New Technologies and Youth Sexuality Education in Georgia

Author: Gvantsa Khizanishvili, Georgia

Improving access to and awareness of health issues among youth using new technologies has become a new way for non-profit sectors around the world to advance issues on their agenda. IntiMate by Bemoni is the first application of such type in Georgia, and it is an excellent example of sexuality education using innovative technologies. It is available for download both by App store and Google play. The app has been developed by Public Union Bemoni as a part of the project “Investing in Sexual and Reproductive Health Promotion and HIV Prevention among Young People in Georgia”.

Non-profit for sex education

Georgia has inadequate policies in the area of sexual and reproductive health and rights. There are strong religious and conservative powers and gender inequality in addition to a fragile civil society that especially influences the lives of adolescents and young people. Much progress has been made in recent years in advocacy to advance youth sexual and reproductive health and rights, for example. In May of 2017, the Georgian Ministry of Education and Science signed a Memorandum of Understanding with the United Nations (UN) Joint Programme for Gender Equality to assist the ongoing revision of the national curriculum and help integrate the issues of human rights, gender equality and healthy living into the educational programme. Additionally, this February, United Nations Population Fund (UNFPA) Georgia initiated an interactive learning module for evidence-based family planning called Virtual Contraception Consultation (ViC), which was introduced at Tbilisi State Medical University.

Despite these advances, there are still many gaps in advancing youth sexual and reproductive health and rights for young people. For example, there are no state supported sex education programs that exist in many countries of Eastern Europe and Central Asia including Georgia. Since there is no state supported sex education programs including information about HIV/AIDS, no information targeted specifically at young people is available, and health service providers are not equipped with the skills to meet young people’s needs for information, counselling and confidentiality of services. Therefore, the non-formal education mostly led by non-profit sector play a significant role in youth sex education.

New ways to raise awareness

The IntiMate app aims to improve knowledge of young people around issues of sexual and reproductive health and rights including HIV/AIDS. With the goal to spark the conversation around the issues, by containing easily comprehensible, fun, attractive content and to encourage participation of young people in prevention of HIV/AIDS. Containing quiz games, video information, definitions, calendar, list of youth friendly services among others, now young people in Georgia will have access reliable information on sexual health and wellbeing at their fingertips. Launched in July 2017, it already has already attracted international media attention.

Russia is Dancing for Life

Author: Anastasia Petrova, Russia

“Congratulations to “FOCUS-MEDIA” and dance4life for the victory in presidential grants competition!” This was the message Ekaterina Artemenko, the coordinator of projects in Moscow “FOCUS Media” foundation, got from her colleague around midnight on July 31. The happy news spread quickly and all danc4life project members knew about it the next day. The initiative was supported this year by the Presidential Grant Foundation.

Starting from 2006, non-commercial organizations in Russia are supported by the president. This was the first year of the presidential grant competition. For 10-year existence, the system of finance distribution was quite complicated: at first the head of the state approved the list of non-commercial organizations (NCO) – the receivers of grants with his decree, and then the NCOs were included into the finance distribution system. In 2017, the procedure was simplified: grant participants may apply online. There has appeared the unified operator – presidential grant foundation.

Coordination committee summed up the results of the first competition on 31 July, 2017. There were 970 NCOs-winners from 79 regions in the winner list, which is around 15% of all applications. There were 6,623 projects that participated in the competition. Three Russian NCOs, included in the register as “foreign agents,” are among presidential grants recipients. Operator has distributed grants with the total sum of 2.25 billion Russian Rubles within the first competition. The most financed project among the 12 grant departments was “Citizen Health Protection, Promotion of Healthy Lifestyle.”

Recognition of merit

Public Health and Social Development Foundation “FOCUS -MEDIA” celebrated its 20th anniversary last year. “We are happy to have received this grant, but frankly, we are also a bit surprised,” the employees of the foundation are saying.

There is a lot of work ahead even after receiving the grant. Financing will allow to run the project dance4life in 14 Russian cities. It will also include a module on tobacco addiction prophylaxis and anti-tobacco campaigns. Besides, the project will include additional component in the form of helping teenagers and young people with HIV. They will be able to volunteer in the project and take part in all of the activities.

