Pain Relief: Ukraine is on the Way to Legalizing Medical Marijuana

Authors: Yuliana Skibitskaya, Yana Kazmirenko, Ukraine

Ukraine may become the 14th European country to allow the use of medical cannabis. Activists are looking forward to the next move – drug policy liberalization.

Ukraine has taken the path of legalizing medical cannabis. In two months, a petition registered on the Ukrainian parliament’s website has collected 25,000 signatures, which makes it mandatory for MPs to review it. According to the petition’s authors, about two million Ukrainian citizens currently have no access to this effective therapy, which can help people with cancer, war veterans and patients in palliative care. Ulana Suprun, acting minister of health of Ukraine, also supports the legalization of medical marijuana. She says that the “rational” use of cannabis for medical purposes is legitimate. It is expected to be made available in pharmacies by prescription.

The draft law may be considered in May-June

The civil society movement for legalizing medical marijuana is led by the NGO 100% Life, the Ukrainian Association of Medical Cannabis, and 16 other civil society organizations.

On 20 March 2019, the relevant parliamentary committee considered the petition but failed to support it as there was no quorum at the session. MPs appealed to the Cabinet of Ministers with a suggestion to amend the current list of narcotic substances, which prohibits the use of cannabis in Ukraine for medical and research purposes. Cannabis would still be considered a narcotic drug but would be allowed for medical use.

“The Human Rights Committee supported the petition. Now MPs have a free hand, they can register a draft law based on the petition,” says one of the authors and leader of 100% Life, Dmitry Sherembey. “There is a group of MPs which supports us. We expect that in May-July the draft law may be registered and considered by the current parliament.” (In autumn Ukraine will hold parliamentary elections – note of editor).

Another author of the petition, Gennadiy Shabas, who heads the Ukrainian Association of Medical Cannabis, says the law should clearly define the rules of using cannabis for medical and research purposes in order to avoid any risks.

Medical marijuana may be used in HIV treatment

There have long been attempts to legalize medical marijuana in Ukraine, but significant progress was achieved only last year when the Ministry of Health openly supported civil society activists. For several years in a row, Cannabis Marches of Freedom have been held in Kyiv, with participants calling on the government to legalize cannabis.

Medical marijuana helps patients with cancer and Alzheimer’s disease, but can also be used for HIV therapy. Apart from the fact that medical cannabis relieves pain, scientists have discovered that people living with HIV who smoke marijuana have higher CD4 counts and lower viral load compared to patients who do not use this kind of therapy. Cannabinoids also help to tolerate opioids, which are often prescribed to AIDS patients. Marijuana prolongs the pain-alleviating effect, improves appetite and prevents tolerance and addiction to “hard” drugs.

Dmitry Sherembey explains that marijuana removes pain syndrome so that the body can direct its resources not at overcoming pain, but at fighting infection. Thus, cannabis not only makes life easier for patients, but it also improves their prognosis for fighting the disease, especially in the case of cancer.

“For instance, even if doctors gave a patient only three months, his prognosis may be improved by up to three years,” he says.

Legalization to reduce stigma

Velta Parkhomenko, the coordinator of the Ukrainian Union of People Who Use Drugs and manager of the NGO Eney Club, thinks that amending legal regulations on the use of medical cannabis is an important step for Ukraine in general, and especially for the community of people who use drugs.

“Legalization of medical cannabis will allow us to accelerate the process of humanizing drug policy. We are convinced that the fewer myths and stereotypes there are around psychoactive substances, the simpler it will be for us to talk about the problems of people who use drugs,” says Velta.

Another argument she offers is that legalizing medical marijuana will reduce stigma and discrimination and reaffirm the widely-recognised fact that drug dependence is not a crime but a chronic, recurring disease.

The activist hopes that the process will not stop with medical cannabis. The next logical steps should be to humanize drug policy, amend the table of maximum allowed quantities of narcotic drugs, and introduce changes in legislation.

Medical marijuana does not alter awareness and does not affect mental states

Medical marijuana is a medicine based on the active components contained in cannabis. The truth is that not all cannabinoids have a narcotic effect. That is why medical marijuana, as opposed to other types of marijuana, does not alter awareness or affect mental states. It may be administered in different ways, such as traditional smoking as well as pills, oils and other pharmaceutical forms.

