Mass media as partners in counteracting HIV/AIDS epidemic

Mass media play a major role in fighting for human rights, especially when it comes to population groups vulnerable to HIV. Through the wide media coverage of successful human rights defence cases implemented by community and civil society, the government can see that the community of People Living with HIV (PLHIV) and people vulnerable to HIV can and should be an equal partner and an ally in fighting HIV/AIDS epidemic.

This helps with forming a positive image of PLHIV and representatives of other key populations in the society, decreases stigma and discrimination, raises their self-esteem and self-significance and gives motivation for further activities and professional growth.

Thanks to the coverage of successful practices in mass media, a large number of PLHIV, people who use drugs (PWUD) and representatives of other vulnerable groups gain opportunity to get basic human rights knowledge, action plans and tools, which allow them to solve problems related to violation of human rights due to HIV in their own regions independently.

Liudmila Vins, project manager of LUNa Social Support Centre, legal adviser of Interregional Center for Human Rights in Yekaterinburg, has applied to the Emergency Support Fund for key populations in EECA for a grant. The goal of her project is to change the legal environment and public opinion towards people living with HIV and representatives of groups vulnerable to HIV through mass media.

Liudmila, what is the core of your project?

Our way of working is as follows – our lawyer together with partners, street lawyers from the regions, collects successful legal practices and strategically important cases, prepares the gathered materials for media publications, provides a legal evaluation and an algorithm for solving the problem. An info manger writes articles based on the cases for mass media and our own media resources, passes information about these cases to journalists through mailing lists, social media, and connects media and people featured in the cases in order to prepare further materials.

Could you tell us about the intermediate project results?

Yes, the project has substantially helped us to develop the informational part of our work and also gave a start to a new project of educating Russian NGOs on working with media. We found 17 cases, which resulted in 33 publications. Each case contained a story of at least one person – the leading story character, and at least 2 more people connected to the story, close relatives of the leading character. In total 51 people were featured in the stories.

Please share the most interesting and remarkable moments of the project.

The most remarkable example of support within this project is Olga’s story (the name is changed). We published it on our website.

Local journalists quickly noticed this material; they immediately reacted and published a number of articles about the fact that a woman in detention facility doesn’t receive treatment for HIV-infection. The news travelled fast: one journalist made a lot of requests to government agencies and received a positive decision from government officials. The result was that this woman received medication the same day.

You started your social support activities for vulnerable groups in 2009. How have the statistics changed since then?

At that time harm reduction programs were developing actively. However, the issue of defending the rights of PWUD was still unresolved, so starting from 2012 I began to develop street lawyers programming in Yekaterinburg. The need for this kind of support is very high now. In 2012 legal assistance was given to 100 people per year, and there was one street lawyer. Currently we work with 5 street lawyers, and we give this kind of support to people on a regular basis.

Who are the street lawyers?

These are people from the key populations community who are taught the basics of human rights defense. So, they can provide basic support with human rights defense, and then, if necessary, pass on cases to professional lawyers.

What is the attitude of the key populations’ representatives towards your activities?

We have a good connection with our target group, they are happy to receive our support. However, there are certain difficulties. For example, a person can disappear for a period of time while being under our supervision. Then (s) he appears again in a month, and we have to start from the beginning.

Why do you think it is so important to involve representative of key populations in such work?

Almost all of our staff members except for two are people from the key populations/PWUD community. I have been in remission for a long time myself. I think that a different approach is simply not effective. Nobody can truly understand PWUD as well as a person who has gone through it too, and most importantly, who was able to overcome it and solve a problematic situation successfully.

When people are doing something for the society, they often have an ideal example of such society in mind. Do you have one?

I don’t have examples of an ideal situation in any country. There are drawbacks everywhere. When it comes to talking about the approach to working with PWUD in Russia, I reply that there’s simple no such work. Those few NGOs that provide harm reduction programs, can’t reach all the PWUD to the full extent. For me the ideal situation is when the system of social support is developed in the country, there are harm reduction programs, access to quality treatment, and there is no stigma and discrimination within the society.

