AFEW International Releases Report on Its Activities for AIDS 2018 Conference

AFEW Network (AFEW)  has a long history of working to link the “east” with the “west” so when the decision was made to hold the 22nd International AIDS conference (AIDS 2018) in Amsterdam, the city that is home to AFEW International, the secretariat of AFEW Network, it was clear that AFEW could have an important role in leveraging the conference to bring global attention to the crisis situation in Eastern Europe and Central Asia (EECA). Starting from 2016, with the support of the Dutch Ministry of Foreign Affairs (MoFA), various strategies (fostering linking, learning and dialogue; developing creative solutions to unresolved challenges; influencing leaders, policymakers and donors; addressing stigma, discrimination and criminalization of people affected by HIV) were undertaken as to empower communities from the EECA to take part in AIDS 2018.

Leading up to and during AIDS 2018, AFEW International engaged in a range of activities to promote EECA at the conference and to promote the conference in EECA. An independent evaluator examined the impact of the implemented activities and factors that contributed to the successes and analyzed the challenges. In the report, you can read what were the key activities and lesson learned.

The short version of the report can be read here.

The full version of the report can be read here.

Research: ‘Virus Carriers’ and HIV Testing: Navigating Ukraine’s HIV Policies and Programming for Female Sex Workers

Background

There are an estimated 80,100 female sex workers (FSWs) in Ukraine, of whom 7% are living with HIV. Early HIV diagnosis continues to be a public health priority in Ukraine as only approximately 54% of people living with HIV are diagnosed nationwide. This study aims to analyse the content, context and discourse of HIV testing policies among female sex workers in Ukraine and how these policies are understood and implemented in practice.

Methods

To analyse past and current national policies, we searched the database of the Ukrainian Parliament and the Ministry of Health for relevant policy documents (e.g. legislation and orders). To analyse the day-to-day practice of those involved in the implementation of these HIV programmes, we conducted face-to-face semi-structured interviews with key stakeholders. All data were coded using deductive thematic analysis initially guided by the Policy Triangle, a framework which addresses policy content, the process of policy-making, the health policy context, actors involved in policy formulation and implementation.

Results

HIV testing policies are formed and implemented in the post-Soviet context through a vertical system of AIDS clinics, resulting in the separation of key affected populations from the rest of the health system. Successive testing policies have been strongly influenced by international donors and non-governmental organisations. Furthermore, a lack of government funding for HIV prevention created a gap that international donors and local non-governmental organisations covered to ensure the implementation of testing policies. Their role, however, had limited influence on the Ukrainian government to increase funding for prevention, including testing of FSWs. Since the early 1990s, when stigmatising and discriminatory forced/mandatory HIV testing was applied, these approaches were slowly replaced with voluntary testing, self-testing and assisted HIV testing, yet stigma was found to be a barrier among FSWs to access testing.

Conclusion

Poor governance and the fragmentation of the health system, ongoing health sector reforms, shrinking international funding, and persisting stigma towards people living with HIV and sex workers might impede the continuity and sustainability of HIV testing programmes. Local civil society may now have the opportunity to contribute to the development and further implementation of HIV testing policies in Ukraine.

Read the full version of the research here.

 

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.

Compendium of good practices in the health sector response to HIV in the WHO European Region

In response to the rapidly increasing number of new HIV infections in the WHO European Region, the action plan for the health sector response to HIV in WHO European Region was endorsed at the 66th session of the WHO Regional Committee for Europe in September 2016. From December 2017 to April 2018, the WHO Regional Office for Europe collected good practices in implementation of the action plan and compiled them in this compendium.

National health authorities, national and international experts, and civil-society organizations involved in HIV prevention, treatment and care were solicited to share their practices. The practices exemplify efforts within five target areas: HIV prevention; HIV testing and treatment; reducing AIDS-related deaths; curbing discrimination; and increasing financial sustainability of the HIV/AIDS response. This first compendium of good HIV practices in the WHO European Region includes 52 practice examples from 32 Member States. The compendium is intended as a resource for relevant stakeholders in the HIV response.

Download the compendium here.

Source: WHO Europe

Awareness and Acceptability of PrEP Among Men Who Have Sex with Men in Kazakhstan

Oral pre-exposure prophylaxis (PrEP) is an antiretroviral method of HIV prevention recommended to men who have sex with men (MSM) at high risk of infection. In Kazakhstan, which has one of the fastest growing HIV epidemics globally, PrEP is not currently available. The aim of this study is to explore the possibilities for PrEP initiatives in Kazakhstan by investigating awareness and acceptability of this prevention method among MSM. This mixedmethods study employs an online survey and qualitative interviews to describe PrEP awareness and acceptability. Less than half (39.8%) of survey participants had heard of PrEP.

However, a majority (85.2%) of MSM would possibly or defi nitely use PrEP if it was available. Awareness of PrEP was positively associated with willingness to use PrEP. The main reason to be interested in PrEP was an increased feeling of protection, whereas barriers were related to the idea of taking daily medication and the potential for side effects. PrEP is an essential component of HIV combination prevention. Our findings suggest potential for PrEP programmes among MSM in Kazakhstan and possibly in other Central Asian nations, when taking into account burdens of taking PrEP as well as more structural health policy issues.

Read more of the study here.

