EECA INTERACT 2019

We are pleased to announce that, on the 18-19th November 2019, the first EECA INTERACT Workshop 2019 will take place in Almaty, Kazakhstan.

The EECA INTERACT 2019 Workshop builds scientific research capacity while simultaneously strengthening clinical, prevention, and research networks across the Eastern Europe and Central Asia (EECA) region. EECA INTERACT 2019 is an abstract-driven workshop focusing on factors unique to the region’s HIV, TB, and hepatitis epidemics. Bringing young and bright researchers together with top scientists, clinicians, and policymakers, EECA INTERACT 2019 aims to ignite a conversation that will build a stronger scientific base to serve the region and connect to the world.

EECA is the only region in the world where the HIV epidemic continues to rise rapidly. UNAIDS estimates point to a 57% increase in annual new HIV infections between 2010 and 2015.1 The World Health Organization has warned of a sharp rise in rate of HIV and tuberculosis coinfection, which poses a real threat to progress.2 Significant barriers to prevention and treatment services remain for people living with and affected by HIV, TB, and hepatitis across the region. For example, although the HIV epidemic in EECA is concentrated predominantly among key populations, particularly among people who inject drugs, coverage of harm-reduction and other prevention programs is insufficient to reduce new infections. The region urgently needs more effective strategies of prevention, treatment, and care and support that are tailored to the particular circumstances of individual countries.

The Amsterdam Institute of Global Health and Development (AIGHD) has over a decade of experience delivering in-country workshops and conferences that bring young researchers and established international experts together to share original research and state-of-the-art reviews on a wide range of topics. AIGHD has co-hosted the INTEREST Conference (the International Workshop on HIV Treatment, Pathogenesis, and Prevention Research in Resource-limited Settings) since its inception in 2007. The conference has grown from a small workshop to a full conference of more than 500 attendees each year.

Building on these proven results, AIGHD will collaborate closely with AFEW International and the AFEW network (AFEW) for EECA INTERACT 2019. AFEW’s deep roots and experience in the region offer a way to build sustainability into the new workshop, placing priority on local contributions. The EECA INTERACT 2019 will bring scientists, clinicians, members of civil society, and government officials together to tackle topics facing individual countries while building capacity and strengthening research and clinical networks. The two-day conference will focus on topics that are specifically relevant to EECA and dive deeply into particularities of the host country Kazakhstan, showcasing its successes, remaining challenges and responses.

The workshop objectives are:

  • To provide cutting-edge knowledge in the fields of epidemiology (modelling), treatment, pathogenesis, and prevention of HIV, TB, and viral hepatitis as well as chronic conditions;
  • To exchange ideas on providing and supporting HIV testing services and clinical care provision to adults, adolescents, and children living with HIV to achieve 90-90-90 goals;
  • To foster new research interactions among leading investigators and those who represent the potential future scientific leadership for health care and research in the region;
  • To build research and clinical capacity across EECA.

EECA INTERACT 2019 takes an innovative approach by bringing together experts in HIV, TB, and hepatitis to participate in the International Conference Committee developing the scientific program. The ultimate aim is a workshop that addresses the unique issues facing the region, finding paths forward to solutions for improvement. Challenges include slow implementation of harm reduction, insufficient access to treatment, and criminalisation and stigmatization of key populations. Sustainable change can be achieved if these challenges are faced head on, embracing scientific evidence and working with marginalized and stigmatized populations.

Introducing the EECA INTERACT concept in Kazakhstan for 2019 extends the sustainable goals laid out during the AIDS2018 conference in Amsterdam. AIDS2018 drew attention to the effectiveness of rights-based approaches to more effectively reach key populations, highlighting this work across the EECA region. By bringing people together, sharing knowledge, and building capacity, the EECA INTERACT 2019 will build further on this base to find tangible solutions.

AFEW-Kyrgyzstan Started the Year with Rebranding

By changing the name “AIDS Foundation East-West in the Kyrgyz Republic” at the beginning of the year 2019, AFEW-Kyrgyzstan emphasized its involvement in the international AFEW Network. Another reason for changing the name and logo of the organisation is the expanding capabilities.

