HIV/AIDS Prevention

Information on Projects concerning HIV/AIDS Prevention

There are five main types of activities in this area:

1. Prevention of HIV-transmission amongst drug users.

This service provides:

1. Primary delivery and exchange of syringes.
2. Provision of condoms.
3. Provision of antibacterial wipes and disinfectants.
4. Secondary exchange of syringes.
5. One-to-one consultations with outreach workers.
6. After testing and medical inspection, referral to the TB Dispensary (in-patient department); Skin and Venereal Dispensary, or Centre for AIDS Prevention and Treatment (mobile, fixed and street clinics).
7. Consultations with social workers on the issues related to a safer lifestyle.
8. Legal help.
9. Psychological help.
10. Medical help: bandages, examination, referral, consultation; provision of medicines.
11. Specialist advice on narcology.
12. Distribution of information: leaflets, newspapers, journals, booklets, guidebooks.
13. Voluntary consultation and testing with the help of express tests.

These services are provided through fixed consultation centres, mobile consultation centres (reequipped minibus) and 12 street routes.

The fixed consultation centre is efficiently located in the centre of the city, near one of the largest areas of IDU use.

The mobile centre for syringe exchange enables us to access even the most remote areas of drug use in the city. The flexibility of the mobile centre means that we can respond easily to changing circumstances and emergencies.

The main aim of the street routes is to locate IDUs and provide them with information on a safer lifestyle, as well as support the work of other HIV/AIDS programmes and medical organizations.

Outreach workers establish and maintain trustworthy relations with IDUs, as well as teaching them about health issues. Street routes characteristically have a high concentration of IDUs and dispense various medicines.

The following scheme shows how the training of outreach workers and the outreach work operate.

Training IDUs, who are part of the ‘Harm Reduction’ programme, has five main stages:

• Selection of IDUs who are trained for further outreach work. The criteria for selection are attendance and results of a post-training test and activities.

• Training of outreach workers: practical training includes the knowledge and skills needed by an outreach worker, as well as management of outreach work. Following the training, an internship is provided.

• Outreach work: the daily tasks depend on the type of outreach work chosen (on the street, at home, etc.), and on the documentation, attendance and participation in the outreach meetings.

• An internal supervisor oversees this process.Once one group of outreach workers has been trained, the next cycle is started immediately.

• Every outreach worker has the help of fomer IDUs in order to establish initial contact with the drug users.

Main results of 2009:

2. Community Center for IDU.

Three of our outreach workers, Aleksey Vlasov, Konstantin Shportun and Mikhail Kolesnikov, came up with the idea of establishing a Community Center as part of the fund.

The purpose of the center is to highlight the problem of drug use and bring together those who have been affected by drug abuse. At the center we educate drug users and seek to provide them with care and assistance, as well as providing a safe and comfortable place for them to congregate and spend time in a different environment to the street         .

Therefore we work in order to:

• Mobilize and bring together drug users, by encouraging them to talk openly about their problems and subsequently solve the problems prevalent in the community.
• Promote the concept of self-help among drug users.
• Provide alternative ways for drug users to spend their time (ie activities which do not entail drug use and illegal behaviour).

Our work with Injecting Drug Users (IDU) in the drug community:

• special “Harm Reduction” program and Needle Exchange Program (NEP)
• with IDU clients at the community centre
• initial talk to identify the needs of the patient and formulate a plan of action
• consultation on ST: criteria for selection, duration of the program, services of the ST program;
• redirection or guidance of IDU according to their needs;
• consultations on life with HIV, ARV and adherence for HIV positive IDU;
• consultations on safer injection and sexual behavior for HIV negative IDU; Age distribution
  

  under 18	17%
  19 – 25 y.o.	27%
  26 – 30 y.o.	22%
  older than 30	34%.

  Years of drug abuse

  1-5 years	24%
  5-10 years	29%
  10-15 years	21%
  more than 15 years	26%.

  Pattern of usage

  Regularely takes drugs	44%
  Occasionally take drugs	56%

  Type of drugs

  Canabioids	22%
  Opiates	27%
  Pervitin	21%
  Polydruguse	30%

There is book and video library in the community centre, which is regularly updated, including a selection of ten books by the detective fiction writer James Chaise.  On Saturdays the center runs a Discussion Club. The members of the community gather together and have discussions on a range of interesting topics (drug use, political affairs; films; news; energy resources…). There is a practical element to these discussions: in the first meeting the discussion was about use a condom correctly. The discussion showed that only seven in ten participants knew how to use a condom correctly. As this example shows, the discussion club is a very important and useful part of the centre – it allows participants to exchange their life experiences with one another.

The centre also organizes IT courses for beginners. Some of the participants learn how to operate a computer using the book «PC for Beginners».

One of the most popular facilities at the center is the laundry room.. On average 2-3 people come to wash their clothes here every day.

Every Summer the members of the community run a summer camp on the coast of the Khadjibey salt estuary. There are two groups that go at different times – each group consists of 25 members and they stay at the camp for 10 days.