Support. Do not punish!

In June 2019, dozens of cities in the EECA region hosted the campaign «Support. Do not punish». Activists took to the streets to publicly protest against repressive drug policies.

This action, which is held annually all over the world, is a great chance to once again draw attention to this unresolved problem. How it was in the EECA region in 2019 you can read here.

Plans for 2020

Are you part of a collective, network or organisation advocating for drug policies that prioritise health and human rights? Are you planning to join the 2020 Support. Don’t Punish Global Day of Action and have an outstanding plan to build momentum? If your answer is “yes” then this call for applications might be for you!

Through this call, the Support. Don’t Punish campaign aims to identify and support local partners (up to 7) with funding of between USD 2,000 – 4,000 for strategic, creative and collaborative projects building up to the 2020 Global Day of Action that advance drug policy reform, bolster harm reduction and build bridges with/within/between communities disproportionately affected by the “war on drugs” (e.g. people who use drugs, farmers of crops deemed illicit, youth, ethnic minorities, LGBTQ+, among many others).

You can apply for the grant here.

What is “Support. Do not punish”?

Support. Don’t Punish is a global grassroots-centred initiative in support of harm reduction and drug policies that prioritise public health and human rights. The campaign seeks to put harm reduction on the political agenda by strengthening the mobilisation capacity of affected communities and their allies, opening dialogue with policy makers, and raising awareness among the media and the public.

The campaign’s yearly high point is the Global Day of Action, which takes place on, or around, 26th June (the International Day Against Drug Abuse and Illicit Trafficking). Historically, this date has been used by governments to showcase their drug control “achievements” in coercive terms. The campaign’s Global Day of Action seeks to reclaim and shift that day’s narrative. And so, every year, an increasing number of  activists in dozens of cities all over the world join this unique and multifaceted show of force for reform and harm reduction.

The Support. Don’t Punish campaign aligns with the following key messages

  • The drug control system is broken and in need of reform
  • People who use drugs should no longer be criminalised
  • People involved in the drug trade at low levels, especially those involved for reasons of subsistence or coercion, should not face harsh or disproportionate punishments
  • The death penalty should never be imposed for drug offences
  • Drug policy should focus on health, well-being and harm reduction
  • Drug policy budgets need rebalancing to ensure health and harm reduction-based responses are adequately financed.

 

The Coordination Committee called on the Global Fund to support the fight against HIV epidemic in Russia

The Coordination Committee for the prevention and control of HIV/AIDS in Russian Federation, responsible for oversight and coordination of the implementation of the Global Fund grants in Russia, called on the Global Fund to allocate funding to support civil society organizations in their fight against HIV epidemic in Russia for the next three years.

2019 is the year of the replenishment for the Global Fund to Fight Aids, Tuberculosis and Malaria (Global Fund) and by the end of this year, based on the results of the replenishment, the Global Fund will make a decision on the allocations for the eligible countries to address HIV, TB and Malaria for the next 3-year period.

According to the 2019 Global Fund Eligibility List, the Russian Federation has met the requirement of two consecutive years of eligibility based on income classification and disease burden and is now eligible to receive an allocation of funding to support the HIV/AIDS response for the next 3 years. Since the Russian Federation is not on the OECD-DAC List of ODA recipients, according to the Global Fund’s Eligibility Policy, the Russian Federation may only be eligible for an allocation to support the HIV response efforts by non-governmental or civil society organizations and only if the country demonstrates barriers to providing funding for interventions for key populations, as supported by the country’s epidemiology.

According to the Global Fund’s Eligibility Policy, “the eligibility for funding under this provision will be assessed by the Secretariat as part of the decision-making process for allocations. As part of its assessment, the Secretariat, in consultation with UN and other partners as appropriate, will look at the overall human rights environment of the context with respect to key populations, and specifically whether there are laws or policies which influence practices and seriously limit and/or restrict the provision of evidence-informed interventions for such populations.”