“Now we are working not only in the field of HIV and AIDS. We are implementing tuberculosis treatment projects, conducting large-scale researches, carrying out advocacy campaigns to protect the rights of people and for the economic empowerment of women. Therefore, the former name no longer fully reflects our goals and values,” says the Chair of the Board of AFEW-Kyrgyzstan Natalia Shumskaya.

The new logo has retained one of the key elements of the previous one – the human figure, because everything AFEW does is aimed at helping specific people. The figure also shows that AFEW-Kyrgyzstan works, involving people from the community, and for them.

Three blue and one red objects around the white pattern represent different countries since AFEW-Kyrgyzstan is a part of an international network and is ready to use the experience of foreign partners to build a healthy future in the country.

In an updated form, AFEW-Kyrgyzstan is ready to welcome its old partners again and look for new opportunities to help people from key populations.

UN High-Level Meeting on Tuberculosis: People should be the Centre of the Fight

New York, 26 September 2018

The challenge of tuberculosis (TB) is faced worldwide, including across all of Europe and Central Asia. 1.6 million people died of the disease in 2017, and Heads of State are meeting today to discuss the matter at the UN General Assembly. TB kills more people each year than HIV and malaria combined. As one of the top ten leading causes of death TB deserves the highest political attention.

“I call on leaders of the world to commit to ending TB in their countries by allocating the necessary resources in their health budget, and involve us, civil society and communities in helping to reach the unacceptable 36% of people with TB who are still missed by health systems every year,” says Yuliya Chorna, the Executive Director of the TB Europe Coalition (TBEC).

Traditionally, people in many countries of the European region have been treated in hospitals for long periods from six months to two years. Patients have to suffer not only the burden and toxicity of a long-term treatment with heavy antibiotics but also being apart from their families, jobs and social lives.

“TB patients are no longer infectious by at most two weeks after they start and receive effective treatment. It is ridiculous that many programmes still isolate people from society for many months. No wonder people are afraid to seek a diagnosis. TB care has to be designed for and with people,” says Ksenia Shchenina, a former TB patient from Russia and Board Member of TBEC.

While European Heads of States are noticeable by their absence at the meeting, the WHO Europe region continues to be a hotspot for the spread of the multi-drug resistant (MDR) form of TB. Conservatism in the way TB is being treated in Europe and the lack of involvement of civil society and communities in TB care, who play a vital role for treatment adherence, has led to terrible figures in Eastern Europe and Central Asia. Too many countries report rates of around 30% of new cases being multi-drug resistant. Furthermore, worldwide only 25% of people with drug-resistant TB are on treatment.

Yet we still don’t have the right tools to fight TB. Our leaders have not allocated the right amount of funds to develop new vaccines, diagnostics, and treatment. We continue to have an astonishing annual $1.3 billion gap in Research & Development for TB.

“While the European Union congratulates itself on allocating on average less than €30 million per year to TB research initiatives in the last four years, it should think of reorienting its priority setting in health research to a needs-driven approach. Our taxpayers’ money should go to funding priorities neglected by the private sector,” says Fanny Voitzwinkler, Chair of the TBEC Board.

The UN High-Level Meeting on TB held on 26 September 2018 is a time for action and unity. We need changes if we want to stop the millions of preventable deaths caused by TB. Civil society can contribute greatly to effective people-centred care, it wants to be involved and will be watching to make sure the commitments made by world leaders at the HLM will be put into practice.

Source: TB Europe Coalition

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

Metropolis 2020: on the Way to 90-90-90

Author: Anastasia Petrova

Dynamics of the HIV epidemics in big cities is a pressing issue all over the world. According to the United Nations, by 2050 most people will live in big cities. This is most relevant for the developing countries with low incomes and growing HIV epidemics. Considering that the key populations are concentrated in metropolises, experts point out that there is obviously a need to implement HIV prevention and treatment programs at the municipal level. The decision to end the AIDS epidemic in big cities by 2020 is embedded in the Paris Declaration signed on 1 December 2014 with support of the UNAIDS.

This topic is the basis of the Fast-Track TB/HIV Responses for Key Populations in EECA Cities Project implemented by AFEW International in collaboration with Alliance for Public Health and presented within the VI Eastern Europe and Central Asia AIDS Conference (EECAAC 2018) held in Moscow, Russia. Together with the municipalities of five big EECA cities, civil society representatives developed measures in response to the spread of HIV/TB in key populations.

