Ukrainian Youth Will Tell Everyone about HIV

Yana Panfilova and Dany Stolbunov from the Ukrainian organization Teenergizer! will perform on 21 July in CREA Theater, Amsterdam. The performance will take place within AIDS 2018 Conference.

The documentary theatre play ‘Don’t Tell Anyone’ aims to draw attention to the issues and stigma which HIV+ teenagers in Ukraine are facing. The performance is a story about two adolescents who are looking for the answers to their questions: “What does it mean to be born with HIV in Ukraine?”, “What do children feel when they have to hide their diagnosis because of the fear to be judged and isolated?”. The documentary theater performance will make the audience feel how it is to live with HIV in Eastern Europe and Central Asia (EECA), and why it is important to let voices of young people living with HIV from EECA be heard at the global level.

Teenergizer! is an organization created by adolescents for adolescents. The organisation creates world where every teenager can realize full potential; world free of discrimination in all areas, including live with HIV; world in which the rights of all young people are fully respected. AFEW is a unique network of organisations working in EECA for 16 years to improve health of people living with HIV, people using drugs, men who have sex with men, LGBTQI, sex-workers, prisoners, and youth at risk for HIV.

Date and time: 21 July, 15:00

Location: CREA, Nieuwe Achtergracht 170, 1018 WV Amsterdam https://goo.gl/maps/ZtDnCLvbwuF2

Language: Russian (English subtitles and translation during the discussion)

Facebook event: https://www.facebook.com/events/408902859584252/

Free entrance

Chase the virus, not the people! Campaign at AIDS 2018

Eastern Europe and Central Asia (EECA) remains the only region in the world where new HIV cases and AIDS deaths continue to grow rapidly. Low access to treatment, repressive legislation, stigma and discrimination of key populations, as well as the unwillingness of states to finance and ensure the sustainability of prevention programs in the EECA region, hinder an effective response to the epidemic.

The response to HIV in Eastern Europe and Central Asia will only be successful if decriminalization, destigmatization, zero discrimination and demedicalization are recognized as key needs of the communities. These aspects require comprehensive support from the global community, enhanced partnerships and immediate action by all stakeholders.

One of the AIDS 2018 objectives is to spotlight the state of the epidemic and the HIV response in Eastern Europe and Central Asia. It’s the right time and place to attract the attention of the whole world to the region and communities’ actions and to support them.

Therefore we, the team of regional community networks*, are joining forces in the campaign at AIDS 2018. Our slogan – Chase the virus, not people! Our goal is to present to the world the impact of repressive, discriminatory laws and practices of their application, as well as stigma against key populations and people living with HIV. To achieve obligations to create an enabling legal environment and to involve key populations and people living with HIV in decision-making processes. We are ready to show the negative consequences of the reduction in international support and to seek global assistance to mobilize resources for stabilizing the HIV/AIDS epidemic in the EECA region.

“Chase the virus, not people!” campaign aims at the common needs of all key populations and focuses on achieving the goals in general and for each community in particular.

The campaign key attribute is handcuffs, as a symbol of limited freedom and actions.

Support the campaign and the EECA region at AIDS 2018 and join its actions!

 How to support and join the campaign:

– insert the logo of our campaign into one of the slides of your presentation at the conference;

– bring handcuffs and put them on during the campaign events (number of handcuffs from organizers is limited);

– join the campaign during the March, the opening of the Global Village, the opening/closing sessions, plenaries on July 24 and 26, and the activities in EECA Networking Zone in the Global Village (pavilion 515);

– support flash mob – every day (time will be announced) in different parts of the Global Village;

– take a picture in handcuffs at the conference and place a photo with the hashtag of the campaign in social networks:

#chasethevirus

#chasevirus

#chasethevirusnotpeople

#chasevirusnotpeople.

Check the schedule of the campaign events and activities at www.chasevirus.org starting from July 7, 2018.

It’s time for joint actions!