Dancing is a universal language

Dance4life project, which won the grant, is a unique international initiative. The initiative aims at promotion of healthy lifestyle among young people, preservation and promotion of reproductive health, HIV infection prevention and many more socially important diseases. More than two million people from 20 different countries have been a part of the programme over the years of its existence.

The project started in 2005 in Russia. It began after “FOCUS Media” Foundation director Evgenia Alekseeva met the Dutch creator of the project Ilco van der Linde. After this meeting, she decided to take this international initiative to Russia. “FOCUS Media” Foundation existed for seven years by that time, dealt with health protection and, in particular, with AIDS prophylaxis among youth. That is why the aim of the project (which includes the prophylaxis of socially important diseases, addiction formation and strengthening young people) coincided with the foundation’s activity.

Now dance4life is a project with 12-year-old history in Russia, and it runs in more than 14 regions. During the years of its activity, it managed to involve around 220,000 young people, who say that dance4life has changed their lives. The keys to the uniqueness of the project are youth culture, energy and creativity that help spread the information on preserving health and taking responsibility for one’s life. Dancing as a part of the project is a universal language, connecting dance4life participants from all over the world.

The results will be presented on AIDS 2018

There were some guests in the ““FOCUS -MEDIA” Foundation office a week before receiving the news about winning the grant. Yulia Koval-Molodtsova, a former project coordinator in Russia and now an associate in the main dance4life office in the Netherlands, came to Russia to talk about the new working models.

After running the same programme since 2005, the international dance4life team has been working on the analysis and improvement of the project methodology. While the old working model made an accent on youth education, the new programme aims at self-realization of society. Now the programme invites young people on a journey: from relationship with oneself, to the relationships with partners and society in general. The components of HIV and sexually-transmitted infections (STI) prophylaxis, issues of contraception and gender equality are now skillfully connected with such important for young people topics: self-knowledge, establishment of personal boundaries, and control of social stereotypes. The principles of work have not changed: to inspire, teach, involve and celebrate. Due to the “peer to peer” approach, young people become the driving force of the project.

New model of work will be approved during this year. The pilot project is running in two regions. In Nizhny Novgorod, where the project is successfully running from the start, they work in cooperation with local schools. The new contacts will be established from scratch in Kolomna, a city in Moscow region, where dance4life is just starting. The model of the project is universal and can be used for both learning and leisure purposes of young people.

Even though the project will be financed by the Presidential Foundation till the end of 2018, the managers of the project would like to sum up the first results of work by next summer. The results of work and experience in the area of HIV/AIDS among youth will be introduced on the International AIDS Conference in 2018. The focus of this conference will be on Eastern European and Central Asian countries.

AFEW Shared Techniques of Relaxation in Kyrgyzstan

The community dialogue platform gathered for the summer school last week in Kyrgyzstan. This summer school was organised within ‘Bridging the Gaps’ programme. The director of programs of AFEW International Janine Wildschut attended the school. After some days of serious work in which the community discussed struggles they face in Kyrgyzstan and how they can come up with a united voice, a training on burnout syndrome and how to prevent it was arranged.

“For many community leaders life is hectic and full of stress. First of all, they do their work with their full heart, which makes them also more sensitive for the stories and troubles of people they help. Secondly, the community members were mostly not trained as managers and leaders of NGOs, and now they are carrying this responsibility with big feeling of commitment. Besides, daily life in Kyrgyzstan for many people consists of a lot of struggle: family responsibilities, economic challenges and little time for relaxation,” Janine Wildschut shares. “This results in feelings of stress, little division of private life and work and little awareness of spending time on hobbies or personal time. Besides, within NGOs there is not much awareness of the need for staff to relax, take holiday time, have some breaks or breathing exercises. Women seem to have more pressure than men, as women are the main caretakers of the household.”

Thіs summer school gave the community members an opportunity to become more aware of stress factors. For one week they were thinking more about themselves, exchanged their worries and learned relaxation techniques.

“As I am not drinking or taking drugs at the moment, I do not know how to relax since that normally was my relaxation,” says one participant of the training who stopped to use drugs. Most of the participants of the summer school also feel that it is very important to be together during such studies since it is the only opportunity for them to gather together outside of official gatherings.

Janine Wildschut shared her experience with stress and burnout. Some of her lessons were taken as eye opener for many.