On 20 April, Anke van Dam, Executive Director, AFEW International moderated a session called “Fast-Track HIV/TB Responses in Healthy Cities” at EECAAC 2018. The session was co-chaired by Svetlana Plămădeală, Country Manager, Coordinator, UNAIDS, Moldova; Alla Yatsko, President, Public Association ‘Youth for the Right to Live’, Moldova; and Erika Tserkasina, Program Officer, Eurasian Coalition on Male Health, Coordinator, MSM Programmes in Almaty, Beltsi, Odesa and Sofia, Estonia.

“We cooperate with five metropolises in the region: Odesa (Ukraine), Tbilisi (Georgia), Beltsi (Moldova), Almaty (Kazakhstan) and Sofia (Bulgaria). The key criteria in selecting the cities were HIV prevalence and readiness of the local authorities for cooperation. Through organizing a network of community representatives, we established cooperation with the municipalities,” said Anke van Dam, Executive Director, AFEW International.

The goal of the Fast-Track TB/HIV Responses for Key Populations in EECA Cities Project is to contribute to achieving 90-90-90 targets, including reduced mortality and increased funding for HIV/TB treatment. One of the main tools is strengthening partnership between the authorities and civil society. To achieve this objective, the project includes research studies, workshops, and meetings with decision-makers. It is planned that the preliminary results of the project will be presented at the International City Health Conference ‘Developing healthy responses in a time of change’ to be held in Odesa on 13-14 September 2018.

A Survey on Collaborative TB/HIV Activities in Countries of the WHO European Region

Tuberculosis (TB) and HIV cause significant suffering in Europe. It is estimated that 27,000 patients have both diseases. The distribution of co-infected patients is heterogeneous in Europe. Collaborative activities are needed to take the best care of those with TB/HIV co-infection. This is the background information of the survey on collaborative TB/HIV activities in countries of the WHO European Region created by the Wolfheze working group on collaborative TB/HIV activities.

The Wolfheze group documents and promotes the best models and identifies research priorities of integrated TB/HIV care in the European region. Members of the group also identify barriers in TB/HIV services and collaboration. AFEW’s executive director Anke van Dam is the chair of Wolfheze Working Group on TB/HIV collaborative activities.

What this survey adds:

• All countries have guidelines for management of TB/HIV co-infection.

• Models of care for TB/HIV co-infection differ between countries.

• Collaborative TB/HIV activities as recommended by WHO are not universally implemented.

The full version of the survey is available here.

 

 

European and Central Asian Countries Can End TB Ahead of The Rest of the World

Stop TB Partnership engage with partners in regional meetings in Kazakhstan, Estonia and Belarus

15 December 2017 – Geneva, Switzerland – Stop TB Partnership Secretariat engaged with essential partners to support their efforts and country TB programmes to advance in the fight to end TB in the European Region to prepare the ground for the UN High Level Meeting for TB in 2018.

In just one week, three regional meetings held in Astana, Kazakhstan, in Tallinn, Estonia and Minsk, Belarus put TB in the spotlight in a region that can lead the way towards a world free of TB.  The discussions were centered around migration and migrants and their access to services, how to sustain and expand programmes after donor support ends and how communities, civil society, and networks of people affected by TB can work together.

“It is very impressive. We managed to focus our efforts on Europe this week and we organized and participated in meetings discussing essential aspects if we want to end TB: vulnerable groups, political leadership, domestic financing, and donor support — including the European Commission’s vision, issues around migration, advocacy and civil society engagement and the UN HLM for TB in 2018. The European region benefits from strong TB programmes and health systems, and amazing partners, especially the European Commission, WHO European Region team, ECDC, networks of civil society and communities, TB people as a network of people affected by TB, IFRC, Project HOPE, IOM, as well as UNAIDS and the Global Fund.  As a European, I hope this region will actually end TB before 2030. There is absolutely no reason not to do it,” said Dr Lucica Ditiu, Executive Director of the Stop TB Partnership.

 

Migration and TB were front and center in Astana, Kazakhstan, when TB experts, policymakers and advocates convened for the third high-level regional meeting on “Migration and Tuberculosis: Cross-border TB Control and Care in the Central Asian Region.”