*EECA communities team: Eurasian Coalition on Male Health (ECOM), East Europe and Central Asia Union of People Living with HIV (ECUO), EECA Sex Workers’ Alliance, Eurasian Harm Reduction Association (EHRA), Eurasian Network of People Who Use Drugs (ENPUD), Eurasian Union of Adolescents and Youth “Teenergizer”, Eurasian Women’s Network on AIDS (EWNA), Sex Workers’ Rights Advocacy Network (SWAN). Organizational partner – AFEW International (the Netherlands).

 

 

Sex-Workers in Russia – for Effective HIV Prevention

In 2015, the Sex-Workers’ Rights Advocacy Network in Central and Eastern Europe and Central Asia (SWAN) conducted a study ‘Failures of Justice’

Author: Anastasia Petrova, Russia

Sex-workers are one of the groups that are vulnerable to HIV. There are no government programs aimed at working with this category in Russia. According to Russian Federal Consumer Rights Protection and Human Health Control Service, over the past two years the way of sexual transmission of HIV has become more prominent: in 50.3% of instances, the positive status was received during heterosexual contacts. According to a study conducted by the Open Health Institute in 2017, the percentage of sex workers with HIV varies from 1.3% to 8.9%, depending on the region. In cases when sex work is combined with drug use, up to 15% of people become HIV-positive.

Epidemic of Violence

Sex-workers are vulnerable to HIV for a number of reasons. They have limited access to medical, legal and social services, information and prevention means. However, the most significant factor is violence from partners, clients, administrators, and police officers.

In 2015, the Sex-Workers’ Rights Advocacy Network in Central and Eastern Europe and Central Asia (SWAN) conducted a study ‘Failures of Justice’. The community on its own studied violence against sex workers. The study showed that 28% of girls in Russia were physically abused, and 4.8% – sexually abused by the police.

According to the study, the above statistics directly correlate with the HIV incidence rate among sex workers. Persecution by the police deprives sex workers of the opportunity to work in safe conditions, choose clients, or use condoms at every contact.

Unique HIV prevention project

Involving community representatives in the project work is the basis for effective prevention. In addition to highlighting services of prevention of HIV and sexually transmitted infections (STIs), a lot of emphasis is placed on strengthening the community and increasing the legal literacy of sex workers

The Silver Rose, a movement of sex workers and their supporters, has been fighting against violence since 2003. Today, the movement unites 450 sex worker leaders in more than 35 regions of the Russian Federation. Under the guidance of the leader Irina Maslova, the Silver Rose, using their own resources, are implementing a unique for Russia HIV prevention project aimed at this key group. The girls are provided with condoms, referrals to trusted doctors, and psychological and legal assistance; they are taught how to protect themselves from HIV and violence.

For instance, during March – December 2017, the Silver Rose implemented on its own the project ‘Bridging the Gaps’ in the framework of the Program on Expanding Access of Vulnerable Groups to HIV/AIDS Prevention, Treatment and Support Services in the Russian Federation. 1509 people were tested for HIV in the course of the 9 months’ work.

Involving community representatives in the project work is the basis for effective prevention. In addition to highlighting services of prevention of HIV and sexually transmitted infections (STIs), a lot of emphasis is placed on strengthening the community and increasing the legal literacy of sex workers. Girls must learn to defend themselves in the face of a constant threat of violence.

“Now this is not a project any more, but a program instead,” says Irina Maslova, referring to the continuity with which the movement helps sex workers. “These processes continue, even if funding ends. Now, at the completion of projects supported with grants of the Global Fund to Fight AIDS, we are thinking about the transition to self-financing.”

Current Legislation Does Not Solve Problems

As of today, the legislation of the Russian Federation triggers and promotes discrimination of sex workers as well as human rights violations. Sex work is punished under administrative and criminal codes. The Code on Administrative Offenses prohibits “Prostitution” (Article 6.11) and “Receiving income from prostitution if this income is associated with another person’s prostitution activity” (Article 6.12).

However, this discriminatory legislation poses more problems than it solves since it deprives sex workers of fundamental rights and freedoms, including freedom of assembly on issues of healthcare and HIV prevention. Sex workers remain vulnerable to humiliation and violence from clients, as well as to abuse from the police.