3. Integrating IDU into programs of alternative and antiretroviral therapy.

These activities are instilling into drug users the refrain: «Treatment is Possible». There is both a basic and an advanced version of this scheme. The basic scheme entails provision of the following services to IDU: consultations with social workerson ST and ART, VCT, consultations with specialist drug doctors (narcologist and infectionist), adding potential patients for the ST program to the centre’s database. The advanced scheme is more comprehensive and aims to find out the needs of IDU which will help them to adopt safer ways of living, and encourage them to take part in ST and ART programs, including participation in the activities which take place at the community centre. The activities are based on modern strategies such as «Case Management» and «Positive Prevention».

Activities.

1. Establishing contact with drug users and providing information about the ST program:

• with IDU clients of «Harm Reduction» in stationary NEP, mobile NEP,
• with IDU clients at the community centre.

2. Guiding the patient through the process of rehabilitation by applying the principles of «Case Management»:

• there is an initial talk to identify the needs of the patient and formulate a plan of action
• consultation on ST: criteria for selection, duration of the program, services of the ST program;
• redirection or guidance of IDU according to their needs;
• consultations on life with HIV, ARV and adherence for HIV positive IDU;
• consultations on safer injection and sexual behavior for HIV negative IDU;

3. Group work with IDU registered in the centre’s database (patients who are in the waiting list for ST) to establish a model that will enable us the maintain contact with IDU, carry out educational work and raise social awareness.

4. Prevention of HIV-infection among prisoners in Odessa jails.

Strategies and approaches to realize the program “Prevention of HIV-infection among prisoners in Odessa jails” are based on the implementation of activities which aim at providing information on topics related to HIV/AIDS, living with HIV, and also by carrying out a training programme to improve the level of knowledge of people infected with HIV/AIDS, TB, Hepatitis and others diseases, teaching them how to care for themselves, and raise social awareness among the infected.

The activities are:

1.    Preparing consultants for a «rapid response» to infected individuals

Results – 200 consultants were trained to carry out a «rapid response» .

- 1000 infected individuals got information from consultants about «rapid response».

2.    Work of self-help groups on HIV/AIDS .

Result – at least 15 self-help groups carry out meetings once a week.

3.    Work of psychiatric group

Result – at least 15 constant self-help groups carry out meetings once a week.

4.    Work of the group for chemically addicted individuals.

Result – at least 15 constant self-help groups carry out meetings once a week.

5.    Providing to infected individuals single-use shaving sets .

Result – 1200 infected users received single-use shaving sets.

6.    Provision of tooth-brushes to infected individuals.

Result – 1200 infected individuals get tooth-brushes.

7.    Development of the theatre «Basis»  – 2 performances.

Result – at least 1000 infected individuals received information on HIV/AIDS, living with HIV.

8.    Development and implementation of radio lectures

Result – at least 1000 infected individuals listened to the radio lectures about HIV/AIDS.

5. Information and Resource Center on HIV/AIDS.

The aim of this programme is to establish and operate a Centre for the Professional Training of Staff and Volunteers for HIV-service Organizations in the Odessa region.

The need to establish this Centre arose for the following reasons:

Due to the reasons mentioned above the following is often the case:

• Absence of training programmes
• Existence of specialists with inadequate knowledge for the project
• A big gap in qualifications and the level of knowledge between NGOs in Odessa and NGOs and initiatives in small towns
• Often new staff from NGOs are sent to specialized trainings when the training is actually irrelevant to their position and the requirements of their role.
• Often when a trained individual leaves an organization the organization is left with a considerable gap in its knowledge with regards a particular field.
• Small towns in particular need a successful educational programme, where specialization is added to the basic knowledge.

The unique feature of this initiative is the introduction of a phased training programme, taking into account the existing level of education and information of the people being trained.

The education programme is divided into 3 stages.

Stage 1. Basic level.

This stage is aimed at new staff and the volunteers of the NGOs.   The main aim of this stage is to increase the motivation of the volunteers and the new workers, provide general orientation in the programs and information about the organisation’s activities in the field of HIV/AIDS, provide basic up-to-date information about HIV/AIDS and ART, including information about modern methods of prevention, and during the training the participants have the opportunity to meet leading specialists and organizations working in this field.

The program of Stage 1 is designed for 30 hours (6 hours per day during 5 days). Regional specialists join the programme and give lectures on topics such as prevention of infection among vulnerable groups, treatment, care and support for PLH, prevention of transmission, medical specialists. This approach gives the participants the chance to see the topic of AIDS/HIV in a new light and prepare them for their activities in the field of HIV/AIDS, and also allow them to choose an area of specialization which is suitable for them.

Stage 2. Specialization.

This stage teaches participants new skills in their chosen specialization which they can apply during their practical work. This stage includes 4 training areas: “Outreach work and work according to the peer-to-peer principle, “Social Guidance”, “Basics of Providing First Aid (for instance in the case of overdoses, bleeding), “Prevention of HIV/AIDS and Tuberculosis”. The people who work for the HIV-service NGOs of Odessa city and region who are directly involved in the provision of services to drug users, take part in the trainings.

Stage 3 Management.

This stage is aimed at the heads and managers of NGOs. Its main purpose is to raise the level of qualifications with the aim of increasing the efficiency of the charity’s management. Training includes 2 three day training sessions, based on the following topics: time management, case management, basics of strategic planning of NGO development, methods of increasing efficiency, etc.