The meeting, held 6–7 December, was organized by the Ministry of Health of the Republic of Kazakhstan, Project HOPE, the Global Fund and the United States Agency for International Development (USAID) with participants from government agencies, national TB programmes and migration authorities from Central Asia; representatives of civil society and communities, experts from the WHO, Stop TB Partnership, IOM, and IFRC.  The event was organized in line with the

 

Comprehensive Plan to Fight TB in the Republic of Kazakhstan for 2014-2020, which calls for activities to address TB among migrants and expand their access to services, as well as the programme “Addressing Cross-border Control of TB, MDR/XDR-TB and TB/HIV among Labor Migrants in the Republic of Kazakhstan” implemented by Project HOPE and funded by the Global Fund. The meeting advanced the regional dialogue on migration matters between Kazakhstan and neighboring countries in Central Asia. The dialogue takes place on a mutually beneficial basis, towards signing of bilateral agreements for effective regional cooperation on cross-border control, prevention, and care of TB in the region.

TALLINN, ESTONIA

For two days, 100 participants from TB and HIV programmes in EU member states and neighboring countries met in Tallinn, Estonia at an event organized by the Ministry of Social Affairs and National Institute for Health Development from Estonia, WHO European Region, UNAIDS, and the Global Fund. The participants, panelists, and speakers discussed challenges and opportunities in ensuring sustainability of programmes when transitioning from donor support to sustainable health systems.

Stop TB Partnership was part of the opening panel and centered its discussion around the need for vision and political leadership in TB and the ambition towards concrete asks for the UN HLM on TB in September 2018. Participants had an opportunity to hear how the Estonian government and TB and HIV programme, in strong collaboration with civil society and community, managed to decrease the number of new HIV cases from 1, 474 in 2001 to 229 in 2016.  Additionally, TB incidence decreased from 47/100,000 to 12.7/100 000.  The meeting discussed concrete steps towards strengthening the national TB and HIV programmes as well as the need for more significant advances in the integration of TB and HIV services.

MINSK, BELARUS

TB advocates in the Eastern Europe and Central Asia region came together in Minsk, Belarus, this week for a three-day workshop on strengthening community TB advocacy and engagement.

The workshop, held 11–13 December, was organized by International Federation of the Red Cross (IFRC) and Stop TB Partnership, in collaboration with national Red Cross and Red Crescent societies, and support of community advocates from the regional networks, TBPeople and TB Europe Coalition (TBEC). Activities broached on subjects as diverse as community challenges in the regional TB response, regional epidemiology, TB treatment literacy and communities, rights and gender tools to build an evidence base for an effective TB response. There was also a community consultation focusing on the rights and responsibilities of people affected by TB. This event was the second of five regional workshops that will focus on building stronger, more-coordinated affected communities, advancing strategic partnerships – particularly between Stop TB Partnership, IFRC, national Red Cross societies and community TB advocates – and composing of an advocacy plan and engagement strategy to ensure community priorities are represented and stakeholders are engaged during the UN HLM on TB in 2018. We look forward to continue to support the advocates of the region as we continue toward the HLM and work together to end TB.

Source: European AIDS Treatment Group 

AFEW Builds Models for the Future with Improved TB/HIV Care

AFEW, Hivos and PharmAccess and KNCV representatives after the presentation on the Dutch congress ‘Soa.Hiv.Seks’

Author: Olesya Kravchuk, AFEW International

The ‘Improved TB/HIV Prevention & Care – Building Models for the Future’ project was presented during the Dutch National Congress ‘Soa.Hiv.Seks’ on 1 December 2017 in Amsterdam, the Netherlands. Three working models from Kazakhstan, the Philippines, and Nigeria implemented by AFEW, Hivos and PharmAccess with KNCV Tuberculosis Foundation as the lead agency were shown to the Congress audience.

HIV and TB are two of the biggest public health threats in the world. Mounting challenges associated with these mutually reinforcing diseases are both medical and socio-political. In the efforts to address many of the common challenges, AFEW, HIVOS, PharmAccess and KNCV, with support from the Dutch Ministry of Foreign Affairs, collaborate in different parts of the world via the ‘Improved TB/HIV prevention and care-building models for the future’ alliance to jointly design and pilot innovative models of cooperation between the public, private and community sectors involved in the fight against HIV and TB, to find new ways of ensuring and expanding affordable, patient-centred and high quality access to care for key affected populations.