“When your system stresses up, it “tells” you to run harder, and that is the moment to stop yourself and slow down completely,” Janine said. “To have a boss that understands that this is important and supports you taking a break sometimes is also very important. As the problems around you are a fact of life, you are the only one that can change how you handle this: with stress or by contributing the best you can, but not more than you can.”

Besides, on her trip in Kyrgyzstan, AFEW’s director of programs conducted a focus group about community advocacy to see if change in this area is occurring, what is required to have a greater involvement of the community, and how the dialogue platform contributes to that. Janine also interviewed community NGOs on the situation of shrinking space for CSOs in Eastern Europe and Central Asia. The situation in Kyrgyzstan nowadays is stable. Wider coalitions are initiated and hard work is done with the government to show the invaluable work that NGOs are doing.

Harm Reduction: Redirection of Resources Needed

Why do we need action?

Harm reduction is an evidence-based and cost-effective approach to drug policy and practice that is about keeping people who use drugs, their families and communities safe and healthy.

Harm reduction is about saving lives and it works!

Yet many countries still do not provide harm reduction services. According to UNAIDS, between 2010 and 2014 only 3.3% of HIV prevention funds went to programmes for people who inject drugs.

Why now?

Harm Reduction International’s data shows that since 2014, no new countries have established needle and syringe programmes (NSP) and just three have introduced opioid substitution therapy (OST). Of 158 countries where injecting drug use is reported, over half (78) do not offer OST and more than a third (68) still do not provide NSP. In 2015, a UN target to halve HIV transmission among people who inject drugs by 2015 was missed by more than 80%.

These figures are a call to action.

By contrast, each year governments spend over $100 billion on drug control strategies that have little effect on demand for drugs or on those who profit from the drug trade. At the UN General Assembly Special Session on Drugs in 2016, governments showed a new willingness to rethink these approaches. But now they must rebalance their spending.

What are we calling for?

We are calling on governments to redirect 10% of the resources currently spent on ineffective punitive responses to drugs and invest it in harm reduction by 2020.

What we will this achieve?

Even this small redirection of funding could achieve big results.

A 10% redirection of funding from drug control to harm reduction by 2020 would:

  • End AIDS among people who inject drugs by 2030.
  • Cover annual hepatitis C prevention need for people who inject drugs. Globally. Twice over.
  • Pay for enough naloxone to save thousands upon thousands of lives every year from opiate overdose.
  • Ensure effective advice, healthcare and emergency responses in the face of newly emerging challenges.
  • Strengthen networks of people who use drugs to provide peer services and campaign for their rights.
What will happen if we don’t act now?

If the adoption of harm reduction in new countries continues at the current pace, it will be 2026 before every country in need has even one or two harm reduction programmes. In the meantime, thousands, if not millions, of lives will be lost.

Source: Harm Reduction International

‘Building a Healthy Future Together’ – AFEW Releases its 2016 Annual Report

AFEW International releases its 2016 Annual Report ‘Building a Healthy Future Together.’ The report highlights AFEW Network’s key activities in the region of Eastern Europe and Central Asia (EECA).

“Now more than ever, key at-risk populations need increased access to health services to combat the three epidemics of HIV, TB and viral hepatitis, something that was highlighted last year in the new World Health Organisation global health sector strategies on HIV and on viral hepatitis,” said Anke van Dam, executive director of AFEW. “Eastern Europe and Central Asia is the only region in the world where new infections of HIV are still on the rise, and where multi-drug resistant TB and viral hepatitis cases, also as co-infection with HIV are so highly prevalent.”

On the road to the 2018 International AIDS Conference that will be held in Amsterdam, last year AFEW International started to engage representatives at all levels to ensure that the relevant issues, successes and challenges from EECA are addressed at AIDS2018.

“With AIDS2018 and through all of our projects detailed in this report, AFEW International continues to contribute to a healthy future for the people of EECA,” says Anke van Dam.

The English version of our Annual Report is available here (download PDF.) The Russian version of the Report can be read here (download PDF.)