It is a well-known fact that Eastern Europe and Central Asia (EECA) is the only region in the world where the HIV epidemic continues to grow , and Russia has been considered as the “driving force” of this regional growth. According to the UNAIDS 2018 Global AIDS Update, “the HIV epidemic in Eastern Europe and Central Asia has grown by 30% since 2010, reflecting insufficient political commitment and domestic investment in national AIDS responses across much of the region. Regional trends depend a great deal on progress in the Russian Federation, which is home to 70% of people living with HIV in the region. Outside of the Russian Federation, the rate of new HIV infections is stable.

 

 

New collaboration of AFEW International

We are happy to announce that AFEW International represented by executive director Anke Van Dam became a consultant of an international project “Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modeling” awarded with NIH grant.

As one of the significant contributors AFEW International will act as a liaison to the key networks, organizations, and partners in the countries in the region of Eastern Europe and Central Asia. We will help the project team access data and the best level expertise for undertaking modeling in EECA. As well as we will provide consultations and feedback on the modeling process in the EECA region.

The overarching aim of the project “Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modeling” is to optimize HIV prevention strategies for people who inject drugs (PWID) in 108 countries worldwide using dynamic economic modeling based on multiple large data sources.

The project will:

1) Develop an epidemic model to estimate the impact of HIV prevention portfolios among PWID for every country with available HIV prevalence data among PWID (108 countries), based on data from multiple large systematic reviews.

2) Externally validate the model in 9 key countries with the highest numbers of HIV-positive PWID (including Russia and Ukraine)

3) Develop a user-friendly and web-based multi-platform portal for dissemination of the epidemic economic model and associated data.

The research team of the project consists of:

Natasha Martin, DPhil, Associate Professor, a leading economic infectious disease modeler (University of California);

Steffanie Strathdee, PhD, Professor and a leading epidemiologist focusing on HIV among PWID with 500 publications;

Javier Cepeda, PhD, Assistant Professor, an economic modeler with expertise in cost data collection among PWID;

Peter Vickerman, DPhil, Professor, a leading modeler of HIV transmission among high-risk groups including PWID, MSM and FSWs (the University of Bristol);

Louisa Degenhardt, PhD, Professor, an epidemiologist with over a decade of experience in conducting global systematic reviews on IDU and health harms among PWID (the University of New South Wales);

Sarah Larney, PhD (the UNSW team).

 

UNAIDS outlines progress on HIV, but decries funding cuts

The Joint United Nations Programme on HIV/AIDS (UNAIDS) released its latest report on the status of the HIV epidemic and the global response ahead of the 10th International AIDS Society Conference on HIV Science (IAS 2019), taking place this week in Mexico City.

The report highlights the impact community programmes have had in successfully expanding access to HIV treatment, supporting adherence and preventing new infections. However, it also shows that this progress is slowing and has been uneven, and that global funding for the HIV/AIDS response has fallen for the first time.

“We urgently need increased political leadership to end AIDS,” said UNAIDS interim executive director Gunilla Carlsson. “This starts with investing adequately and smartly and by looking at what’s making some countries so successful. Ending AIDS is possible if we focus on people, not diseases, create road maps for the people and locations being left behind, and take a human rights-based approach to reach people most affected by HIV.”

Some countries are meeting or exceeding the UNAIDS 90-90-90 targets – 90% of people living with HIV knowing their status, 90% of those diagnosed being on antiretroviral therapy and 90% of those on treatment having viral suppression by 2020 – while others are falling behind.

Global progress stood at 79% knowing their status, 78% on treatment and 86% with viral suppression in 2018. However, when looking at the proportion of all people living with HIV worldwide – not just the proportion of the previous subset – the figures are less impressive, with just 62% being on treatment and 53% having viral suppression.

