical expert support. Community education has become one of the most important and long-lasting pre-research phases. Nowadays, they possess new knowledge and skills, and we have honest and frank research data.”

Data mining has been conducted since April, and the final reports are being currently prepared. It has already become clear that the research contains new and unexpected discoveries.

“It was really interesting to see how the needs of sex workers differ before and after they turn 30,” Ulan Tusunbaev says. “They even sat apart from each other during the focus group meetings. Young women said they had enough condom supplies from prevention projects, outreach work and legal assistance. Older sex workers wanted to change the area of work and asked for the assistance with this.”

Many said that they rather would not provide sex services for the rest of their lives, and wanted to start building their future then.

“In course of my work, I was able to buy some land where I am starting to build a house, and where I will then open a store. I have already prepared the materials for construction,” says one of the interviewees of the research. “I hope this store will help me and my child when I will no longer do sex-work. Therefore, it is good to have some skills training programs available. After all, we have all been working here for 5-8 years and have no education. In order to engage in something different, we would need additional skills.”

The South and North have different needs

Women with HIV: “We need special support.” The head of Public Foundation Prosvet conducts a focus group in Bishkek

Employment is also one of the most important problems for women living with HIV. According to the representative of PF Prosvet, women say that many of them have no spouses and thus they need to take care about their own financial well-being. Some of them are the only ones who financially support their children. Employers often unreasonably demand HIV and medical examination and refuse employment.

“Thanks to the research, we are sure now that the services need to be divided according to the needs of a certain group,” Margarita Sabirova shares. “We have not only identified the priority needs, but also clearly noticed the difference in the set services needed in the North and South of the country. For instance, people in the South need social support, while people in the North of the country are more socialized clients who have different needs.”

The next phase in the Small Grant Program by AFEW International is the training on how to write abstracts (thesis) for organizations in preparation for AIDS 2018 and teaching them how to present their research results.

“The lack of gender approaches in the provision of services and the specifics of different areas of the country often limit access to the health care, legal, social, and psychological support. We hope that the presentation on the results of our study during AIDS2018 will encourage participants from other countries to pay attention to this problem in their own part of the country,” Margarita Sabirova is saying. “The research has identified a number of specific service needs for women, which are not met now either fully or partially. We hope that funds will be available to finance this unmet need. We have many recommendations in our report, and these will help to improve existing services. In any case, as an organization, in whom the community trusts, we should express community needs to the government, donor and non-governmental organizations.”

Communities will be Educated how to Analyse Data and how to Act

Two new modules for the program community-based participant research CBPR [e] Education that is supporting and strengthening the research capacity of organizations acting on behalf of and representing the interests of communities in Eastern Europe and Central Asia (EECA) are released online today.

The program consists of the number of activities, including training for community-based participatory research, small grants program, workshop on dissemination and abstract writing and workshop on presenting research findings on AIDS2018 Conference.

AFEW International gives program participants the opportunity to take part in online e-learning modules for further development of their research skills. The modules are also available for others who are interested in community-based participatory research. Course that costs 75 euros, includes 7 modules on the preparation and conduct of community-based participatory research.

The first module announced today is Data Analysis. Analyzing data is necessary to make sense of the outcomes of the study and to answer the research questions. Analyzing data will help working towards a way of representing the data to a larger public.

The second module is called Bringing about social change: translating knowledge into action. After the data is collected and analyzed, the participant is ready to write the reports and to disseminate the results to others. It is the time now to determine how the participant can bring social change that will benefit the community. The evaluation of the research will be also discussed in this module.

Later on, everyone will be able to participate in the webinar on data analysis, which will be held in late spring or summer of 2017.

Community-based Participatory Researches are Starting

IMG_114226 applications out of 44 were selected in the small grants programme to support community-based participatory research (CBPR) projects in Eastern Europe and Central-Asia (EECA) region. The small grants fund is part of a wider programme to build the research capacity of community based organisations in EECA region and increase meaningful participation of the region at the AIDS2018.  The Dutch Ministry of Foreign Affairs provides financial support to the programme.

The supported applicants are from 10 countries of the EECA region: Ukraine, Tajikistan, Kyrgyzstan, Kazakhstan, Moldova, Belarus, Armenia, and Uzbekistan. They represent the following target groups: people who use drugs, people who live with HIV, sex workers, HIV positive women, MSM, transgender people, prisoners, and LGBT.

