We are no longer at risk of having to close our doors!

In 2020, the Emergency Support Fund for key populations in Eastern Europe and Central Asia supported 85 applications from 9 countries. One of them was a project to support the Revansh drop-in centre in Kazakhstan, which at the time of filing the application was facing the threat of closure.

Elena Bilokon, Head of the center, told AFEW International about how the Fund helped the centre to continue its activities and provide vital services aimed at removing barriers to access to treatment and medical and social services among People Who Inject Drugs (PWID) and People Living with HIV.

An emergency situation

Our centre first opened 3 years ago. Since then, we have succeeded in providing assistance to people from socially unprotected segments of the population, people who are often rejected even by those closest to them due to being diagnosed with HIV or tuberculosis; people who have lost all hope that the future could be brighter than the present. In 2020, our drop-in centre was under threat of closure due to inability to pay the rent. If it were closed, then 18 people living in the drop-in center would be on the street, and 422 people could lose their registration and, accordingly, access to ARV treatment and prevention, as well as other medical and social services. At the time of contacting the Fund, the center had a 3-month lease debt of 600 thousand Kazakhstani tenge (approximately 1400 USD), and did not have the means to pay fees to team members.

Results

Our activities within the framework of the project provided people with access to medical and social services. This included increased the access of PWID to medical services, allowing them to enter opioid substitution therapy programs, enabling people to start taking ARV therapy and TB treatment, and improved their quality of life. We were also able to communicate the problems and situations experienced by people with TB and HIV to government agencies, the media and the partner network of providers.

Centre for women who left detention facilities

During the implementation of our projects, we had an urgent need to revise a range of special social services, taking into account needs by gender. We had to solve the problem of finding temporary housing for women with socially significant diseases and their children. Centres which provide services to men, including those registered with probation services, such as The Centre for Social Adaptation, do not accept children. During the COVID-19 quarantine and global crisis, women of this target group suffered the harshest consequences. Many of them lost their jobs, due to the inability to pay the rent, or due to a lack of documents or gadgets, or low computer literacy. Many could not receive government benefits during the emergency.

Therefore, in May, within the framework of the UNFPA project to strengthen the potential of women, we opened another centre for women living with HIV. The centre was dedicated to women who left detention facilities and found themselves in difficult life situations, where they underwent a re-socialization program and received temporary accommodation services. A range of services were provided to 132 women and 37 children. These women learnt computer literacy, completed courses in hairdressing and sewing, received help from a psychologist and a lawyer who was attached to the clinic, and began to receive ARV treatment. Also, the women studied in a law school organized with the support of the Emergency Aid Fund. This project ended at the end of September and we see a need to continue this initiative.

What does the Emergency Support Fund mean for you?

The support of the fund was a kind of lifeline for us, since our organization was on the verge of collapse. In addition, the grant from the Fund became a launching pad for new opportunities and expanding partnerships. So, for example, from September 1, 2020, we are participating in the 4-year project “Radian” – “Creation and implementation of a sustainable, comprehensive, cost-effective urban program to control the HIV epidemic in the city of Almaty”. This is aimed at increasing adherence to ARV treatment, as well as testing and prevention.

The Soros Foundation extended its support in 2020. Within the framework of the project, people can receive the entire necessary range of services, including completing necessary documentation for registration and temporary residence, they can also use paid ultrasound and dentist services – many have not received these services since the age of 15-18. The types of services our organization provides has expanded, and today we provide psycho-social support to women of fertile age at a new clinic, where our peer consultants provide Sexual Reproductive Health and Rights consultations and consultations on ARV adherence. In general, the Emergency Fund helped to strengthen the capacity of the organization, the professional growth of employees, the development of policies and procedures of the organization. Through a variety of gender-oriented services, it helped to solve acute psychological, legal and social problems of women from key populations, helped them to gain counselling skills, communication skills, the ability to speak with employers, government officials, and enabled them to re-establish broken social ties with relatives.

A client´s story

A man, originally from Karaganda, was in Almaty, working, when the COVID-19 emergency hit. It so happened that he lost his documents, contracted COVID-19 and received treatment. However, after being discharged from hospital, the man had nowhere to go. Being in a new city, without documents, he was facing his difficulties alone. He was also unable to receive his ARV therapy. Luckily, the man ended up in our centre. During his stay at the project, he managed to recover his identity card, and registered with Centre-AIDS, where was provided with psychological and legal assistance, and found a job.

Maria, 42 years old, a person living with HIV, a user of psychoactive substances, had been on the list of lost patients of the State AIDS Center since 2019. She was admitted to the Revanch Foundation from the Republican Center for Mental Health after undergoing treatment for addiction to psychoactive substances, with partial amnesia and suicidal inclinations. During the three months of her stay in the Project, she received all the necessary range of services: she was signed up to receive primary health care, she received access to ART, accommodation services, assistance in obtaining disability pension payments, she underwent an ultrasound of the heart, she received a grocery certificate. She now attends Counselling Groups and Legal Literacy Schools.

It is for the sake of happy stories such as these that we continue our activities. Thank you very much to your foundation for supporting the most vulnerable groups of the population and helping us to implement socially significant projects.

Emergency Support Fund for Key Populations in EECA goes on holidays!

Attention!
Due to the winter holidays Emergency Support Fund for Key Populations in Eastern Europe and Central Asia (EECA) region will not evaluate applications for the period from December 17th to January 11th 2021.

The last day to submit proposal is on 17th December, midday Amsterdam time.

Apply for Emergency Support Fund for Key Populations! 

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

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

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

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

Please find details here.

The desire to live

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

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

Openly about HIV status

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

BEFORE

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

AFTER

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

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

Fear of talks with family

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

To accept the status

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

HIV denialist

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

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

Prevention should not be overlooked

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

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

About the reason for the growing numbers

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

About the Emergency Support Fund for Key Populations in EECA

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

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

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

                About MSM/LGBT community in St. Petersburg

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

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

                About the ideal society

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

                About community engagement

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

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

Don’t blame your status

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

Why do you speak openly about your status?

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

What is HIV for you?

HIV is a human immune virus, nothing more.

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

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

Your relationships with society

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

What helped you to overcome that fear?

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

Why is it important not to be pessimistic?

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

What would you say to all other teenagers with HIV?

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

No One Can Stop Young People Now!

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

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

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

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

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

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

How did this grant help you?

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

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

How did the young people change?

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

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

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

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

What does the society think about your work?

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

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

ATTENTION! GRANTS!

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