We Fight, We Hide or We Unite

We Fight, We Hide or We Unite: coping strategies amongst resilient harm reduction organisations and community networks in the context of shrinking space for civil society in Eastern Europe and Central Asia

The title of this report, ‘We Fight, We Hide or We Unite’, reflects the survival strategies we identified amongst resilient harm reduction non-governmental organisations and community networks of people who use drugs (PWUD) in Eastern Europe and Central Asia (EECA). This assessment forms a part of the regional approach of the AFEW Network within the ‘Bridging the Gaps: health and rights of key populations’ programme, financed by the Ministry of Foreign Affairs of The Netherlands. This report presents the primary findings from the assessment, ‘Shrinking Space for Civil Society Organisations in Eastern Europe and Central Asia’, conducted between June and September 2017 at the international level by AFEW International and at the regional level.

We provide a detailed description of the overall study purpose, methodology, background and context regarding the shrinking civil society space and the coping strategies of HIV and PWUD CSOs working under these circumstances. The results of this assessment will be used to develop ideas and strategies on how to cope with the local contexts of the shrinking civil society space. In this way, it will contribute to the survival of CSOs and improving the current situation. This assessment represents the first step in the development of this focus within the AFEW Network’s regional approach within the ‘Bridging the Gaps’ programme. It will be followed by an analysis of existing gaps in the support necessary for specific interventions and initiatives to support specific coping strategies; the development of pilot projects on advocacy, service delivery or capacity building; and the continuous monitoring of results.

The full version of the report is available here.

Key Asks from Tuberculosis Stakeholders and Communities for the United Nations High Level Meeting

The five tuberculosis (TB) “Key Asks” announced by stakeholders and communities are priority actions that have been developed through a combined extensive engagement with the global TB stakeholders and communities, including the United Nations (UN) agencies, high-burden TB countries, donors, civil society, people affected by TB, and the private sector. It is crucial that the aspiration of the TB Stakeholders and Communities are considered to inform the content of the Zero Draft and the subsequent final Political Declaration that will be endorsed at the UN High-level Meeting (UNHLM) on September 26th to achieve the goal of ending TB by 2030.

Through the Sustainable Development Goals and their endorsement of the World Health Organisation (WHO) End TB Strategy, UN member states have committed to ending the TB epidemic by 2030. However, at the current rate of progress, this will not be achieved for at least another 150 years. Without immediate concrete action, an estimated 28 million people will die from TB by 2030, at a global economic cost of USD$1 trillion. The case for ending the TB epidemic is clear. Every dollar spent on TB could return benefits to society worth US$43.

The following priority actions must be taken by Heads of State and Governments to accelerate progress and achieve the goal of ending TB:

  1. Reach all people by closing the gaps in TB diagnosis, treatment, and prevention
  2. Transform the TB response to be equitable, rights-based, and people-centered
  3. Accelerate development of essential new tools to end TB
  4. Invest the funds necessary to end TB
  5. Commit to decisive and accountable global leadership, including regular UN reporting and review

 

Source: http://stoptb.org

Needs and gaps in treatment and rehabilitation for people who use drugs in selected countries of EECA

Report on the needs and gaps in treatment and rehabilitation for people who use drugs in selected countries of EECA

This report presents the results of an assessment on the availability of and access to treatment and rehabilitation services for people who use drugs (PWUD) in selected countries of the Eastern European and Central Asian (EECA) region. It was carried out through a regional approach developed by the AFEW Network within the programme ‘Bridging the Gaps: health and rights for key populations. Phase 2’, fi­nanced by the Ministry of Foreign Affairs of the Netherlands.

The assessment focused primarily on the topics of rehabilitation and human rights. AFEW International was responsible for information at the international level, whilst regional level assessments focused on EECA countries where the AFEW Network implements the project amongst PWUD, namely, Georgia, the Kyrgyz Republic, the Russian Federation and Ukraine. We expect the results of this assessment will be used to improve the current situation with access to treatment and rehabilitation services for PWUD in the EECA region, particularly in those countries in which the AFEW Network works. Findings from this analysis of existing gaps, this assessment represents the fi­rst step to developing rehabilitation services and human rights under the AFEW regional approach. Furthermore, the ­findings will inform the development of pilot projects on advocacy, service delivery or capacity building and the continuous monitoring of results.

The full version of the report is available here.

Findings from a needs assessment survey of labour migrants among people who use drugs in the pilot regions of Kyrgyzstan and Tajikistan

Findings from a needs assessment survey of labour migrants among people who use drugs in the pilot regions of Kyrgyzstan and Tajikistan

30 November 2017

Financial support for this survey was provided through the budget of the project ‘Bridging the Gaps: Health and rights for key populations 2.0’, funded by the Ministry of Foreign Affairs of the Netherlands. Additional financing agreements with AFEW International as of 1 July 2017 and with the UNAIDS country office in Tajikistan as of 31 July 2017 helped finance the survey.

Our analysis points to a set of problems related to information, as well as social, legal and education issues. People who use drugs face these same problems whilst planning, remaining in and returning from periods of labour migration. A lack of finances and social vulnerability represented key problems faced by migrants when planning their labour migration. A lack of finances hampers access among people who use drugs to complete medical examinations through primary healthcare facilities, HIV testing and TB diagnosis in order to obtain the necessary certificates, including those from HIV centres, drug rehabilitation centres and TB control institutions.

The full version of the report is available here.