Today, medical cannabis is mainly brought to Ukraine from neighbouring Poland, where it is sold in pharmacies. However, at present importing cannabinoid-containing medicines to Ukraine is equivalent to drug trafficking.

Olena Voskresenska: “2018 Was Very Active and Diverse for AFEW-Ukraine”

Author: Olya Kulyk, ICF “AIDS Foundation East-West” (AFEW-Ukraine)

The executive director of International Charitable Foundation “AIDS Foundation East-West” (AFEW-Ukraine) Olena Voskresenska is telling about the main achievements of organisation in 2018 and its plans for 2019.

– Olena, how was the year of 2018 for AFEW-Ukraine?

– 2018 was a very active and diverse year for AFEW-Ukraine. During the last year we strengthened and expanded our work on empowering key communities, developing community leaders and facilitating the dialogue between the communities. In our work with adolescents who use drugs within the project “Bridging the gaps: health and rights for key populations”, the special focus was on developing youth leaders. In 2018, young activists from four regions of Ukraine had a chance to develop their own projects, and small grants that we provided to them allowed young people to implement youth-led projects in their regions. Through the Country Key Populations Platform, that we continue to support, we had an opportunity to learn more about the needs of different key populations – people who use drugs, sex workers, LGBT, and ex-prisoners. We also help the communities to develop communication algorithms to ensure that the voices from the most remote areas of the country are heard by the community leaders.

Besides, at the end of the year, we started the project aimed at empowering HIV-positive women in Kyiv and Cherkassy as advocates for their rights. The project was supported by the Embassy of Norway – a new donor for our organization.

– What were the three main achievements over the past year that you can determine?

– Since 2011, AFEW-Ukraine has been working with adolescents who use drugs, and I am very proud that in 2018 we managed to expand this work to small cities and rural areas of Ukraine. It was possible thanks to the project “Underage, overlooked: Improving access to Integrated HIV Services for Adolescents Most at Risk in Ukraine” that is supported by Expertise France – Initiative 5%. The project is implemented in cooperation with Alliance of Public Health, and now services for adolescents who use drugs are developed in 28 small cities of seven regions of Ukraine. Initial project research, that is now being finalized, is the first of its kind not only in Ukraine but probably in most of the countries of Eastern Europe and Central Asia (EECA).

In 2018, AFEW-Ukraine supported the development of standards on rehabilitation for the Ministry of Social Policy. I am very proud that we managed to bring together a good team of experts for working on the standards, including a representative of the community of people who use drugs. We hope that these standards will help to improve the quality of rehabilitation services in the country, based on the best international practices, human rights approach and needs of the community. We are very much looking forward to further work in this direction not only in Ukraine but also in Georgia.

2018 was also a very important year for all HIV service organisations, as it was the year of the 22nd International AIDS Conference that took place in the Netherlands. Being a part of AFEW Network, with AFEW International Secretariat in Amsterdam, we worked hard to ensure maximum involvement of EECA participants in the conference and attracting attention to our region. I am very happy that we managed to support a large delegation of AFEW-Ukraine partners, including young activist from Kropyvnytskyi, representatives of the community of people who use drugs, and HIV-positive women from Ukraine.

– What are the plans of the Foundation for 2019?

– In 2019 we will continue working with young people in Ukraine, focusing on their active involvement in decision-making processes, including monitoring of the local budgets. I hope that we will be able to expand our work to include young detainees in our projects.

Developing harm reduction friendly rehabilitation remains a priority for us, and we will stimulate the changes in current rehabilitation practices in Ukraine and Georgia with our local partners. Also, we are very much looking forward to closer working with HIV-positive women in Ukraine, disseminating the successful model of immediate intervention that was already tested in Kyiv, to Cherkasy, and potentially other regions of the country. In 2019 we are also planning to revise our strategic plan, which will define the priorities of AFEW-Ukraine’s work for the upcoming several years.

Why Ukrainian Key Communities Unite in One Platform

Author: AFEW-Ukraine

In many countries, different key populations unite. They do it for the better representation of their interests in the development of public policy. This is often the alliance within one community, and less frequently – of several communities.

Four key populations in Ukraine – ex-prisoners, LGBT, people who use drugs (PUDs), sex workers (SW) – have their own self-organizations, being at different stages of development. There are communities with great experience in advocacy and work with international donors, but there are those that are at the initial stage of development. They grow stronger with the support from more experienced activists.