But these figures mask some notable disparities. Nearly 90% of people in Western and Central Europe and North America know their HIV status and are on treatment, but only about 80% of those have an undetectable viral load. In Asia and Latin America, the proportions tested and on treatment are lower, but almost everyone on treatment has achieved viral suppression. Eastern Europe and Central Asia, the Middle East and North Africa, and Western and Central Africa are falling behind on all three measures.

Globally, new infections and AIDS-related deaths continue to decline, but less steeply than before. At the same time, the number of people on HIV treatment continues to rise and appears on track to meet the 2020 target. According to UNAIDS global estimates, in 2018:

  • 37.9 people worldwide were living with HIV;
  • 23.3 million (62%) had access to antiretroviral therapy;
  • 1.7 million newly acquired HIV;
  • 770,000 died from AIDS-related illnesses.

This represents a 16% drop in new infections since 2010, with most of the progress seen in Eastern and Southern Africa. But incidence has increased in some regions including Eastern Europe and Central Asia (up 29%), the Middle East and North Africa (up 10%) and Latin America (up 7%).

The report shows that members of key populations and their sexual partners now account for more than half (54%) of the 1.7 million people who newly acquired HIV in 2018. These groups include men who have sex with men, transgender people, sex workers, people who inject drugs and prisoners. In Eastern Europe and Central Asia and in the Middle East and North Africa, these populations are thought to account for 95% of new infections. Here too, the distribution of who bears the brunt of the epidemic varies widely by region.

Despite the availability of antiretrovirals that can prevent mother-to-child HIV transmission, just 82% of pregnant women have access to them, resulting in 160,000 new infections among children – well short of the target of less than 40,000.

Regarding HIV prevention, the report says that only around 300,000 people worldwide – including 130,000 in the US – are using pre-exposure prophylaxis (PrEP), although this is at best a rough estimate. Similarly, although people who inject drugs account for a high proportion of new HIV infections in some regions, many lack access to adequate harm reduction services.

Although it is harder to gauge progress in this area, the report notes that stigma, discrimination, criminalisation, harassment and violence remain problems for many people living with HIV.

 

Nonexistent? We exist!

On the 28th of June in the framework of Drug Policy Week at the University of Geneva a documentary film “Nonexistent? We exist!” was shown.

The film is based on the result of the Program to expand the access of vulnerable groups to HIV / AIDS prevention, treatment and care services, which was implemented in the Russian Federation in 2015-2018.

The film told about the results of work under the Program to expand the access of vulnerable groups to HIV / AIDS prevention, treatment, and care services in Russia. This author’s documentary film about how the sincere desire of people to support each other, mutual respect and respect for rights should be the foundation of a modern health care system. Especially regarding socially significant diseases, such as HIV infection.

“This film is very authentic because it was created in cooperation with the representatives of key populations”, says Maria Yakovleva, executive director of the Russian Charitable Foundation “Candle”.

“Today 1 million people with HIV positive status live in Russia. A lot of them represent key populations at risk for HIV: people who inject drugs, men who have sex with men, sex-workers. With the help of this film we hope to draw the attention of our international partners to the problem of HIV infection in Russia and to show them that we are still far away from solving the problem and we need any support from the world society”.

The film was created by journalists Igor Kuzmenko and Alexey Kurmanayevsky from DUNews (Drug Users News) – an independent Russian-language news channel about events in and around a community vulnerable to HIV / AIDS.

After the film, there was a discussion about advocating for the needs of people who use drugs in Russia. Participants talked about the achievements of the project and the difficulties that communities are experiencing now caused by the absence of stable funding and stiffening stigma and discrimination of key populations. Daria Alekseeva, AFEW International Program manager, told about the role the organization plays in communities’ lives in the EECA region and particularly in Russia. AFEW International in cooperation with Aidsfonds provides small grants within the framework of the Operational Assistance Fund for key populations to help communities to execute harm reduction programs and to provide services to people.

You can watch the film “Nonexistent? We exist!” here https://youtu.be/5I5ZFug1Cbg.