For this very reason, introducing amendments to the legislation and repeal of Article 6.11 have long been the main goal of the work of the Silver Rose movement in general and Irina Maslova in particular. After all, the repeal of the mentioned article, according to experts, will promote the observance of the rights of sex workers since they will not be afraid to turn to the police for help in cases of maltreatment or violence from clients. Decriminalization will also help sex workers self-organise to protect their rights, health and life.

Vladimir Kurpita: “Dnipro Will Become the Third City in Ukraine to Join the Fast-Track Cities Initiative”

Vladimir Kurpita thinks that the Fast-Track Cities initiative allows drawing public attention and raising additional funding for the HIV response

Author: Yana Kazmirenko, Ukraine

To learn about the benefits for the Ukrainian cities joining the Fast-Track Cities initiative and about the expectations from AIDS 2018 conference to be held in Amsterdam, read the interview with Vladimir Kurpita, Head of the Public Health Centre of the Ministry of Health of Ukraine. According to him, though Ukraine is one of the leading countries in terms of the number of people living with HIV, the government does its best to cover such people with treatment.

– What successes and challenges of Ukraine related to HIV response will be presented at the XXII International AIDS Conference in Amsterdam (AIDS 2018)?

– Today Ukraine is the second country in the European region with the biggest number of people living with HIV. Only Russia is ahead of us. In our country, there are over 230 thousand people living with HIV, while 146 thousand have been diagnosed with HIV and receive care. The HIV epidemic in Ukraine is a problem of big cities, industrial metropolises and is still concentrated in the key populations (people who inject drugs, men who have sex with men, sex workers). The issue of HIV is in the focus of attention in our country. Currently, the seventh national HIV programme is implemented, which is a result of the effective cooperation among the international partners, governmental agencies, and civil society organizations. The governmental policies may be illustrated with the fact that Ukraine is one of the few post-Soviet countries where prevention programmes, in particular, the opioid substitution treatment programme, are funded from the national and local state budgets.

The issue of detecting new HIV patients who are not aware of their diagnosis is on our agenda. In particular, we change the testing algorithms and are ready to intensively promote self-testing. A significant achievement is the fact that people already know that they can live with HIV.

 – Today, over 90 thousand people receive HIV treatment in Ukraine, and it is expected that this coverage will be increased to 196 thousand people by 2020. What will help to make it happen?

– As of 1 April 2018, over 98 thousand people received HIV treatment in Ukraine. We are actively scaling up access to treatment. Currently, the therapy is offered in more than 300 healthcare institutions and in 100 places of confinement. In 2014-2016, there were certain problems with access to antiretroviral treatment at the local level, but now the situation has been improved.

Ukrainian patients have access to innovative drugs. Besides, the cost of treatment is reduced through the use of generic drugs. Today, the average cost of treatment course is less than USD 200 a year. Now the treatment is easier both for the doctor and the patient. If the treatment is initiated on time, one pill a day will be enough.

The healthcare reform in Ukraine stipulates that testing and prescription of the first treatment scheme may be provided by the family doctor or the general practitioner. Of course, such changes require some time. There is a need to overcome fears and concerns from the side of patients and improve the level of knowledge and expertise among doctors. However, without changing the existing standards we will not be able to provide treatment to such high number of patients.

– The WHO guidelines state that to control the HIV/AIDS epidemic among people who inject drugs, 20 thousand people should receive opioid substitution therapy. Now there are 11 thousand people who receive such therapy in Ukraine…

– Opioid substitution treatment (OST) is the most effective method to prevent HIV among people who inject opioid drugs. In the recent several years, Ukraine made a big progress in scaling up the OST programmes: approaches in the government policies were changes, the number of healthcare institutions offering such treatment was increased, and we were the first in our region who started providing OST using the state budget funds. However, OST is still a high-threshold treatment method as only narcologists may prescribe it and to be prescribed with the therapy one needs to be registered with drug treatment facilities. The patients are concerned about their security and confidentiality, they are afraid that their data may be given to law enforcement bodies. Besides, it should be mentioned that OST is a therapy to treat opioid dependence. Changing drug scene, with the growing use of stimulants, salts and other synthetic drugs, requires application of other methods in addition to methadone and buprenorphine. That is why the goal of the state policy is not to increase the number of patients, but to provide access to OST to all patients who need such therapy and are eligible.