“Despite growing importance of the community voice in decision-making processes related to access to health and social services, very often representatives of HIV-service organisations speak on behalf of key populations rather than community representatives. Having the voices of community directly heard leads to a situation where the actual needs of key communities are much better taken into account in programs planning and implementation”, says Olena Voskresenska, executive director of ICF “AIDS Foundation East-West” (AFEW-Ukraine).

In October 2015, during the meeting held within the framework of Tripartite cooperation between the Kingdom of the Netherlands, UNAIDS and civil society, community activists expressed the idea of creating a Platform. This Platform had to become an independent structure for sharing experience, dialogue and developing a common position and advocacy messages of several communities, as well as facilitating representation of communities in public bodies, working groups and other organizations. In addition, the Platform could contribute to collecting data on the needs of communities and raising new activists.

“My idea was to give communities the opportunity to advocate for their rights and change policies and to bring communities together to help each other. Also, it was important to allow communities to develop and mobilize themselves without external influence,” recalls Petro Polyantsev, a member of CKPP steering committee.

Creating the Platform

Initially, it was necessary to understand whether all key communities are interested in the Platform. Then the priorities of the Platform had to be identified. In 2016, the most active representatives of the LGBT, SW and PUD communities formed an initiative working group. Participants of the Tripartite cooperation initiative – UNAIDS, ICF “AIDS Foundation East-West” (AFEW-Ukraine) and LGBT Association “LIGA” (partners in the project “Bridging the Gaps: Health and rights for key populations”) – helped to organise group’s work and found the necessary funding for the Organizational Forum of the Country Key Populations Platform (CKPP).

“Today the priority for communities is to maintain access to services in the context of transition to state funding. By working together, communities can achieve much better results than by working just by themselves,” says Andrii Chernyshev, a member of CKPP steering committee.

The first CKPP Forum was held in January 2017. The main result of this event was a decision to establish the Country Platform as an association of key communities’ representatives. During the Forum, also representatives of the community of ex-prisoners joined the Platform.

CKPP was officially registered as a public association in December 2017. The Steering committee, representing all four communities, coordinates the work of the Platform. The main strategic issues are resolved during the CKPP Forums. Funding for Platform activities is provided through the selection of several grant programs managed by the organizations endorsed by the Steering Committee and an Advisory Group. As of today , the work of the Platform has been financially supported by the Ministry of Foreign Affairs of the Netherlands in the framework of the project “Bridging the Gaps: Health and rights for key populations”, UNAIDS, Eurasian Harm Reduction Association (EHRA), International Renaissance Foundation, the Embassy of the Netherlands in Ukraine. Such diverse funding model allows the Platform to remain independent and unbiased.

First steps are successful

The activities of the Platform in the last two years were mainly focused on the development of its structure, as well as the strengthening of the communities. During this period, 163 activists from 18 regions of Ukraine took part in important and interesting events and trainings, the topics of which were determined by the participants. Communities’ members developed CKPP Regulation and the CKPP Code of Ethics which regulates the basic principles of work.

In 2018, members of the Platform presented it at the XI National LGBT Conference in Ukraine and the 22nd International AIDS Conference (AIDS 2018) in the Netherlands.

“I believe in the Country Key Populations Platform. We are already seeing the results. The government is more inclined to listen to us because we gained legitimacy by joining our forces. When people are motivated to make change happen and work together, human rights will be a reality in our country, and not just words. Only together we can save our lives,” says Vielta Parkhomenko, a member of CKPP steering committee.

The researcher Anastasia Bezverkha in the recent study “Country Key Populations Platform – from better communication to stronger voice. The case study from Ukraine” highlighted the positive changes influenced by the creation and work of the Platform.

“CKPP impacted the communication between the partners in the field in a positive way. Key population leaders became more visible and new leaders emerged. In addition, CKPP serves as an important space for communication of national decision-makers with key population leaders,” summarizes Anastasia.

The IV CKPP Forum, which was held in December 2018, was focused on developing the strategies and work plans of the Platform for 2019.

Under 16 and Above: Protecting the Rights of Adolescents and Preventing HIV

Author: Yana Kazmirenko, Ukraine

Shortage of HIV prevention programmes for young people was one of the key topics discussed at the 22nd International AIDS Conference (AIDS 2018). At the conference, AFEW-Ukraine presented its best practices in HIV response among young people. Since 2012, it has been supporting the initiatives aimed at most-at-risk adolescents within the Bridging the Gaps: Health and Rights for Key Populations project funded by the Dutch Ministry of Foreign Affairs.