 

 

Daria Alexeeva: “The Majority of Applications to the Emergency Support Fund Come from Russia”

Author: Olesya Kravchuk, AFEW International

Starting from December 2018, organisations from 10 countries in Eastern Europe and Central Asia can receive small grants with a maximum amount of €5,000 per grant. AFEW International and Aidsfonds started awarding emergency grants in the framework of the Emergency Support Fund for Key Populations (ESF). The activities of the Fund are financed by the Elton John AIDS Foundation and Aidsfonds. With these small grants AFEW International and Aidsfonds support organisations representing key populations in surviving in difficult situations which they face due to legal barriers, stigma and discrimination, financial challenges and political restrictions. Support is 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. The total funds available in the Emergency Support Fund is equivalent of the 750,000 pound sterling.

Today we are talking with AFEW International’s program manager Daria Alexeeva about the first results of ESF’s work, and what it takes to be awarded the small grant.

– What are the first results of Emergency Support Fund’s work?

– During this first phase, our main tasks were to set up the grant application process, the selection procedure and the infrastructure for receiving and qualifying applications. All three aspects were ready by December 1, 2018. The invitation to apply for a grant from the ESF was spread widely in the networks of AFEW, Aidsfonds and the members of the Advisory Board. In December 2018 AFEW International has established a system to administer grants to applicants. On January 4th the first meeting of the Operational Team took place to review first applications. Since December 1, 2018 we received 96 applications, of which 42 (44%) were approved for grants. The total committed amount by the end of March 2019 was Euro 235.000.

– What countries are applying to the Fund the most?

– The majority of applications came from Russia. We received 45 applications from the Russian Federation and awarded 22 applications. The next most active country was Tajikistan with 15 applications, and 7 being awarded. The third one was Ukraine with 16 applications, 5 of which were awarded.

– What problems do organisations address the most?

– More than half of the awarded grants are targeting people living with HIV (PLHIV) – 55%. One third of all awarded grants went to the projects which provide support to communities of LGBTI, and one third – to communities of men having sex with men (MSM). One third of the awarded grants support projects for people using drugs (PUDs). The equal amount of the awarded grants – 21% – supports projects for sex workers and vulnerable women.

– How does the Fund help to solve the problems organisations have?

– We are helping with a broad range of emergencies. We have several goals within the Fund. The first one is contributing to decline in the annual number of new HIV infections in Eastern Europe and Central Asia (EECA). The second goal is increasing access of everyone who is living with HIV in the EECA region to treatment. The third goal is full funding of the AIDS response in EECA.

Thus, we are funding activities, which contribute to these goals. Among the grants we awarded are projects aimed at the provision of harm reduction services, HIV testing and referrals for the treatment for difficult to reach populations (MSM, LGBTI). We have funded repairing mobile units for outreach work, purchasing milk formula to secure stock for HIV positive women. We support project working for disabled PLHIV making sure they are able to adhere to their treatment regimens, and projects which help prisoners getting access to testing and treatment, and to adhere to their treatment after they are released from prisons. Besides, there are projects organising trainings of the medical staff with the goal to form a tolerant attitude towards key populations, for instance, transgender people, in order to improve access and quality to health services and antiretroviral treatment. We also support advocacy activities to raise awareness of the needs of the key population and to call for the funding increase, for instance, provide legal support to cases of rights violation in prisons to generate evidence for advocacy. There are much more issues we support that are aligned within our three goals that I have mentioned before.

– What type of applications is being rejected by the Fund?

– Some of the projects are one-off events which are not carefully thought through from the sustainability point of view. For instance, conducting training for outreach workers without creating a system to support their work in the future. Besides, there are projects which are contributing to solving a real emergency situation. Some of the proposals are just weakly written. In all cases, we provide feedback and advice on how to improve the proposal if an applicant decides to submit again.

– What are ESF’s plans for the future? How many projects do you plan to support in 2019 and in the years afterwards?

