AFEW: Projects >> Drug Demand Reduction and Health Promotion Among Sex Workers (Tajikistan)

Drug Demand Reduction and Health Promotion Among Sex Workers
Tajikistan

PROJECT DURATION: October 2002 through September 2005

DONOR(S): United States Agency for International Development (USAID; www.usaid.gov)
The Drug Demand Reduction Programme (DDRP) is a five-year USAID-funded initiative in Central Asia designed to respond to the dramatic increase in drug use among vulnerable populations in two key countries of a region in which HIV/AIDS is spreading rapidly and primarily through injecting drug use.

Throughout the five-year Programme, Drug Demand Reduction interventions will be implemented in select oblasts of Tajikistan, Uzbekistan, and the Ferghana Valley region of Kyrgyzstan with the short term goal of 'increased knowledge and skills with respect to the prevention of drug use in select populations'. This is stated as a step toward the long-term goal of a 'decrease in drug use among these select populations'.

PARTNER(S): The Open Society Institute - Kazakhstan, The Open Society Institute - Tajikistan, Internews, Population Services International (PSI); Accord - an affiliate of Street Kids International; The Ministry of Health of Tajikistan, The Ministry of Internal Affairs of Tajikistan

REGION: Tajikistan

BACKGROUND:
The number of women working in the sex industry has rapidly increased in the Central Asian Republics during the last decade. This growing phenomenon is the result of a multitude of factors including the significant and far-reaching socio-economic and political changes which have continued to sweep the region since gaining independence in the early 1990s.

Many women from this region continue to struggle with high levels of unemployment and ultimately, the feminisation of poverty. Sex work is often one of the few income-generating options available to support themselves and their families. As such, tendencies such as high migration patterns from rural to urban regions, and frequent movement across borders into neighbouring countries, have been noted among women and young girls.

Drug use and sex work are strongly interlinked. Drug users often sell or trade sex for narcotics and sex workers often use drugs as a coping mechanism. As of 1 April 2003, the Republican AIDS Centre reported 92 registered cases of HIV/AIDS for Tajikistan. Among these cases, 60% are attributed to injecting drug use where the route of transmission is known. An additional 20% of registered cases have been attributed to heterosexual contact.

OVERALL OBJECTIVE:
To contribute to the implementation of a comprehensive and sustained, country-wide drug demand reduction policy through the development of a pilot programme on drug demand reduction and health promotion among sex workers in Tajikistan

SPECIFIC OBJECTIVES:
1. To develop within the Tajik government and NGOs the appropriate tools and structures for drug demand reduction and health promotion among sex workers and to promote the transfer of knowledge and skills among all counterparts involved
2. To strengthen the personal decision-making skills of sex workers related to drug demand reduction via drug counselling services, peer support, and the distribution of appropriate information materials
3. To reduce the relative isolation of Tajik sex workers by promoting and facilitating the establishment of peer-led self-help groups, strengthening survival skills, increasing access to alternative employment training, and by stimulating co-operation with the respective municipal health institutions and NGOs
4. To stimulate the replication of developed structures in Tajikistan in close co-operation with the Ministry of Health, municipal health authorities, and NGOs

TARGET AUDIENCE(S):
· Sex workers
· Selected governmental and non-governmental organisations
· Law enforcement agencies
· Health professionals working within drug treatment establishments, sexually transmitted infection clinics, and AIDS centres
· Local and national health authorities

PROGRAMME ACTIVITIES:
The following activities may be developed, implemented, evaluated and handed over to local agencies during the five-year programme:
· Conduct an extensive rolling needs assessment in Tajikistan among sex workers
· Development and dissemination of practical training guidelines for local partner organisations and agencies on themes related to drug demand reduction and health promotion among sex workers
· Conduct capacity building seminars on themes related to drug demand reduction and health promotion for local project partners and target audiences
· Regular consultancy site visits by AFEW technical advisors to project sites
· Development, production and dissemination of a wide range of printed materials on issues related to drug demand reduction and health promotion for all programme target audiences (i.e., sex workers, NGO personnel, medical professionals, law enforcement officials, health authorities and policy makers)
· Promotion of and support for the establishment of local peer-led initiatives such as self-help groups to assist in building self-esteem, confidence, and to provide education and support to other sex workers
· Development of links to existing alternative employment training programmes and potential partnerships with micro-credit initiatives to support opportunities for women seeking to leave the sex industry
· Development of a training programme and information resources on drug demand reduction for Tajik law enforcement agencies and medical establishments
· Participation in a regional drug demand reduction conference during the third and fifth years of programme activities

(EXPECTED) RESULTS:
· A comprehensive, multi-sectoral results-based programme will be developed and implemented on drug demand reduction and health promotion as a direct outcome of the extensive needs assessment among sex workers
· A continuum of 10 to 12 capacity building training seminars will have been implemented among NGO personnel, police and health authorities, and medical professionals from several regions of Tajikistan
· A series of best practice training guidelines for partner organisations on drug demand reduction and health promotion among sex work populations will be developed and widely disseminated across all regions of Tajikistan
· Response-based targeted materials on drug demand reduction and health promotion will be developed and disseminated in collaboration with sex work populations in Tajikistan
· Political commitment and involvement from local and national health authorities will facilitate the development and dissemination of materials and will support the sustainability of programme operations through a controlled hand-over process to local structures

(EXPECTED) MATERIALS PRODUCTION:
Throughout the duration of the five-year programme, a comprehensive series of quality printed materials and best practice resources will be developed and disseminated among sex workers, medical professionals, NGO personnel, law enforcement officials, and policy makers in Tajikistan, including the following:
· As many as four (4) best practice manuals on drug demand reduction, and health promotion materials will be developed and disseminated among the project target audiences
· 50 000 copies of health promotion printed materials will be disseminated among sex work populations in Tajikistan
· 8 000 copies of best practice resources and guidelines will be developed and disseminated among NGOs, health professionals, and health authorities in Tajikistan
· 10 000 copies of guidelines on health promotion and drug demand reduction materials will be developed and disseminated among Tajik law enforcement officials

RESEARCH COMPLETED AND PLANNED BY AFEW:
· In December 2002 to January 2003, AFEW completed a baseline needs assessment among NGO counterparts.
· In June 2003, AFEW completed a Rapid Assessment and Response on psychoactive substance use and sexual risk behaviour (SEX-RAR) among sex workers.
· In June 2003, AFEW completed a baseline KAPB survey among sex workers.

FOR FURTHER INFORMATION, PLEASE CONTACT:
Robin Montgomery
Head
HIV Prevention and Health Promotion Among Sex Work Projects

Office Address:
Chayanova St. 15/5
Moscow 125267 Russian Federation
Tel: +7 495 250 6377
Fax: +7 495 250 6387
Email: robin_montgomery@afew.org
Website: http://www.afew.org

Olga Barakaeva
Project Co-ordinator
HIV Prevention and Health Promotion Among Sex Work Projects

Office Address:
64 Zhibek Zholy St., Office 500
Almaty 480002 Kazakhstan
Tel: +7 3272 730 506, 73 57 46, 73 29 77, 73 10 49
Fax: + 7 3272 73 32 84
Email: olga_barakaeva@afew.org
Website: http://www.afew.org

International Postal Address:
AFEW
P. O. Box 75752
1070 AT Amsterdam
The Netherlands