Gaps analysis

Over the course of project implementation, social welfare centres for adolescents who use psychoactive substances were established in Kharkiv, Poltava, Kropyvnytskyi and Chernivtsi and a rehabilitation day care centre for such young people was opened in Chernivtsi. In 2017 only, over 12 hundred adolescents received 21,290 services in those four cities.

Olena Voskresenska, Director of AFEW-Ukraine, recalls that when the project just started, a gap analysis was conducted. It turned out that there were a lot of programmes for adults who use drugs, while few donors were supporting similar activities for adolescents. It was considered that this population does not make a considerable contribution to the HIV epidemic. Thus, both most-at-risk adolescents and generally schoolchildren and students of vocational training centres remained out of focus.

“Of all the countries involved in Bridging the Gaps project, Ukraine is unique in terms of the activities implemented for under-age drug users. We work with non-injecting drug users trying to prevent them from switching to injecting drugs,” says Olena.

Children do not use drugs

One of the main achievements of AFEW-Ukraine is developing a tool to monitor the violations of human rights of most-at-risk adolescents. Questionnaires are used to collect data on adolescents’ rights violations, providing urgent response and legal support. Iryna Nerubaieva, AFEW-Ukraine Project Manager, thinks that in the Ukrainian society there is a strong belief: children cannot use drugs and they do not use them.

“This community is invisible and unheard. Most often, adolescents do not know about their rights, do not know that they have any rights or how these rights are to be protected,” says Iryna.

Adolescents – mostly high schoolers and students of vocational training centres – are brought to the community centres by their friends. Often they are referred by social welfare institutions, departments of juvenile services and even police.

Currently, AFEW-Ukraine works in four cities of Ukraine: Kharkiv, Chernivtsi, Kropyvnytskyi and Poltava. Besides, thanks to the cooperation with Alliance for Public Health, since 2017 the activities for adolescents, including monitoring of human rights violations, have been conducted in five more cities of Ukraine.

Testing as a prevention tool

At the conference, Yevheniia Kuvshynova, Executive Director of Convictus Ukraine, implementing partner of AFEW-Ukraine and Alliance for Public Health, told about the Voice of Adolescents project, which covers 717 adolescents.

The Underage, Overlooked: Improving Access to Integrated HIV Services for Adolescents Most at Risk in Ukraine project is aimed at teenagers who use drugs and live in small towns and villages in seven regions of Ukraine. Adolescents from Kyiv attend the Street Power youth club. In this club, teenagers who use psychoactive substances and practice risky injecting and sexual behaviours can watch films, play computer games and receive social support.

According to Yevheniia, most of them use non-injecting drugs and HIV testing for them is rather a prevention tool. So far, no HIV cases have been detected. Adolescents are tested for hepatitis C and B as well as sexually transmitted infections.

For many years, Convictus has been working with adults who inject drugs providing services to 11 thousand people. Working with adolescents is different: they are tested only starting from 14 years of age, with a social worker and a doctor involved.

“One of our priorities is building a network and a map of services, so that adolescents could go to any organization of the network and receive services from our partners. If a person coming to us needs more in-depth support, we provide such support and also help him or her with clothes as we maintain a clothing bank,” tells Yevheniia.

Convictus is planning to develop a School of Leadership and a sexual health programme for girls, which are to close more gaps in the system of HIV prevention among most-at-risk adolescents in Ukraine.

Chemsex and Drug Use Among MSM in Kyiv: New Challenges

Analytical community-based participatory research report based on the results of the study “Chemsex and drug use among MSM in Kyiv: new challenges”, 2017.

According to a bio-behavioral research conducted in Ukraine every two years with the support from the ICF “Alliance for Public Health”, men who have sex with men, is a group where the prevalence of HIV continues to grow. Thus, in Kyiv at the end of 2015 – the beginning of 2016, the prevalence of HIV among MSM was 15%.