– We plan to support at least 100 applications and maybe even more in the period till the end of 2020. We will continue supporting applications until the total funds that are available will be exhausted. We might be done in the middle of 2020 already. The amount of grants to be awarded depends on the size of the requested funds. In some cases, we allow a grant up to 10,000 euro, in particular when the project is contributing to solving situations which concern bigger groups of key populations or when the project is contributing to generating the evidence needed for developing prevention programs and advocacy towards national or local governments. When the emergency situation cannot be solved with 5,000 euro – then the bigger amount is awarded as well. We foresee a little fewer approved grants in the second quarter of 2019. By the way, there will be a summer break in the reviewing of applications from 8th July till 16th August due to holidays.

Anastasia Pokrovskaya: “Deportation of Migrants with HIV Leads to Criminalization”

Photo: minusvirus.org

Author: Oksana Maklakova, Russia

The government of the Russian Federation is planning to increase the country’s population by 5-10 million people, by attracting migrants from Ukraine, Kazakhstan, Uzbekistan and Moldova. This is what Russian policy-makers say. However, Russia is the only country in the Council of Europe which still deports foreign citizens living with HIV. Anastasia Pokrovskaya, senior research associate of the Federal AIDS Centre, says that introducing amendments to the relevant regulations could protect the health of many people and contribute to their decriminalization. As part of the Partnership Program, she was involved in drafting an expert report for a project to ensure migrant access to HIV treatment and abolish the provision on deportation of foreigners living with HIV who enter the Russian Federation.

How many migrants come to Russia and what is the rate of HIV prevalence among them?

– According to the Ministry of Internal Affairs, in 2018 Russia issued 1,671,706 labour patents to migrants. Those are people who enter the country legally and are officially registered with the relevant authorities. To get a labour patent or a permit to stay in the country for a period exceeding three months, medical examinations, including HIV testing, are mandatory. HIV prevalence is about 100 cases per 100,000 people tested. However, this number does not reflect the real HIV prevalence as some migrants, anticipating possible test results, avoid health check-ups. They come to the country illegally, get short-term visas without getting any patents, buy fake health certificates or send another person to be tested in their place. This law on deportation of foreigners with HIV creates many opportunities for illegal activity, both among migrants and among Russian organizations which offer migrants illegal services to help them get round the law.

Is this typical only for Russia? What’s the situation in other countries?

– Initially about 60 countries applied the rule: if you fall ill or cross the border with HIV, you have to leave the country. However, there are now only nine countries, including Russia, where such regulations still exist. Other countries, such as the United States, Armenia and Ukraine, abolished such legislation in the last 5-10 years.

What is the goal of your project?

– Our goal is to show why this approach should be changed in the first place; to demonstrate the demographic and epidemiological premises for abolishing deportation provisions. We have developed a document providing medical and legal justifications why we need to amend the legislation. We state that this provision should be repealed because it does not bring any benefits. Firstly, it is clear that it will not help us to end the HIV epidemic. In terms of new HIV cases we are ahead of many neighbouring countries from which migrants come to Russia. Secondly, in reality this law does not work anyway. People stay in the country, but go underground and continue living in the ‘grey zone’. As a result, they remain sick and infect others while their disease progresses, as they have no access to treatment. Meanwhile, they cannot go back to their home countries to get treatment because they are afraid they will not be able to return.

Photo: minusvirus.org

What is the current response to such challenges?

– There are some NGOs which help deliver services to such people. According to the law, we are not able to ensure comprehensive medical check-ups or provide relevant health assistance to migrants. The biggest challenge is that we are not able to provide them with antiretroviral therapy (ART). This is the biggest issue. Russian citizens can access ART free of charge. However, our government is not ready to allocate funding to treat foreigners, for obvious reasons.

So there are economic reasons for not abolishing the regulations?

