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HIV Prevention with a Focus on People Who Use Drugs: Interim Results

Since November, the EVA Association has been implementing a project called HIV Prevention with a Focus on People Who Use Drugs in Leningrad oblast, Tumen, and Orenburg.

What is the project’s aim? Outreach workers conduct HIV testing among people who use drugs and their sexual partners, help to resolve social and legal issues, and also accompany people living with HIV to the AIDS Center. We are publishing the findings from the first three months of the work of the project.

Since the start of the project, the specialists have provided services for 441 clients. The detection rate of HIV among people who use drugs and their sexual partners is 9.8%. Of them, 1.8% learned of their HIV status for the first time. Before conducting the rapid HIV test, clients say that they don’t know their HIV status, but during the testing they start to open up and admit they know their diagnosis but decided to double check it or that they are not being monitored by the AIDS Center. Some of them are registered for their HIV status, others not. The reasons for refusing to be monitored at medical institutions are various: some deny that HIV exists, some are afraid that the information will be shared with the police. The outreach workers accompany them to the AIDS Center.

A bit about how the support is provided. The main way is on foot and in mobile units. The locations of outreach work are:

24% in residential buildings and in entranceways

24% on the street or in a cafe

19% at nonprofit offices

9% in medical institutions such as at the narcological clinic. Sometimes clients seek out detox and spend 2-3 days at the clinic and then decide to stop in the middle before they finish the procedure and they don’t manage to find out the results of their HIV test. In such cases the outreach workers propose they take an HIV test over again.

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The project specialists took part in special training where colleagues from Chelyabinsk shared their experience in organizing work for penitentiary inspections.

Alexei Tananin from the Source of Hope Charity shared:

“According to the court sentence, conditionally convicted persons must report to a Penal Inspection Institution based on their residence on a monthly basis. Over 50% of the wards of the Penal Inspection Institution have experience with psychoactive substance use. With support from the Chelyabinsk oblast AIDS Center, in 2017 we implemented a pilot project which included conducting consultations and short lectures for conditionally convicted persons on the topics of prevention of HIV and hepatitis C on the grounds of seven Penal Inspection Institutions across Chelyabinsk. At first there was a bit of tension and mistrust of our specialists, as the convicted persons were required to report to the institutions by law, not on their own accord. But in time, after learning we are representatives of a nonprofit organization, they started to trust us and come to us themselves.

In 2018 we started to work with a wider reach in the oblast (we work in the Penal Inspection Institutions in Chelyabinsk, Kopeisk, and Magnitogorsk) and we expanded the number of prevention services we provide: we conduct rapid testing, distribute tools for protection and informational materials, and, of course, provide medical and social care. Additionally, we but great emphasis on the principle of community and invite wards to events which are held at the Place of Support low threshold community center with locations in Chelyabinsk and Magnitogorsk. You can always be counseled by a specialist or peer counselor there as well as be tested for HIV and hepatitis C, receive information about the right to health and medical care, and of course have a chat over a warm cup of coffee or tea with someone who has had a similar experience in life.”

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The main inquiries for social and legal issues are:
How to reduce one’s sentence on the narcological registry
Rights violations when seeking employment

Approximately 70% of the clients of the project are men. Why? It’s possible that women use drugs less commonly than men or seek out assistance less often. If you know research that has been done which confirms or refutes this, please share it. You can send a link with the research to the project coordinator Ekaterina Mikhailova at mihailova@evanetwork.ru.

We asked clients why they came to a nonprofit to receive services and one the the main answers was the opportunity to receive services anonymously.

Moreover, outreach workers make note of who was the first point of contact: in 63% of cases, it was staff and volunteers from nonprofits.

We would like to remark that 31% of clients have children who are not living with their parents. We offer the clients support to reinstate their parental rights. The regional coordinators wrote in their reports: “Issued a power of attorney to represent their interests in court on the termination of parental rights due to drug use, also went to the hairdresser.” This is the essence of support in social and legal issues.

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