According to the observations of social workers of the PO “ALLIANCE.GLOBAL”, that carries out outreach work through gay dating mobile applications, Internet web-sites, where sex workers’ ads are published, gay clubs and saunas in Kyiv, in recent years, the number of MSM who use different chemical substances in a non-injecting way (amphetamines, ecstasy, LSD, oxybutyrate, etc.) has significantly increased, which suggests that their sexual behavior becomes riskier and significantly increases the likelihood of HIV infection, viral hepatitis, and other STIs, both in terms of getting infection as well as transmitting the infection. To assess the drug scene, the risks of using chemical substances and the possible negative effects of sex under their influence in the context of the spread of HIV, viral hepatitis and other STIs, we conducted this study, the aim of which was to develop recommendations for more effective prevention of HIV infection, drug-related harm reduction and other related means and planning of specific services for subgroups of MSM who practice sex under the influence of chemical substances.

The purpose of the research is to study how the use of drugs, psychotropic substances and / or certain medications affects sexual behavior and mental health of MSM and how to minimize the risk of transmitting infections, in particular, HIV.

Read the report here.

AIDS 2018 Sidenotes: How We Tested Drugs

Experts of the centre testing a tablet

Author: Yana Kazmirenko, Ukraine

Saturday morning at the Schiphol airport. A conference participant from Ukraine – camera operator Igor K. – finds out that his tablets are gone. In a second, a confident man loses his heart: he becomes pale, his hands are shaking, and his eyes are full of dread. Igor has been taking methadone therapy for a few years, and for him losing his tablets can be life-changing. In Ukraine, it is not possible to receive methadone at the weekend.

Ukrainian drug users say that losing your tablets is the same as losing your passport. In both cases, you have to report to the police, where police officers issue a certificate to confirm the loss and only then a doctor would give you methadone. Igor is standing in the huge Amsterdam airport. He has three hours before his flight. It turns out that it is easier for a Ukrainian citizen to access methadone in Schiphol than back at home. After listening to Igor’s story, the doctor at the health station just prescribes him tablets for EUR 20.

Diseases are born in the streets

That was how the 22nd International AIDS Conference in Amsterdam (AIDS 2018) ended for me. After the event, it became clear that the capital city of the Netherlands had a full right to host this global forum. First of all, this right was earned because of its innovative HIV programmes, including progressive drug policies. It is not only about coffee shops where one can taste cupcakes with marijuana…

The first syringe exchange programmes, safe injection rooms and drug testing sites – those are all Dutch inventions, which were widely practised back in 1980s. This country was the first to realize that diseases are born in the streets and that nobody can tell better about the threat of HIV and ways to prevent it than drug users.

I could see it with my own eyes when I went with a study visit to the Jellinek drug testing centre with a group of journalists accredited at the conference. The building of the centre looks just the same as the neighbouring buildings. The centre has branches in Amsterdam, Utrecht, Almere, Amersfoort, Hilversum and other cities. In all of them, you can anonymously test your drugs for dangerous components.

Nightclub goers test their drugs

In 2017, over 12 thousand people tested their drugs (in 60% of cases ecstasy was tested). The centre has two tasks: monitoring of the market of club drugs and reducing the harms associated with their use.

A staff member of Jellinek says that visitors can access two types of tests: rapid test with a marker and laboratory testing, which takes a week. All kinds of things can be tested: tablets, powders, liquids, capsules or crystals. Every visitor may bring up to three samples to be tested. The price of one test in EUR 2.50.

E.g., an ecstasy tablet is first inspected, recording its colour, size, logo, acid test and comparing it to the national database with aggregated data of 30 drug testing centres from all over the country. If such tablet has already been tested (which happens in 75% of cases), the visitor is informed about its content straight away. If the tablet does not match any entry in the database, with the consent of its owner it is sent to a laboratory for further testing. The result is ready in a week. The only exception is LSD. Testing this drug is expensive, so Jellinek does partial testing not to go bankrupt.

Rapid test is the preferred option of the main drug users in the Netherlands – nightclub goers. After getting the testing results, they usually follow up with claims to the dealer who has sold them a dangerous product.

By the way, every year the Netherlands host more than a thousand musical festivals, with a mobile drug testing site operating at each of them. Such strict measures were introduced after 2014 when three visitors of a festival died after using low-quality drugs. However, using any drugs is a risk.

“People who started using drugs 5-10 years ago have to realize that now drugs may be more potent with a higher risk of overdose,” warn the experts working at the centre.