The total grant fund for the proposals is €230,000. “Previously we announced that the fund was €120,000, but we managed to get more funding and that is how we can afford implementing more projects,” project manager Aids2018EECA in AFEW International Daria Alexeeva is saying.

The grant winners will soon start to implement their researches in their countries. It is expected to have the results of the CBPR in the fall of 2017.

AFEW Announces Online E-Learning Program

cbpr-engAFEW International is starting the program that is supporting and strengthening the research capacity of organizations acting on behalf of and representing the interests of communities in Eastern Europe and Central Asia (EECA.) The purpose of the program is to increase region’s participation in AIDS2018 conference in Amsterdam. The financial support is provided by the Ministry of Foreign Affairs of the Netherlands.

The program consists of the number of activities, including training for community-based participatory research, small grants program, workshop on dissemination and abstract writing and workshop on presenting research findings on AIDS2018 Conference.

AFEW International gives program participants the opportunity to take part in online e-learning modules for further development of their research skills. The modules are also available for others who are interested in community-based participatory research. Course that costs 75 euros, includes 7 modules on the preparation and conduct of community-based participatory research.

In addition, everyone will be able to participate in the webinar on data analysis, which will be held in late spring or summer of 2017. These days, AFEW International is also working on preparation of workshop on dissemination and abstract writing for AIDS2018, which will be held in autumn of 2017. It is supposed to be available to a wider circle of people.

Online application for Community-Based Research training

The-main-square-of-Bishkek675AFEW (International) is organising a community-based research programme. The programme consists of several trainings and a small grants fund for community-based research projects. The programme is meant for communities in Eastern Europe and Central Asia (EECA) and is aimed to result in the submission of abstracts for the International AIDS Conference 2018, which will be held in Amsterdam.

Please find herewith the link for the application here. If you have more questions about the application, please email us at research@AFEW.nl.

The training will take place in Bishkek, Kyrgyzstan, on 8, 9 and 10 November 2016. This training is the first step in a community-based research programme.

We are looking for motivated participants from the EECA region with a keen interest, some experience, and familiarity with community-based research. We foresee to invite two participants per organisation: one decision maker and one research implementer. The training is free of charge.

Following the training, you will be able to access online training modules to further shape your research skills. On a later level, training participants are expected to fill in an application form for the community-based research fund. This call will be released towards the end of 2016.

We are now accepting applications to attend the training. The deadline for application is Friday 9 September 2016.

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Community-based research: the key population small grants fund AIDS2018

FB AIDS 2018 coverAs the HIV epidemic continues to grow in Eastern Europe and Central Asia, new, more relevant, interventions are needed to address this public health concern. Before such interventions can be implemented, the needs of certain communities at higher risk for HIV, TB and Viral Hepatitis need to be understood. Involving members of key population communities in research gives an opportunity to identify needs that are currently not being met. Community based research captures the actual situation on the ground more clearly and such research can be used as a powerful advocacy tool. By equipping community based organisations and community members with the tools to conduct research and collect data, research capacity will increase, and research results will reflect an inside perspective on needs and priorities.

Fund for community based research

Towards the end of 2016, AIDS Foundation East-West (AFEW) will release a call for proposals for community-based organizations to conduct research to benefit key populations living in Eastern Europe and Central Asia (EECA). The proposals will be assessed by a steering committee. Activities proposed by grantees must contribute knowledge to improving the health of key population groups in EECA. The grantee must be a legally recognized community-based organization registered and operating in EECA. All awarded projects should be completed within 9 months.

Training and Guidance

Training and guidance on how to conduct the community-based research, write abstracts, and present and disseminate findings, will be provided to the grantees. We will be looking for participants with a keen interest, some experience, and familiarity with community based research. A first training, Tools for Change: conducting community based research, is being planned for October/November 2016, followed by a call for proposals, selection, and grant awards.

Monitoring

The awarded research projects will receive guidance and support from the AIDS2018 project team, with some logistical support provided by the AFEW secretariat.  The research report and other relevant materials will be shared via the websites of relevant parties (AFEW, GNP+, EHRN, and others), in other briefings, newsletters, and at meetings and workshops. We anticipate that you submit an abstract to AIDS2018, with the aim of presenting a poster, or an oral presentation.

If you would like to know more about, or be considered for, this unique opportunity to gather knowledge and raise the voice of key populations in research, and at AIDS2018, send us an email at research@AFEW.nl. We will send you the application form on request. Please feel free to get in touch with us with questions or remarks. AFEW is looking forward to implementing this project, with and for you!