Currently, together with our colleagues from the National Police, the Ministry of Justice, the Ministry of Health, civil society and international organizations we work to change the approaches and implement innovative models to scale up OST (e.g., in places of confinement) and study the experience of pilot projects in some regions of our country, where OST programmes are managed by family doctors.

 – In Ukraine, Kyiv and Odesa joined the Fast-Track Cities initiative to accelerate the AIDS response. Have they achieved any results?

– The Fast-Track Cities initiative allows drawing public attention and raising additional funding for the programme. When the mayor of Kyiv, Vitali Klitschko, is talking about the response to the HIV epidemic, people trust him, they seek care, get tested, start treatment, and thus the municipal authorities are able to control the epidemic. It is also important that both in Kyiv and in Odesa the local authorities approved new plans and objectives for the municipal AIDS programmes and allocated additional funding from the municipal budgets. Besides, participation in this initiative allowed attracting additional funding from the international donors.

 – What other Ukrainian cities are going to join the initiative?

– Hopefully, the next city to join the initiative will be Dnipro (former Dnipropetrovsk – author’s note). Dnipropetrovsk region is already leading in terms of the number of patients who receive treatment. In the region, there are 15 thousand people who are on treatment, which is 1/6 of all the patients in Ukraine.

Expert: Polygamy Increases the Risk of the HIV Spread in Tajikistan

Author: Nargis Khamrabaeva, Tajikistan

Polygamy is one of the main factors contributing to the rapid spread of HIV in Tajikistan. This is stated in the research of the Tajik network of women living with HIV. In 2018, this network in cooperation with the public fund Your Choice conducted a review of the legal environment in relation to HIV.

Protection of rights regardless of the status

In Tajikistan, polygamy is officially prohibited and is punishable by a fine of two years of correctional labour. However, as the religious influence on the society increases, many men have several wives. The second and subsequent marriages are not registered but are consecrated by a mullah and normally wives do not live in one house.

“The committee on the elimination of discrimination against women called on Tajikistan to ensure the protection of women’s rights in existing polygamous and religious marriages regardless of their registration status,” says Larisa Aleksandrova who represents the public fund Your Choice and acts as a gender and legal consultant of the research.

According to the expert, polygamy has negative consequences in relation to HIV. First of all, in sexual relations women in Tajikistan usually do not have the right to make a decision to use condoms. Women are not able to counteract the unsafe pattern of men’s intimate behavior. According to the statistics on HIV, programmes promoting safe sexual behavior and family planning are not successful. They also do not have impact on men and youth.

Undisclosed  information is a threat to unofficial wives

Larisa Aleksandrova says that another problem is that men living with HIV prohibit their wives to go to the hospital for treatment.

Larisa Aleksandrova, representative of the public fund Your Choice, gender and legal consultant of the research

“One of the reasons why men have such behavior is the fear of public disclosure of their HIV status. Another reason is additional expenses on the treatment of the spouse, who usually is being financially taken care of by the husband. In many cases, such behavior led to the death of women,” tells the expert.

Besides that, polygamous men living with HIV infect all their spouses. During consultations in the AIDS Centre, they often choose not to tell that they have several wives because polygamy is a criminal offence. Therefore, undisclosed information becomes a threat to the lives of unofficial wives. They simply will not know about their status and will not be able to receive the treatment.

“Polygamy is a major risk for the spread of HIV. In 2017, in the town of Nurek a lawyer defended the interests of a woman who contracted HIV from her husband. She demanded compensation for moral and material damage due to the transmission of HIV. The investigation showed that the woman’s husband had a second wife who had died of tuberculosis. After that, according to the Muslim traditions, the man got remarried for the third time. He was seen together with his new spouse in the AIDS Center in Nurek where both of them were receiving antiretroviral therapy. It is possible that the third wife already was HIV-positive as well”, tells Larisa Aleksandrova.