Ukraine needs changes

AIDS 2018 participant from Ukraine Anton Basenko, who is the head of the Ukrainian Union of People Who Use Drugs (PUD.Ukraine) says that establishing drug testing centres and safe injection rooms is the reason why there are no more streets covered with used syringes in Amsterdam.

In Ukraine, there are also talks about opening such drug testing centres and safe injection rooms. However, they will not appear unless the legislation changes. So far, such facilities are outlawed and people who open them may be incarcerated for running drug dens.

‘Bridging the Gaps’ through the eyes of teenagers

In 2011-2017, over eight thousand clients received 70,232 medical, psychological, social and legal services within ‘Bridging the Gaps: Health and Rights for Key Populations’ project in Ukraine. Halyna, Artem and Carl (names changed) were also clients of ‘Bridging the Gaps: Health and Rights for Key Populations’ project.

Resolving problems with the family

Halyna is 19 years old. She is a slim girl with beautiful eyes and a charming smile. Halyna was born in a small Ukrainian town bordering with Moldova. She has been living with a man she loves for a year. A month ago, they got married.

However, just two years ago, Halyna’s life was neither easy nor happy. Back then, she lived with her mother and stepfather and was a constant victim of abuse. Halyna’s stepfather did not want the girl to live with them, so was turning his wife against her own daughter. Halyna, who was still a minor, had to leave her home, find a job and make her own living. The girl started using drugs – first marijuana, then amphetamine, sometimes ecstasy or LSD. It lasted for a few months.

Once, when the girl told her mother everything. Talking about that period of her life, Halyna cannot hold her tears back.

“When I came back home, I was not quite adequate and had hysterics. Once, my stepfather called police and they took me away. They sent me to a juvenile shelter in Chernivtsi. I spent two months there. At first, it was difficult, and I wanted out of there as soon as possible, but when I went back home to my family, it was even worse. My stepfather abused me and made my mother do the same,” tells the girl.

The psychologist working in the shelter referred Halyna to the Dialogue Centre of Social and Psychological Support (New Family Foundation), implementing ‘Bridging the Gaps: Health and Rights for Key Populations’ project. Three times a week, Halyna attended counselling sessions with a psychologist and a social worker there. Besides, the girl, her mother and stepfather took part in family group conferences. The approach of family group conferences stipulates that a child may not be viewed separately from the family, so family members should be involved in solving child’s problems. Halyna says that it helped to maintain relations in her family for a while.

“Later, as my legal age was approaching, my mother and stepfather said that they did not want me to live with them. Our problems resumed, and I went back to drugs. After I turned 18, I had to move out,” tells the girl.

Despite the challenges, Halyna continued coming to the Centre for support and soon was able to quit drugs. She attended the Centre for about eight months. The girl says that for her, the Centre was a safe place and people working there helped her a lot. Halyna thinks that it is quite possible that if not for this support, she would still be using drugs.

Coming home for Mom’s birthday

Artem from Kropyvnytskyi is 22. He lives with his family – his parents, sister and grandmother. The young man says that he likes mountains, nature, rock-climbing and drugs.

When Artem was a teenager, he started taking alcohol, smoking cigarettes and then tried drugs for the first time. He confesses that he was not happy with his life and wanted to escape the reality, so he started “systematically” using drugs. Crystal meth, LSD, ecstasy and so on – he used everything except injecting drugs. It lasted for over four years.

Then his family intervened. Artem’s uncle suggested he should visit a psychologist from Lilia social bureau (NGO Return to Life). Psychologist’s counselling, awareness-raising classes, school of volunteers – all those things became part of the young man’s life.

However, just in several months he went back to drugs and had to start everything from scratch. Later, Artem spent three months in the rehabilitation centre run by the Return to Life NGO. He came back home last autumn, on his mother’s birthday.

“If it were not for this project and the social bureau, I would probably still be an active drug user. Maybe I would even end up in jail,” says Artem.

He became an active volunteer of the organization. Campaigns, workshops, summer school, working on his own project – all those things interest him and are an important part of his life. He has no desire to go back to drugs.

Drugs bring an illusion of the solution

Nineteen-year-old Carl is a second-year psychology student from the western region of Ukraine. He has parents and an older sister. Carl enjoys learning new things and likes history, especially military history. A year ago, he experienced some problems and his friends offered him a “way out” – together with them, he started using drugs.