“After the project has started in Almaty, Kazakhstan, we can observe positive changes. A patient has information about good quality care, knows where to go for treatment and support, and has a choice in seeking care in the public sector, private sector and civil society,” the executive director of AFEW International Anke van Dam is saying. “Self-support groups and client management for TB patients are being organized and the HIV and TB working group is supported by the head of the Almaty City Health Department.”

Private clinics in Kazakhstan are now engaged in the public healthcare sector. They are integrated into the national monitoring and evaluation system for public/non-public TB/HIV care provision in Almaty city.

With Tuberculosis, it is Important to Take Medicine and Believe in Yourself

Sultanmurat from Kazakhstan wanted to get cured of tuberculosis no matter what but the treatment was difficult

Sanat Alemi is one of the civil society organizations (CSOs) supported by the Improved TB/HIV prevention & care – Building models for the future project which gives support to TB patients and their relatives. Founded in 2016 in Almaty, Kazakhstan by a group of ex multidrug-resistant or extensively drug-resistant TB patients, they quickly showed successes through their established self-support groups as well as one-to-one TB patient support. Sanat Alemi is also implementing several community-based activities such as social mobilization, advocacy, and communication to improve TB literacy among people affected by TB, TB/HIV, AIDS and other socially significant diseases (drug abuse, alcoholism, etc), aiming at reducing stigma, discrimination.

Success is possible with trust and professionals

“The social support for TB patients plays a key role in increasing adherence to the treatment. The success in treatment is possible with the combination of trust, human relationships and the support of professionals, such as a psychologist and social worker,” the current director of Sanat Alemi Roza Idrisova is saying.

A TB patient and client of Sanat Alemi Sultanmurat did not know anything about tuberculosis, except that it was a dangerous disease.

“I was horrified when I heard I had TB. I could not even imagine how I got it. I started coughing blood which was so scary, but I did not suspect that it could be TB,” he says. “I thought that the pain was caused by my liver or another internal organ. I told about this to my mother, as she is my closest relative. The other relatives reacted with understanding and this helped me a lot.”

What does not kill us makes us stronger

Sultanmurat wanted to get cured no matter what but the treatment was difficult. In the beginning, he could not tolerate the drugs, and he developed allergies.

“I struggled and tried not to miss a single day of medications and injections. I heard about Sanat Alemi from other patients and started to attend their self-support groups. Receiving support from other patients and social workers during treatment is of great help and being able to join trainings and meetings with different specialists is very useful and gives a lot of interesting information. I had the opportunity to ask questions that I had for a long time. I believe that in the future Sanat Alemi will keep the same spirit and will support many other TB patients,” Sultanmurat says. “TB completely changed my life. I started to appreciate life and learned to tolerate the sickness. I started to appreciate and love my relatives even more as they proved once again that they are there for me and that they would never give up on me during difficult times.”

Sultanmurat would like to say to other TB patients that this disease is curable like many other diseases. The most important thing is to follow the treatment, take pills without interruption, eat well and do sports. It is also important to be friendly, always and everywhere provide support and assistance to other people with TB. The most important thing is to believe in the best, in your recovery and do not forget that what does not kill us makes us stronger.

HIV Prevention in Key Populations: an Overview of Service-Delivery Projects in Russia

The Blue Bus mobile prevention unit, the bus of hope

Author: Anastasia Petrova, Russia

According to the World Health Organization, about half of new HIV cases occur in key populations: injecting drug users, men having sex with men and sex workers. Social stigma, violation of human rights, lack of access to the necessary services create barriers to protection of health for millions of Russian citizens. That being said, providing care to people with an HIV-positive status and those who are at risk of infection is an essential measure to safeguard health of the whole nation. By implementing service-delivery projects for key groups, non-governmental organizations play an important role in preventing the spread of the HIV epidemic both in the communities and among the general population.

The bus of hope

The Blue Bus mobile prevention unit, engaging clients in service provision

The Blue Bus of the Humanitarian Action Foundation is the first mobile prevention unit for drug users. In 2017, the project celebrates its anniversary: 20 years ago, the Blue Bus started its first journey in St. Petersburg.