– Probably. There are concerns about financial and administrative consequences. International agreements should be signed between governments. It is difficult for us to use the experience of other countries in addressing the issues of HIV and migrants, as the Global Fund to Fight AIDS, Tuberculosis and Malaria and other international charities which could take over some functions in this regard do not operate in Russia. Even if the country abolishes the regulation on deportation of foreigners living with HIV and such people get the right to stay in our country legally, they could still receive ART at home. All AIDS centres in neighbouring countries accept migrants who are registered for HIV care, and provide them with ART medications for several months. However, to get registered for HIV care, people have to leave Russia and then come back, which is currently not possible due to the travel ban on foreigners living with HIV. Thus, we will have to find our own solutions to this situation. There are some options currently being discussed, but it needs time. The final decision should be made by policy-makers, but unless they are informed about this issue they will not resolve it. We have to speak about it and suggest possible solutions. Only then could the laws be revised. I am sure that in our society there will be people who oppose such amendments, as they think migrants are bad for our country. However, those people often forget that migrants are a unique labour resource and in a way a demographic resource which modern Russia really needs.

AFEW International and Partners Start Implementing a New Project in Russia and Kyrgyzstan

Anke van Dam (on the right) and Daria Alexeeva presented the project in Russia. Photo: E.V.A.

Starting from January 2019, AFEW International began to implement the project St. Petersburg and Bishkek – Key Populations and HIV & TB Prevention Priorities funded through the Aidsfonds under the PITCH. The project covers key populations and HIV and tuberculosis prevention priorities in St. Petersburg, Russia and Bishkek, Kyrgyzstan.

PITCH is a strategic partnership between Aidsfonds and the Frontline AIDS (former International HIV/AIDS Alliance) working with those most affected by HIV: adolescent girls and young women, LGBTI, people who use drugs, prisoners and sex workers. The program aims to enable these groups to transform (inter)national HIV responses by strengthening their advocacy skills and capacities and promoting the innovative evidence-informed practice. This will contribute to cities in the Russian Federation and Eastern Europe and Central Asia (EECA) joining the fast-track city initiative and building political support for an HIV/AIDS response focused on key populations.

“Within this project, we are focusing on working with St. Petersburg and Bishkek and municipal level governments on HIV geographically-focused responses,” says AFEW International’s program manager Daria Alexeeva. “In this way, we are continuing our work we stared under the Fast-track Cities project in partnership with Alliance for Public Health where we are developing models of sustainable city responses to HIV and TB in key population in EECA that significantly contribute to achieving 90-90-90 HIV/TB targets for key populations.”

The project St. Petersburg and Bishkek – Key Populations and HIV & TB Prevention Priorities will work on several strategies: community based participatory research to reveal the most acute needs of the key populations, changing attitude of the decision maker towards key groups, involving key groups into the advocacy process, and experience exchange between the three countries, negotiations with the cities authorities on signing Paris Declaration and Zero TB Declaration.

Svetlana Izambaeva: “Uncovering the Topic of HIV, We Talk About Violence and Bullying”

Author: Olesya Kravchuk, AFEW International

Svetlana Izambaeva was one of the first women living with HIV in Russia who was brave enough to open her face. Now Svetlana supports other people living with HIV. In summer 2018, Svetlana Izambaeva’s Non-Profit Charitable Foundation held a gathering of adolescents living with HIV with the financial support of AFEW International and other donors. We talked with Svetlana to ask her what was interesting about this gathering in Georgia and why, when we talk about HIV, we also “uncover” other topics.

– Svetlana, could you please tell us how the idea of having a summer gathering was born? Who was able to take part in it?

– It started with our desire to support adolescents living with HIV in Kazan. Later those boys and girls, who had been participating in such meetings for five years, offered to hold a meeting with adolescents from other cities and countries. Several adolescents from Kazan dreamt about going to the seaside. Thus, those adolescents’ dream gave birth to our project #vseprosto (#itseasy). Before, we held one- or three-day workshops in the cities of Tatarstan, Ufa, Nizhny Novgorod, and Irkutsk.