“At first, I liked it, it felt exciting. Then I realized that drugs only bring me new problems. I grew addicted to drugs, could not communicate with people in a normal way, it interfered with my studies. When I understood that it all turns out to be a problem, I came to the Centre,” says Carl.

He heard about the Dialogue Centre a year and a half ago. Project workers regularly come to student dormitories and tell young people about HIV, drugs, safe sex, test them for HIV and hepatitis, distribute condoms.

“I lost many friends and acquaintances. Sometimes even my fellow students rejected me and called me a drug addict. I am a human, so when the society turns its back on me, it is very painful,” he recalls.

In the Centre, there was a psychologist who worked with Carl for six months. Embarrassed, Carl tells that he opened up during those counselling sessions and even cried. He says that the psychologist helped him to keep his life from going to pieces. Besides, in the Centre he could eat a meal and spend his leisure time.

“I know for sure what would happen to me if not for this Centre and this project. There was a friend of mine in the dormitory, who had a “point of no return”: he switched to hard injecting drugs, was kicked out of the dormitory and then – out of the university. It is quite probable that it would be the same with me,” says Carl.

The problems, which led the young man to drug use, are still there, but he realized that drugs do not resolve them, only bringing an illusion of solution. He is sure that every person should understand it.

About the project

‘Bridging the Gaps: Health and Rights for Key Populations’ is an international project, which was launched in Ukraine in 2011 and is aimed at protecting the human rights of drug users by changing social attitudes and government policies and improving the services they can access. The main activities are aimed at under-age drug users. Four partner organizations provide services to adolescents in four cities: Return to Life CF in Kropyvnytskyi, Public Health PRCF in Poltava, Blago CF in Kharkiv and New Family CF in Chernivtsi.

In Chernivtsi, there is a rehabilitation centre, while in other cities the services are provided through social bureaus and day care centres. The efforts are aimed at reducing the risks of drug use, re-establishing social connections and finding resources in the lives of adolescents to support them. The most important task for project workers is to make adolescents understand that in the centres they will be welcomed and will not be judged because of their drug habits.

AIDS 2018: Engaging Young People who use Drugs in the HIV and Human Rights Response in Ukraine

Source: www.aids2018.org

Ukraine presented its experience in engaging young people who use drugs in the HIV and human rights response during International AIDS Conference AIDS 2018 in Amsterdam. Organisations ACO “Convictus Ukraine”, ICF “AIDS Foundation East-West” (AFEW-Ukraine), CF “Return to Life” and CF “KCF “Blago” shared the results of their work.

Club for teenagers

The main purpose of the activity in the framework of the PITCH project is to prevent the spread of HIV and other dangerous diseases among vulnerable adolescents and to develop healthy lifestyle habits, the director of “Convictus Ukraine” Yevheniia Kuvshynova is saying.

In their work, “Convictus” team is actively using mobile clinic where they provide services for teenagers. A multidisciplinary team is operating on the basis of a mobile clinic. The mobile clinic helps them to bring the services to those who are not covered with prevention and treatment programs. There is also a school of leaders and a Street power youth club, where teenagers can spend their leisure time and receive help from psychologist or social workers, get information, medical services, testing, etc. Around 500 teenagers received services in the club.

Accepted the monitoring tool

Iryna Nerubaieva

The project manager of the ICF “AIDS Foundation East-West” (AFEW-Ukraine) Iryna Nerubaieva shared the results of the piloting of the tool for monitoring the violations of human rights of most-at-risk adolescents which was developed and implemented in the framework of the project Bridging the Gaps: Health and Rights for Key Populations. From January till December 2017 in four pilot cities, 792 interviews with adolescents and youth aged 14-21 were conducted. 430 adolescents were 14-18 years old. The number of cases of human rights violations registered in an online form was 92 of all surveyed. A young activist of the CF “Return to Life” Daria Kopyevska, a social worker of the CF “KCF “Blago”Alina Khokhlova and a lawyer and AFEW-Ukraine’s consultant Vita Musatenko also shared their experience.

“It is good to see that teenagers realized why they need this tool, and how social workers accepted it. Now they know how that it will help in their work,” Vita Musatenko is saying.

According to the latest estimates, the number of most-at-risk adolescents is 129 000, including 21 700 injection drug users. However, there is no official data on the exact number of most-at-risk adolescents, including underage drug users. In Ukraine, most-at-risk adolescents represent a very closed group, thus the lack of statistical data, stigma, discrimination and legal barriers make their access to HIV/STI services more complicated.