This is not an individual incident. When interviewing women living with HIV, some respondents said that their husbands had second wives, and in most cases, they found out about it when they got to know about their positive HIV status.

 

Mother-to-Child Transmission of HIV in Kyrgyzstan is Minimal

Now about half of the money allocated by Kyrgyzstan for the HIV component goes to the procurement of test kits for pregnant women

Author: Olga Ochneva, Kyrgyzstan

Kyrgyzstan is getting prepared to receive a certificate to confirm elimination of mother-to-child transmission of HIV. In the last five years, over 95% of pregnant women were covered with prevention projects, while the new cases of vertical HIV transmission are now at the level of 2%.

Testing is an integral part of prevention

Since 2007, all pregnant women have been tested for HIV when registered in maternity care. In case of a positive result, the woman is registered with HIV treatment facilities and receives consultations on the need of antiretroviral treatment (ART).

“A good, easy-to-understand consultation leads to the woman giving her voluntary consent to the therapy initiation. There are rare cases when women refuse treatment due to the lack of knowledge or religious beliefs, but most often – due to their self-stigmatization. The share of such refusals is now less than 2%,” says Erkin Tostokov, physician working at the Prevention Unit of the Republican AIDS Centre. “There are some cases when a woman is first seen by the doctor only when she delivers her baby. For such women, we do rapid HIV testing in the maternity clinics and, if HIV is confirmed, we hand out ART drugs right there. We update our clinical protocols in line with the most recent WHO guidelines and train our doctors on a regular basis.”

Children born to HIV-positive mothers go through several stages of examination: early diagnostics to identify if the foetus is infected intra uterine; then within 4-6 weeks doctors have to exclude HIV transmission during the delivery; and the last test allows detecting the HIV status of the infant after the breastfeeding is completed. Children receive preventive ARV therapy depending on their risk level and receive monthly social benefits during the whole period until final confirmation/non-confirmation of the diagnosis (up to 18 months).

Social benefits for children living with HIV

Elena learned that she had HIV in 2011. In a while, the woman found out that she was pregnant. Back then, she was in a difficult situation: no job, no place to live, and no money. The woman felt lost because of her HIV status.

“The doctor prescribed ART and I started taking the pills, though before I refused to take the therapy because of my allergy,” Elena recalls. “When my daughter was born, she received preventive therapy for two months. When my girl was 18 months, the doctors did the last test and took her off the register as she was perfectly healthy. However, I was still scared and took her for HIV testing until she was four years old.”

Now about half of the money allocated by the state for the HIV component goes to the procurement of test kits for pregnant women. The government provides social benefits for children living with HIV and free breast milk substitutes.

“In the recent 7-8 years, our programmes to prevent mother-to-child transmission of HIV achieved a big progress: the share of such transmission was reduced from nine to one percent,” says Aybek Bekbolotov, Deputy Director of the Republican AIDS Centre. “To a great extent, this result was achieved through the efforts of doctors working in general and maternity clinics. Now there is almost no pregnant woman whom we miss. All maternity clinics have been provided with rapid HIV tests and ART drugs. We received a strong support from UNICEF. They provided training to doctors, supported the launch of early diagnostics in newborns and rapid testing in maternity clinics. Now they help us to get prepared to receive the certificate of having eliminated mother-to-child transmission of HIV. A country can get such a certificate provided that the rate of vertical transmission is less than 2% and if over 95% of pregnant women have been covered with prevention programmes in the recent two years. There are certain requirements to indicators and procedures to calculate such data, and now we are working on meeting them.”

Support and training in the summer camp

Currently, there are 478 children with HIV registered in care, 464 of them receive treatment. Every year, summer camps are held for children living with HIV with UNICEF support. This year, this event will be brought to the international level for the first time.

“In July, there will be a one-week summer camp for children, parents, doctors and social workers from Kyrgyzstan, Kazakhstan, Tajikistan, Uzbekistan, and Turkmenistan. There will be trainers from the UK, Ukraine, Russia, Germany, Spain, the Netherlands, and Italy,” tells Aybek Bekbolotov. “The camp will include several parallel events: a forum for adolescents living with HIV and their parents, workshop for pediatric medical staff and training for psychologists and social workers.”