The Photo Exhibition ‘Life in the Shadow’ was Shown in the Netherlands

Last week the photo exhibition ‘Life in the Shadow’ was brought to the Netherlands by public Foundation ‘AIDS Foundation East-West in Kazakhstan.’ It was possible to see the images of people affected by HIV and tuberculosis during Wolfheze workshops in the Hague on 31 May – 2 June.

The main goal of the exhibition is to reduce stigma and discrimination against people with HIV and tuberculosis.

“We were very lucky with the opportunity to bring the exhibition to the Netherlands and show it to the bigger number of people,” the project manager of AFEW Kazakhstan Kristina Zhorayeva is saying. “Our models were very brave to show their faces and share their personal stories. They wanted to tell people that they are not different and they also have dreams and hopes.”

At the end of March the photo exhibition ‘Life in the Shadow’ was shown in Almaty, Kazakhstan. Some people from Kazakhstan saw the images for the first time in the Netherlands though.

“I have heard about this exhibition from AFEW, and today I saw it in the Netherlands even though it was displayed in my native Almaty,” the head doctor of one of the private clinics of Almaty Galiya Tulebayeva is smiling. “I look at these pictures of the patients with pleasure. It is great to see that there are smiles on their faces and they are in positive mood.”

As of February 2017, in Kazakhstan there were registered 29,568 HIV cases. According to the official data, in 2016 there were 14,345 tuberculosis patients registered in the country.

Visitors reviews of the photo exhibition ‘Life in the Shadow’

Jamshid Gadoev, WHO Country Office for Combating Tuberculosis, Hepatitis and HIV-AIDS in Uzbekistan:

– Only brave people can show themselves in such a way. They got sick and went through the processes that other people are going through now and do not hesitate to show all of this. On each photo I see a smile. Probably, they are happy with their treatment and are glad that they were rescued. They seem to be happy with their lives.

We also published a book and made a video about what tuberculosis patients feel before, during and after their treatment. We asked our patients to associate tuberculosis with some color, and children were asked to associate it with color and with the animal. Many people said that the disease for them is associated with red, yellow or black. Children usually said that their illness is a red teddy bear. Adults told that for them tuberculosis is black and is associated with the sound of a trumpet. After treatment, these associations often change and colors become brighter.

Alexei Bobrik, WHO technical specialist on HIV, tuberculosis and hepatitis, WHO Country Office, Ukraine:

– To overcome the burden of these diseases, it is necessary to talk about this problem so that the population knows about it, and the negative attitude towards the diseases decreases with time. It is necessary to communicate information, so that there is no stigma and discrimination. We must know that normal people are vulnerable to these serious diseases as well.

PrEP: effective and empowering

Author: Marieke Bak

Pre-exposure prophylaxis (PrEP) is a new HIV prevention method that consists of a daily pill taken by HIV-negative people to reduce their risk of becoming infected with HIV. PrEP is highly effective in preventing HIV transmission, as scientific research shows. A large international study among gay men and transgender women, the so-called iPrEx trial suggested that PrEP can reduce the risk of HIV infection by at least 92% when the pills are taken consistently. PrEP is also effective when used by heterosexual men and women, as well as by people who inject drugs.

Although PrEP is more expensive than other HIV prevention methods, it can be a cost-effective tool, especially when delivered to people at high risk of HIV. By preventing the costs of lifetime HIV treatment, PrEP may even lead to healthcare savings, especially when the drug patents expire and the cost drops.

Moreover, PrEP is the first method of HIV prevention that is directly under the control of the at-risk individual. This is in contrast with treatment as prevention (TasP), which is dependent upon partners’ HIV treatment adherence to ensure suppressed viral load. Besides, because PrEP separates the act of prevention from the sexual encounter, it can be used without sexual partners knowing and provides additional protection when condoms are not used consistently.

The World Health Organization now recommends that PrEP should be offered as a choice to key populations affected by HIV as well as to anyone else at substantial risk of HIV infection.

TRANSFORMING HIV INFECTION

PrEP is a pill consisting of anti-retroviral drugs that needs to be taken every day in order to be effective. Currently, the only drug approved for use as PrEP is sold by Gilead Sciences and is called Truvada, which consists of a combination of tenofovir and emtricitabine (TDF/FTC). Truvada was first approved for prevention in 2012 in the United States of America.