 

IVF for Women with HIV in Ukraine: Bringing the Right to Have a Child Back

Svetlana Moroz (second on the right) discusses the elimination of the discriminatory norms at a round table. Photo by Positive Women NGO.

Authors: Yana Kazmirenko, Tamara Balayeva, Ukraine

In Ukraine, amendments are prepared to the regulations of the Ministry of Health (MoH) prohibiting in vitro fertilisation (IVF) for women living with HIV. Currently, HIV is in the list of diseases, which are contraindications for IVF, approved by the MoH. In Western countries, IVF has been successfully delivered to women living with HIV for a long time. Ukrainian activists strive for the prohibition on in vitro fertilisation for women living with HIV to be abolished.

In early July, a round table discussion was held in the Public Health Centre at the MoH. At AIDS 2018 in Amsterdam, activists are planning to meet with Ulana Suprun, Acting Minister of Health of Ukraine, to present their insights and explain why it is so important to abolish the outdated regulations.

Discrimination and self-stigmatization

There is no statistics on how many women living with HIV apply for IVF in Ukraine every year and are refused. Svetlana Moroz, representing the Positive Women NGO, sent relevant requests to 10 regions. So far, there have been no replies. Svetlana says that information about the attempts of women living with HIV to make IVF is shared only among civil society activists.

A woman with HIV status sought help in their organization. After long searches, she found a clinic in Kharkiv, which was ready to work with women living with HIV

“She made two attempts, which have not been successful so far. Another woman from Sloviansk used her advice and also sought assistance in this clinic, but she had a miscarriage,” tells Svetlana.

She says that some private clinics agree to make IVF to women living with HIV but do not advertise it due to the orders of the MoH. Such clinics charge their clients a double price because of the possible risks. Other health facilities use standard excuses: lack of equipment or reference to HIV being on the list of contraindications for IVF.

Apart from the MoH orders and reluctance of clinics, there is another barrier – self-stigmatization. According to Svetlana Moroz, many women living with HIV do not even try to seek assistance in IVF clinics: they know that they will face a refusal or do not know that they even have such a right.

All IVF risks are myths

Valentina Kvashenko, chief physician of the A.A. Partners Health Company also thinks that refusal to make IVF to HIV-positive women is a discriminatory practice and that concerns about the risks of HIV transmission are ungrounded. Doctors carry out all the manipulations with semen and eggs with disposable catheters and needles. In the course of deliveries, they wear gloves, glasses, and aprons. The same safety precautions are used during all standard deliveries. Usually, only one embryo is transferred to women with HIV status to reduce the potential need of invasive interventions.

“There is no need in “prohibiting” regulations, due to which people are not able to perform their reproductive functions and become parents,” says Valentina, adding that HIV may be transmitted from mother to child, but only if the woman is not taking antiretroviral therapy (ART).

She gives statistics to prove her words: in 1996-1997, when there was no access to antiretroviral drugs in Ukraine, HIV was transmitted from mother to child in 60% of cases. Now this rate is less than 10%. Even this percentage only relates to children born to women who do not receive ART. Besides, the IVF procedure reduces the risk of virus transmission to a minimum.

Litigation for the right to IVF

If the letter to the Ministry of Health will not give a result and will not allow to promptly introduce amendments to the regulations, the activists have a second option – legal action.

“We will work on creating a legal case. The fact is that the MoH regulations contradict the laws of Ukraine, which do not prohibit in vitro fertilization for HIV-positive women. If nothing else works, we will find a woman living with HIV who is ready to go all the way and defend her rights in court,” explains Svetlana Moroz.

It is expected that draft amendments to the regulations will be ready and presented to the Ministry of Health in late November. While the old regulations are still in force, Svetlana gives recommendations to women who are refused the IVF services.

“Always demand official refusals. With the doctor’s words only, you will not be able to file a lawsuit in court and all the more to win it. Secondly, seek assistance in human rights organizations. For example, our organization is ready to provide free lawyers’ services to women, help them to prepare the required documents and in general offer all the necessary legal support,” sums up Svetlana.

After the discriminatory regulations are abolished, Ukrainian women living with HIV will have a right to participate in the state-funded IVF program for childless couples.

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