Medical and social workers will be trained to work with children living with HIV, while children and their parents will develop support and leadership skills and are expected to form a new community.

AFEW’s Statement: Do not Abandon the HIV-Fighters in Russia

It is urgently needed to continue working in Russia on the prevention and treatment of HIV. Now that the health situation in Russia is becoming critical, solidarity with the Russians and Russian non-governmental organizations (NGOs) is more necessary than ever. Policymakers, international donors and aid organizations must focus on what is still possible to combat HIV.

One million HIV infections

Russia has the highest number of new HIV infections in Eastern Europe and Central Asia. In January 2016, the number of people living with HIV exceeded the limit of one million. It is estimated that there are still 500,000 more people who do not know their diagnosis. Within this group, it is mainly the injecting drug users who contract HIV. This is the case with no less than 54% of the new HIV infections. Just like sex workers and lesbians, homosexual men, bisexuals and transgenders (LGBTs), this risk group faces stigmatization and discrimination that prevents from treatment and care.

Pragmatism works

NGOs are crucial to contain the HIV epidemic in Russia. It has been proven worldwide that this is successful. With the Dutch approach applied, no new HIV infections among drug users are added in the Netherlands. Among sex workers, there are now even fewer sexually transmitted diseases than among the students. A pragmatic and tolerant policy works everywhere.

Strengthening the capacity of local NGOs enables them to reach the groups that they work for and provide access to HIV care. Communication between local government and NGOs also gives drug users, sex workers and LGBT people a voice in developing a joint fight against the HIV epidemic.

Not easy

Unfortunately, Russian legislation against NGOs does not make it easy to come to a constructive approach. But it is possible. There are strong, knowledgeable and motivated organizations that stand up and provide care and assistance with limited financial resources. They need (financial) support and solidarity, because in almost no other Eastern European country international support for HIV control has been reduced so far. Moreover, after about 17 years of providing support in Eastern Europe and Central Asia, AFEW Network has learned that one should always continue to point out to the Russian authorities their responsibilities and the importance of NGOs.

Continue with HIV control

If we continue to only observe from a distance, the already difficult situation in Russia will deteriorate even further, with disastrous consequences for global health. We should not let this happen. There are numerous specialists who have the required knowledge and local authorities who simply want the best for their citizens. We therefore continue to focus on conducting dialogue and supporting grass roots organizations in Russia. For example, in February 2018 a delegation from Russia came to the Netherlands to learn how the government can give subsidies to NGOs. From trust building with the local Russian government and from humanity and pragmatism, much is still possible. It is with this in mind that we call on policy-makers, donors and aid organizations not to abandon the Russian HIV-fighters.

Integrated Care Centre in Almaty – a Home for Everybody

Three months ago, the building hosting the centre – a three-story cottage – seemed huge and empty. Now it is filled with voices

Author: Marina Maximova, Kazakhstan

A month ago, the first Integrated Care Centre for people in difficult life circumstances, called Revenge, was opened in Almaty, Kazakhstan. The centre was established at the initiative of the community of people living with HIV.

Invisible People

People living with HIV (PLWH), people who use drugs (PUD), those who are released from places of confinement… Those people are often left behind and ignored. They are invisible, pinned to the wall of despair, with a trail of problems that remain unresolved for years, not believing that there is a light at the end of the tunnel. Now they know where they can find help. Where they will be understood and will not be neglected. Now the address 14A Omarov Street, Almaty is well known to many people. They pass it on to each other, realizing that for someone it might be the last hope.

“The centre was opened by the community, which is one of the factors attracting the potential clients. Here people can stay overnight or even live for a while until they are able to resolve their most pressing problems. The main thing is that here they are able to get a temporary registration, which is the main barrier in re-issuing the documents, getting “registered” with a healthcare facility, etc. The centre is a unique initiative and its launch was very well timed,” tells Roman Dudnik, Executive Director of AFEW Kazakhstan.