In contrast to PEP, or post-exposure prophylaxis, PrEP is taken before exposure to HIV to prevent any possible transmission. PrEP works by blocking an enzyme called HIV reverse transcriptase, thereby preventing HIV from establishing itself in the body. While PEP can be thought of as a “morning-after pill” for HIV prevention, PrEP can be compared to the contraceptive pill that is taken every day. Similarly, PrEP may transform HIV infection just like the pill transformed family planning.

The most common side effects of Truvada for PrEP are nausea, vomiting, dizziness, headache and fatigue, although these symptoms usually resolve within a few weeks. Some people in trials also experienced small changes in kidney function or a decrease in bone mineral density. An updated version of Truvada was created that contains a new form of tenofovir, which is thought to be safer for bones and kidneys. At the moment, the so-called “Discover study”, is being set up in North America and Europe to investigate the new PrEP medicine called Descovy.

By the way, PrEP does not protect from sexually transmitted diseases (STDs). Fears that PrEP might be used as a “party drug” exist. However, in the iPrEx study as well as in a meta-analysis by the World Health Organisation, it was shown that PrEP does not lead to an increase in the number of STDs and has no effect on condom use. Rather, PrEP reduces the fear and anxiety that often comes with sexual activity for those at high risk of HIV.

However, because PrEP is not 100% effective and because it does not protect from STDs, it should not be used as a standalone prevention method. According to WHO guidance, PrEP should be offered as part of so-called “combination prevention” which includes the use of condoms as well as regular follow-ups and HIV testing.

PREP IN EASTERN EUROPE AND CENTRAL ASIA

Despite the recommendation to offer PrEP to people at high risk of HIV infection, the global availability of PrEP remains limited. The PrEP target set by UNAIDS in their strategy on ending the HIV pandemic is to get three million people on PrEP by 2020. However, only 2% of this target had been reached in June 2016.

At the moment, Truvada for PrEP has been approved in the United States, Canada, Australia, Peru, South Africa, Kenya, Zimbabwe, Israel, and the European Union. Approval is pending in Brazil and Thailand. In the European Union, PrEP has been approved by the European Medicines Agency (EMA) although the implementation of PrEP programmes is the responsibility of each member state separately. To date, only France and Norway have made PrEP available as part of their healthcare system. Scotland recently announced that it will do the same.

In Eastern Europe and Central Asia (EECA), PrEP is not available yet. However, demonstration projects are currently being set up in Georgia, Ukraine and Azerbaijan. These pilot studies consist of several phases. In Georgia, the first stage of PrEP implementation included a training session for those involved in the pilot, as well as the conducting of a needs assessment among Georgian men who have sex with men (MSM) and capacity building for local NGOs, before the actual start of the pilot in 2017. In Central Asian countries, there seems to be less interest in PrEP, although the Ministry of Health of Kyrgyzstan is planning to start an evaluation on the possibilities of introducing PrEP in the country.

Challenges of introducing PrEP in EECA may include the cost of PrEP, but also the high levels of stigma and discrimination in some countries. However, with HIV incidence in EECA rising by 57% between 2010 and 2015, treatment alone will not stop the epidemic. Given its proven effectiveness, providing PrEP to key populations can be a significant step in controlling the explosive growth of the HIV epidemic in this region.

Communities will be Educated how to Analyse Data and how to Act

Two new modules for the program community-based participant research CBPR [e] Education that is supporting and strengthening the research capacity of organizations acting on behalf of and representing the interests of communities in Eastern Europe and Central Asia (EECA) are released online today.

The program consists of the number of activities, including training for community-based participatory research, small grants program, workshop on dissemination and abstract writing and workshop on presenting research findings on AIDS2018 Conference.

AFEW International gives program participants the opportunity to take part in online e-learning modules for further development of their research skills. The modules are also available for others who are interested in community-based participatory research. Course that costs 75 euros, includes 7 modules on the preparation and conduct of community-based participatory research.

The first module announced today is Data Analysis. Analyzing data is necessary to make sense of the outcomes of the study and to answer the research questions. Analyzing data will help working towards a way of representing the data to a larger public.

The second module is called Bringing about social change: translating knowledge into action. After the data is collected and analyzed, the participant is ready to write the reports and to disseminate the results to others. It is the time now to determine how the participant can bring social change that will benefit the community. The evaluation of the research will be also discussed in this module.