We made a decision on the venue and started sharing information about the event through social media and AIDS centres. The response was immediate. We heard both from mothers of children living with HIV and from adolescents living with HIV. Every person who wanted to attend our event had to fill in a questionnaire based on which we selected the participants. An important eligibility criterion was the awareness of adolescent of his or her HIV status. This year, the meeting in Georgia brought together adolescents aged 11 years old and above from six countries – Russia, Ukraine, Armenia, Georgia, Belarus, and Kazakhstan – and nine cities of Russia – Vladivostok, Irkutsk, Ekaterinburg, Nizhny Novgorod, Kazan, Orenburg, Rostov, St. Petersburg, and Moscow.

– How was this gathering different from a traditional summer camp for children?

– Our gathering was more than a camp. We had full immersion into the topic of HIV, including all medical and psychological issues. Interactive games and quests help us to reinforce the theory. We raise the questions related to feelings, emotions, and experiences, explore guilt, resentment and pain, acceptance of diagnosis and empowerment. An important factor is that we offer many games on HIV – while playing, adolescents learn about the immune system and realize why they need to take pills strictly in accordance with their schedule. For some adolescents, this is the first time when they meet other boys and girls with HIV. At the gathering, we openly talk about HIV for ten days, which allows “recognizing” and accepting one’s diagnosis.

– What was your biggest insight during this gathering? Where there any good or maybe bad surprises for you?

– Each gathering has its own story and each one of them is special. Every time, we sit down with the team of trainers and prepare new exercises and new quest games for the adolescents. What is surprising is the depth of feelings and the extent of trust and openness among the adolescents living with HIV. They are all ready to work on their problems but not all of them are willing to do it in a group. From the very first day, we offer individual sessions with psychologists. Besides, one of the insights was that when we uncover the topic of HIV, we bring up deeper topics, such as violence, bullying, and reliance on parents. Parents or guardians may be a negative factor. There was a case when the guardian was not ready to work together all day long and also in the evening. We pay a lot of attention to building knowledge, but information is presented in the format of games and our participants have fun. Though it is just a five-minute walk to the seaside, our priority is keeping up with our agenda and the knowledge to be gained by the adolescents and their parents or guardians.

– What challenges did you encounter when planning the event and how did you cope with them?

– The main challenge was raising funds. We needed money to cover accommodation and meals for the participants, pay the trainers (though three times we did not pay either to trainers or to the logistics provider), to buy stationery, gifts, T-shirts and caps. It was important to have at least five trainers for 30 participants as we had both general activities and small group sessions. We had to find sponsors to cover our costs, and it was not easy. Besides, at our gathering we started training people who would like to conduct similar activities in their regions.

– Why is this event important? Have you achieved the goals that you wanted to achieve?

– This event is important for every adolescent – that is what they say in their comments and follow-up questionnaires. The changes happening with every boy and girl may be tracked through the diagnostic drawings that they do in the first and last days of the event. On the first day, when they are asked what they feel, think and want to do when they hear the word “HIV”, they draw scary images and write “pain, guilt, fear, do not want to talk about it.” On the last day, when answering the same question, they depict strength, confidence, freedom, easiness and desire to support their peers. The event is also important because after it they will not stop taking their therapy and will adhere to treatment. We already see the results of their blood assays. Our event is also aimed at the prevention of suicide attempts and depression.

Do you plan arranging similar events in future?

– We have already organized and held four gatherings: in 2017 – in Sochi and St. Petersburg, in 2018 – in Ureki (Georgia) and Vladivostok (Russia). We have piloted the programme, trained the trainers and we plan to launch such gatherings in Russia and open centres for adolescents in Irkutsk, Kazan, and Krasnodar region. Next year, we plan to conduct first-level training for new participants in each of the territorial units, hold a gathering in Irkutsk at the Baikal Lake and then – an international event in Armenia. Besides, we would like to hold a meeting and workshop in Moscow suburbs for a team of leaders from all our gatherings.