Throughout these 20 years, Humanitarian Action has been true to its principles of helping those most vulnerable to the HIV epidemic. Many clients have double or even triple diagnosis: HIV, tuberculosis, hepatitis B and C, and addiction to psychoactive substances.

People are referred to service-provision programs through street outreach, mobile units and stationary needle exchange centers. Peer counsellors provide motivational counselling, assist with hospitalization to specialized medical institutions and follow-up their clients to increase retention in treatment programs.

The Blue Bus mobile prevention unit, distribution of materials, motivational counselling

Bus workers distribute sterile syringes, needles, water for injections, alcohol swabs, cotton balls, bandages, vitamins, vein ointment, naloxone, etc. People who use services are not always ready to change their behavior just like that. Talking to the project staff, they get important information on how to reduce infection risks and protect their health.

For most clients, the Blue Bus is the only safe place where they are treated with respect and understanding, and the only possibility to take a rapid test, receive primary medical counselling, get access to HIV and TB testing and treatment, be referred to public institutions and learn how to protect human rights. The team of the Blue Bus proudly values these trustful relationships between project staff and clients that have been built over the years of program implementation.

Dialogue between equals

Outreach work in the Cabaret bar

NGO Positive Dialogue is one of the oldest HIV-service organizations in St. Petersburg. Since its establishment in 1996, Positive Dialogue has gained substantial experience in working with key populations. In July 2015, the organization launched HIV prevention projects for closed population groups: men having sex with men (the Positive Dialogue project) and sex workers (the Silver Rose project). Both projects are community-driven, with the main goals to promote safer sex practices among MSM and SWs, increase access to services, including HIV/STI testing, uphold human rights, strengthen communities and counteract stigma.

The outreach team of the Positive Dialogue project conducts weekly field work in the night clubs visited by MSM and the LGBT community. The clients talk to peer counsellors and ask questions about HIV and other STIs, learn about pre- and post-exposure prophylaxis, receive condoms and lubricants.

Outreach work in the Priscilla club

The Silver Rose staff members provide counselling for sex workers in their office and conduct outreach work in the local saloons and street sex work areas. The project helps the girls preserve their health and human rights, protect themselves against violence, receive contraceptives, get tested for HIV and get referrals to trusted doctors. Peer counsellors also provide psychological support and involve sex workers in client management programs.

Training on how to use a female condom

Legal components make up an important aspect of the project’s work – the so-called “street lawyers” trained by the project provide legal aid and support in cases of violations of MSM/LGBT and SWs rights. Project clients take part in educational trainings and seminars.

Particular attention is devoted to community development and mobilization, to encourage community-driven HIV responses. Project activists organize campaigns and round table discussions aimed at overcoming societal stigma.

Women plus

Social support center for women, pre-test counselling

HIV-positive women are the focus of one of the projects run by EVA Association. In October 2017, a social support center for women affected by HIV will be launched by EVA – a low-threshold service offering comprehensive individual assistance to HIV-positive women in crisis situations.

The project team unites specialists with various experiences: peer counsellors, client management officers, lawyers, psychologists. Clients will be offered counselling, rapid HIV testing with pre- and post-test counselling, and individual management of each case. Women will be able to obtain contraceptives (condoms) here and take part in self-help group sessions for women living with HIV and their family members.

Social support center for women, rapid testing for HIV

Experienced specialists working in EVA will do their best to make the center as client-friendly and as responsive to clients’ needs as possible – for example, by allowing clients to bring their children, organizing distribution of clothes for women and kids, giving out hygiene kits. EVA collaborates with the municipal public services and socially oriented NGOs, which will improve activities aimed at informing women about the existing support services, providing access to various specialists and representing women in these institutions.

The center will give special attention to the prevention of violence and dependent and co-dependent behaviours. It is pilot project, unique for the region, with a focus of preventing negative social consequences of HIV among women.

Social support center for women

Prevention projects for vulnerable groups in Russia were launched 20 years ago by our western colleagues. However, international funding for these and other social projects has been significantly reduced. Unique low-threshold HIV prevention programs are becoming as vulnerable as their clients. Some organizations manage to secure financial support from the government. Others try to change their structure. We would like to believe that projects that help thousands of people representing very closed populations to protect their health will not become extinct in Russia.