AFEW Kazakhstan supported the idea of opening the Revenge Centre within the Project “Fast-track HIV/TB responses among key populations in cities of Eastern Europe and Central Asia.” Among other initiators – activists of the Kazakhstan Network of Women Living with HIV and the Revenge Social Support Fund.

I reached the lowest point of my life

Director of the newly established centre Yelena Bilokon knows about the lives of people who practice risky behaviours not by hearsay. She was using drugs, lived in the street and has been living with HIV for 22 years. Rehabilitation centres inspired her to start a new free life. She got acquainted with the rehab clients within her community activities. When she saw the premises, the joint work, the support people provided to each other and their enlightened faces, she felt that she wanted to open her own centre.

Timurtau centre was her first success. It is a crisis centre for families called My Home, which provides assistance to many women and their children who are in trouble. The Almaty project is more large-scale.

“We have clients who have not been able to access antiretroviral treatment (ART) and, thus, to reduce their viral load and even go through medical examinations for three years or more. What can we say about migrants if even our citizens cannot receive these services? The same story is with tuberculosis patients who are left without social benefits, which they are entitled to. People are not even able to find jobs. As for children, when they get into crisis situations with their parents, they also need help, sometimes even more than adults,” says Yelena Bilokon, Director of the Kazakhstan Network of Women Living with HIV.

Up to 40 calls a day

In the centre, telephones are ringing all day long. Many people need help. The centre, in fact, is also in need of help. Kitchenware, clothes, bed linen, furniture, food… All these things are brought by good people. There was a call for help in social networks – and a lot of people responded.

Three months ago, the building hosting the centre – a three-story cottage – seemed huge and empty. Now it is filled with voices. 25 people were tested for HIV with rapid tests, 17 found jobs, 11 were examined for hepatitis and tuberculosis. It is not just statistics. Every number symbolises the struggle for someone’s health and life. Every day.

“Opening of such centre offering integrated services for vulnerable populations is an important event for our city. All the crisis centres, which existed before, had their own profiles and worked only with certain populations. People who need help cannot always find a centre offering the necessary services quickly. The Revenge Centre helps everybody,” says Alfia Denebayeva, Deputy Chief Physician of the Almaty AIDS Centre.

Workshops on case management, outreach work, stigma and discrimination delivered by medical professionals and civil society leaders help the centre clients to become volunteers. Recently a youth and adolescent club was opened in the centre, with many guests coming for the opening ceremony. In fact, they are not called guests here – those are our friends and allies, and their number is growing day by day.

AFEW International Welcomes New Board Member

AFEW International is pleased to welcome Maria Yakovleva as the new member of its Board. Maria joined the Board in May 2018.

Maria Yakovleva is a Director of the Program-Target Charitable Director of Candle Charitable Foundation. Maria has been working in the field of HIV since 2010. She joined the organization as a volunteer, and in 2013 became the director. The Candle Foundation is a community organization working with HIV-positive people. Mainly, the organization works with people who use drugs. During her eight years in the field of HIV, Maria participated in various patient initiatives: she was the coordinator of HIV Young Leaders Fund for Eastern Europe and Central Asia, and she was also one of the founders of the Patient Control movement. Maria Yakovleva is a member of the All-Russian Women’s Association EVA – a network of women affected by the HIV epidemic and other socially significant diseases.

As of 2018, there are seven board members at AFEW. More information about them you can find here.

Mikhail Golichenko: “HIV Epidemic in Russia is an Epidemic of Powerlessness”

Mikhail Golichenko is a lawyer and Senior Policy Analyst at the Canadian HIV/AIDS Legal Network

Author: Anastasia Petrova, Russia

We discussed the human rights issues in the context of HIV in Russia with Mikhail Golichenko. Mikhail Golichenko is a lawyer and Senior Policy Analyst at the Canadian HIV/AIDS Legal Network — organization, which has a special consultative status at the United Nations Economic and Social Council. Previously, Mikhail was a Legal Officer with the UNODC Country Office in Moscow. His work is focused on the promotion of human rights and addressing legal barriers to accessing health rights and effective HIV/AIDS prevention and care programs for prisoners and people who inject drugs. He holds a Candidate of Sciences degree (PhD equivalent) in Law.

