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

Drug Demand Reduction and Health Promotion Among Sex Workers
Uzbekistan

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 - Uzbekistan, Internews, Population Services International (PSI); Accord - an affiliate of Street Kids International; The Ministry of Health of Uzbekistan, The Ministry of Internal Affairs of Uzbekistan

REGION: Uzbekistan

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 July 2003, and according to the Republican AIDS Centre of Uzbekistan, Ministry of Health of the Republic of Uzbekistan, 2 534 cases of HIV/AIDS have been officially registered in the country. Among these, 98 individuals have died from AIDS-related causes. Among all cases where the route of transmission is known, 60.5% are attributed to injecting drug use, and 11.5% are attributed to heterosexual contact. Women living with HIV/AIDS account for 17.2% of all registered cases.

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 Uzbekistan

SPECIFIC OBJECTIVES:
1. To develop within the Uzbek government and non-governmental organisations the appropriate tools and structures related to drug demand reduction and health promotion among sex workers and to promote the transfer of knowledge and skills among all counterparts involved in programme activities
2. To strengthen the personal decision-making skills of sex workers with regards to drug demand reduction via drug counselling services, peer support, and the distribution of the appropriate information materials
3. To reduce the relative isolation of Uzbek 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 Uzbekistan 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 course of the five-year programme:
· Conduct an extensive rolling needs assessment in Uzbekistan among sex workers
· Development and dissemination of practical training guidelines for local partner organisations and agencies related to drug demand reduction and health promotion among sex workers
· Conduct capacity building seminars 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 and support for the establishment of local peer-led initiatives such as, sex worker 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 related to drug demand reduction for Uzbek law enforcement agencies and medical establishments
· Participation in a regional 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 carried out among sex workers
· A continuum of 10 to 12 capacity building training seminars will be implemented among NGO personnel, police and health authorities, and medical professionals from several regions of Uzbekistan
· A series of best practice training guidelines for partner organisations on issues related to drug demand reduction and health promotion among sex work populations will be developed and widely disseminated across all regions of Uzbekistan
· Response-based targeted materials on themes related to drug demand reduction and health promotion will be developed and disseminated in collaboration with sex work populations in Uzbekistan
· 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 activities 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 Uzbekistan, 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 project target audiences
· 50 000 copies of health promotion printed materials will be disseminated among sex work populations in Uzbekistan
· 8 000 copies of best practice resources and guidelines will be developed and disseminated among NGOs, health professionals, and health authorities in Uzbekistan
· 10 000 copies of guidelines on health promotion and drug demand reduction materials will be developed and disseminated among Uzbek law enforcement officials

RESEARCH COMPLETED AND PLANNED BY AFEW:
· A comprehensive literature review on sex work in the Central Asian Republics was completed by AFEW in June 2003.
· Rapid Assessment and Response (RAR) research, including a KAPB survey is currently pending.

FOR FURTHER INFORMATION, PLEASE CONTACT:
Robin Montgomery
Head
HIV Prevention and Health Promotion Among Sex Work Projects
AIDS Foundation East-West (AFEW)

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
AIDS Foundation East-West (AFEW)

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