Later on, everyone will be able to participate in the webinar on data analysis, which will be held in late spring or summer of 2017.

AIDS Foundation East-West becomes AFEW International

ImprimirAIDS Foundation East-West, an international network of civil society organisations that is dedicated to improving the health of key populations, has changed its name to AFEW International.

A new logo and communication strategy have been created, and now they are part of the organisation’s identity. “With this new name we keep the recognisability and our brand as many partners in the field already know us,” says the executive director of AFEW International Anke van Dam. “With the new name we also acknowledge that we do more than HIV and AIDS. AFEW has built a track record for projects on TB, viral hepatitis and sexual and reproductive health and rights as well. AFEW strives to social inclusion of the key populations at risk and a healthy future of Eastern Europe and Central Asia!”

AFEW is dedicated to improving the health of key populations in society. With a focus on Eastern Europe and Central Asia, AFEW strives to promote health and increase access to prevention, treatment and care for major public health concerns such as HIV, TB, viral hepatitis, and sexual and reproductive health.

AFEW International is an uniquely positioned organisation as one of the few HIV, TB, hepatitis and sexual and reproductive health and rights organisations working in Eastern Europe and Central Asia. This is a region where the work is critical, as HIV and sexually transmitted infections are on the rise, sexuality education is deficient and gender-based violence goes largely unrecognized. Further, cases of multidrug resistant and extensive drug resistant tuberculosis are increasing; and there is a very high prevalence of hepatitis C. The group with the highest risk for HIV and HIV related diseases are people who use drugs. However, transmission through sexual contact is increasing and the prevalence among women and men who have sex with men is increasing.

Natalya Shumskaya: “We Want to Improve Country Health System Coordinating Mechanisms”

shumskayaPublic Foundation “AIDS Foundation East-West in the Kyrgyz Republic” makes a significant contribution to public health of the country in reducing the growth rate of socially significant infections in Kyrgyzstan. The head of AFEW-Kyrgyzstan Natalya Shumskaya is telling what we should expect from the organisation in 2017, and outlines the achievements of the previous year.

 – How was the year of 2016 for AFEW-Kyrgyzstan? What do you think were your greatest successes?

– 2016 was a successful and fruitful for our organization. We managed to keep our activities on HIV prevention in the prison system, including law enforcement, prevention of HIV among women who use drugs. During the last year, 1013 women received an access to health and social services. One of the achievements was that in 2016 our organization supported the Ministry of Health of the Kyrgyz Republic in the development of the clinical protocol “Pregnancy, childbirth and the postnatal period for women who use drugs.” In December of the last year this protocol was adopted. Later, we started a very difficult project with the aim to return the patients with multidrug-resistant tuberculosis (MDR-TB) to the treatment. Since August 2016, AFEW-Kyrgyzstan together with the City Centre for Tuberculosis Control in Bishkek started a project “Joint control of tuberculosis and HIV in Kyrgyz Republic.” During five months of 2016, 17 MDR-TB patients returned for the treatment; three patients co-infected with HIV were connected to antiretroviral treatment, five patients with tuberculosis and extensively drug resistant TB (XDR-TB) had the necessary tests, and their results were given to the council for inclusion in a treatment program under the new scheme. There was organized controlled treatment at home for 28 patients. The delivery of products is done 6 days a week, except Sundays. Additionally, project case managers conduct information sessions with patients with MDR-TB and their inner social circle, monitor the side effects of anti-TB drugs, and, if necessary, deliver drugs to relieve the side effects. They also maintain regular contact with doctors. In January of 2017 we increased project staff. It was done for the full coverage of all MDR-TB patients who need to receive treatment at home and assisting them to diagnosis and friendly services. Two case managers and a social worker were hired.

– How is the work of the research department of your organization that you created two years ago?

– The Department continues to work successfully. Over the past year, the researchers conducted a qualitative study among the inmates of correctional facilities that are getting ready to be released. It was called “Prisons, injecting drugs and the environment of risk of HIV infection.” This is a continuation of the positive experience of effective cooperation of AFEW-Kyrgyzstan with medical school researchers from Yale University and the State Penitentiary Service of the Kyrgyz Republic. This study aims to describe and research the quality of the program of methadone substitution treatment in the penitentiary system of Kyrgyzstan and civil society. The recommendations based on those results will be offered to the country to optimize harm reduction programs.