– The International AIDS Candlelight Memorial Day was marked recently. What is this day about for you?

– It is a good occasion to reflect on the victims of HIV and at the same time think about our role in making sure that people who died of this disease did not die in vain.

In Tolyatti, in 2012, if I am not mistaken, on this day people traditionally went to a park, they handed out condoms, HIV awareness-raising materials, lit candles. It was all happening near the monument to the glorious heroes of the Great Patriotic War. Tolyatti is a small city and there are not many locations to hold public campaigns. It happened that during the campaign the bowl with condoms was put near the eternal fire and this fact was misinterpreted by mass media. As a result, the campaign organizers were fined for holding a mass event in close vicinity to the monument to the Great Patriotic War heroes. That is a local law in Tolyatti.

It shows that we are on different sides of the processes: the society is aware of the problem and the state doing nothing to start considering this problem from the right perspective.

Could you please tell us about the human rights situation in Russia and its implications for the HIV epidemic?

The key factor in the development of HIV epidemic in Russia is human rights violations, which make certain populations more vulnerable to HIV. People who use drugs, sex workers, men who have sex with men (MSM), transgender persons and migrants do not have access to adequate prevention, care and support for HIV and other socially significant diseases.

Rights are the social clothes of a modern person. They are represented by the laws imposing obligations on the state. The set of human rights keeps people warm and protects them from any aggressive impacts of the social environment. Some populations, such as people who use drugs, had part of their clothes removed. So, in fact, these people have to stay naked when it is minus forty degrees Celsius outside. Of course, they get sick. We should not cherish any illusions: even if we have sterile needles and syringes on every street corner tomorrow, it will surely improve the situation, but not much. We will still have repressions, persecution of people who use drugs, which prevent people from seeking health services.

There is a similar situation with sex workers. They know that they should use condoms. However, they know that if they get beaten up by a client who insists on having sex without a condom, nobody will protect them. Police will, first of all, blame the sex worker for being involved in sex work. Sometimes it is easier not to use condoms hoping not to get infected than being beaten up knowing that it makes no sense to seek protection in the police.

As for MSM, it is the same. Now the website PARNI-PLUS, which published information on HIV prevention among men who have sex with men, has been closed. There are almost no similar sources of information in Russia. Where will people who live with their sexual identities take this information? Their vulnerability and stigma will grow. There is a direct linkage. HIV epidemic in Russia is an epidemic of powerlessness.

– Could you tell about your speech in the Committee on the Rights of Persons with Disabilities? After it, a recommendation was made to revise the approach to the drug policy in Russia…

– There have already been many such recommendations. The Committee on Economic, Social and Cultural Rights, then the Human Rights Committee, the Committee on Women’s Rights, the Committee on the Rights of Persons with Disabilities, now there will be the Committee Against Torture. The committees realize that the drug policy in Russia is one of the drivers of systematic violations and issue those recommendations.

In my opinion, the main recommendation was given in October 2017, when the Committee on Economic, Social and Cultural Rights recommended Russia to decriminalize drug possession with no intent to distribute. The same goes for scaling up harm reduction services, legalizing substitution treatment, distributing truthful information on drugs, preventing overdoses, implementing substitution treatment for pregnant women, stopping tortures of drug users in police, in particular discontinuing the practice of using withdrawal syndrome to get evidence from detainees. Russia does not really follow all those recommendations, but the constant pressure will gradually give its results.

Our main tool is the attempt to involve government authorities in a dialogue so that people feel a certain need to introduce some changes. There is a set of clear recommendations, which are to be followed. It will certainly work. Where human rights are violated, there is no sustainability, there is a space for internal conflict, and there is no development.

What measures, in your opinion, does Russia need to take to stop the HIV epidemic?

We just need to remember that we are people. No laws are needed. There is a Constitution and it is enough. Safe coexistence is a value without which we cannot live. It is possible only with love, mutual understanding and help.