– One of the main directions of your work is cooperation with the police and the prison systems. Please tell us, how is this cooperation going? What is the role of AFEW in it?

– AFEW cooperates with the Ministry of Internal Affairs for 10 years already. In 2016 our organization has provided technical support to the Ministry in carrying out monitoring visits to all the regions of the country. The aim of the visits was to control how the law enforcement officers perform the instruction on HIV prevention. In addition, we organized and conducted four trainings for the staff responsible for the official trainings and for non-governmental organizations on the reform of law enforcement agencies. It is important that the civil sector supports current reforms, and it is important that law enforcement officers assist the execution of the State Programme on HIV.

AFEW is also working with the penitentiary system of the country for more than 10 years. We work together in three areas: technical assistance and coordination, increasing the capacity of staff and providing direct services to prisoners. In 2016 we worked first in six and then in four institutions to promote the goal 90-90-90. We provided services for people who inject drugs (PIDs), told them about HIV and the ways of transmission, motivated them to pass the test for HIV. We actively worked with people living with HIV at the stages of realising of the diagnosis, preparation for therapy, start of therapy, development of adherence to treatment. One of the achievements, of course, is to extend the work on the colony-settlements. Before, prisoners there fell of HIV prevention services, as there are no medical units there, and they usually have no documents for getting help from the civilian health organizations.

– In October AFEW-Kyrgyzstan helped to sign a memorandum of cooperation of four key groups. Please, tell us what these groups are and why their teamwork is so important? How is this cooperation going now?

– Unfortunately, there is mutual stigma within the key groups. Cooperation can help to overcome barriers and build partnerships. The leaders of key groups started to work closer. They discuss new joint projects, research abstracts for AIDS2018 conference in Amsterdam. Together they will carry out activities to reduce stigma and discrimination in relation to other key groups through the mini-session, for example, PIDs for LGBT and sex workers’ organizations. Since last year, we have been inviting all the participants of memorandum for the event and, of course, they also invite us for their events.

– In February, you will host a training for the members of the Country Coordinating Committee on HIV/AIDS (CCC) project BACK UP-Health. Tell us more about it. What are other areas of your work with the CCC?

– Starting from July 2016, AFEW-Kyrgyzstan will implement the project “Harmonization and consolidation of resources to fight HIV infection and tuberculosis in Kyrgyzstan.” It will be done with the financial support of GIZ, program Back Up-Health. With this project we want to improve the coordination mechanisms in the country’s health care system. We want to involve civil society in the discussion on the reform of CCC, and we also want to increase the capacity of the Committee. In February of 2017 AFEW-Kyrgyzstan plans to host a seminar for members of the CCC to prepare the Country Request for continued funding in the state funding for 2018-2020. The following groups will take part in the seminar: members of the Committee for the preparation of applications for resource mobilization and harmonization of CCC; CCC board; members of the Advisory Working Group, which were included by the Kyrgyz Ministry of Health; national experts who work on the preparation of the request for continued funding who will directly collect information and write application; international consultant; head of the expert working group on writing requests for funding, and also key partners from the public and international sectors which may influence decisions and who expressed their readiness to provide technical assistance in the preparation of high-quality country request to the state financing from Kyrgyzstan. During the workshop, participants will act as experts and will share their knowledge and experience with each another. They will also learn how to fill the forms for the requests, will learn the new priority areas of TB and HIV, which are included in national policies and programs, will discuss and analyse the share of public funding, make mapping of the services, clients and funding. Actually, the main purpose of this seminar is to assist the CCC, experts and other stakeholders in the preparation of high-quality application. We want everyone to have one vision and one structure of the request, so that the process of approval of the CCC members is efficient and fast.

– What are AFEW-Kyrgyzstan plans for the year of 2017?

– AFEW-Kyrgyzstan spent its first three years as a local non-governmental organization. The most important achievement is that we were able to successfully implement its first strategic plan and to develop partnerships with international and donor organizations. In 2017 we will review the strategic plan of the organization. Of course, the priority for the board of the organization has been and continues to be ensuring of the stability of the organization.