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PROGRAMME UPDATE OVERCOMING HIV/AIDS EPIDEMICS IN UKRAINE

PROGRAMME UPDATE OVERCOMING HIV/AIDS EPIDEMICS IN UKRAINE. Activities and Results in Priority Oblasts. Presentation at the 4 th Stakeholders’ Meeting on the GFATM Grant to Ukraine by Mikhail Minakov in Kyiv, January 28, 200 5. PRIORITY OBLASTS.

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PROGRAMME UPDATE OVERCOMING HIV/AIDS EPIDEMICS IN UKRAINE

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  1. PROGRAMME UPDATE OVERCOMING HIV/AIDS EPIDEMICS IN UKRAINE Activities and Results in Priority Oblasts Presentation at the 4thStakeholders’ Meeting on the GFATM Grant to Ukraine by Mikhail Minakov in Kyiv, January 28, 2005

  2. PRIORITY OBLASTS The Alliance strives to focus all programmatic efforts on certain oblast of Ukraine aiming to create models to be replicated in other oblasts of Ukraine. Six oblasts with highest level of HIV/AIDS epidemic growth have been chosen as sites for the programme’s start. Nine more oblasts were identified as sites for the next step of the programme implementation. The rest of oblasts are to become regions for programme implementation in the following years of the programme implementation. The reason behind geographical focus of the programme is that treatment, care and support, and preventive activities need certain level if investments that would create a supportive environment to fight HIV/AIDS epidemics on oblast level.

  3. PRIORITY OBLASTS Regions with treatment started: Autonomous Republic of Crimea Dnipropetrovsk oblast Donetsk oblast Mykolaiv oblast Odesa oblast Kyiv city Regions getting prepared to start treatment: Kherson oblast Kharkiv oblast Kyiv oblast Lugansk oblast Zaporizzhia oblast Poltava oblast Ivano-Frankivsk oblast Vinnitsa oblast Sevastopol city

  4. CRIMEA TREATMENT The Programme established cooperation with Crimean AIDS Centre and main Simferopol hospitals to start the ARV treatment. We have now 160 patients on treatment in Crimea, of which are 136 adults and 24 children.

  5. CRIMEA CARE, SUPPORT AND PREVENTION Activities in treatment were supported by ~ four care and support projects ~ five projects in HIV prevention among vulnerable communities ~ work of Crimean and Sevastopol Info & Resource Centres on HIV/AIDS issues ~ 2 PLHA rights advocacy projects ~ project gathering alternative information re HIV/AIDS, etc. The Alliance established partnership with 10 civic organizations and activist groups to develop these projects in Crimea. Their work was financially supported with over than $250,000.

  6. CRIMEA LIFE STORY NADIA I PORIATUNOK Foundation, Simferopol Two multidisciplinary teams are organized by this NGO, attending to 50 adults and 9 children both in Simferopol city and in its region, and one paediatric team attends to children taking ARV drugs. Altogether 618 PLHA benefit from the project services. The major achievement of this project is on-going information campaign for PLHA about the treatment possibilities – 632 PLHA were informed about ART.

  7. DNEPROPETROVSK OBLAST TREATMENT In cooperation with Dnipropetrovsk AIDS Centre the Alliance has started treatment for 157 patients. Among them: 145 adults and 12 children.

  8. DNEPROPETROVSK OBLAST CARE, SUPPORT AND PREVENTION Treatment in Dnepropetrovsk was supported by other activities of the Alliance and its partners, such as: ~ five care and support projects in three cities of the oblast ~ four projects in HIV prevention among vulnerable communities ~ project gathering alternative information re HIV/AIDS ~ establishment of Dnipropetrovsk Info & Resource Centre on HIV/AIDS issues (VIRTUS Centre), etc. In partnership with five civic organizations and activists groups the Alliance, IRF and PLHA Network support 11 projects in the oblast. The projects received financial support exceeding $230,000.

  9. DNEPROPETROVSK OBLAST LIFE STORY VIRTUS Rehabilitation centre, Dnipropetrovsk So far 116 clients, including 92 PLHA and 24 people from their close environment have received services of the project. One of the most important project fields of work is working with HIV-positive children. The project has already established cooperation with the orphanage “Barvynok” where HIV-positive orphans live. Social workers of the project carry out patronage at the orphanage. A distinctive feature of this project is providing various services helping project clients to adhere to treatment: alarm-clocks, several types of containers for keeping medicines, time-tables of taking medicines, and diaries of psychosomatic state of the clients.

  10. DONETSK OBLAST TREATMENT In cooperation with Donetsk AIDS Centre, the Alliance has started treatment for 248 patients, among which 229 adults and 19 children.

  11. DONETSK OBLAST CARE, SUPPORT AND PREVENTION Activities in treatment are accompanied by supportive projects, such as: ~ eight care and support projects in six cities of the oblast ~ six projects in HIV prevention among vulnerable communities ~ project gathering alternative information re HIV/AIDS ~ development of Donetsk Info & Resource Centre on HIV/AIDS issues (Donetsk Association for Assistance to PLHA) , etc. In partnership with seven civic organizations and activist groups, the Alliance, IRF and PLHA Network support 16 projects in the oblast. The projects received financial support exceeding $320,000.

  12. DONETSK OBLAST LIFE STORY Donetsk Regional Association of Assistance to HIV-positives The biggest project dealing with ART adherence began to function. To engage 450 people into treatment 8 multidisciplinary teams were created in three cities of the region: Donetsk, Mariupil, and Slovjansk. During 2 months of the project functioning 229 PLHA started ART and 1066 home based consultations were provided. This project presents an example of well-established cooperation between several programmes: “Non-medical home based care” – providing assistance to the project by home based patronage of clients with low level of adherence; “Reduction of drug related harm among IDUs” – assistance in informing HIV+ IDUs about the possibility of treatment. Thanks to additional activity of the multidisciplinary team leader in Mariupil, clients of the project could receive social assistance from the metallurgical plant in the form of food packages. The staff of the multidisciplinary teams believe that establishment of the trusting relationships with both clients and their close environment was the primary achievement of the project. Local TV channels as well as national TV channel “Inter” in the “Podrobnosti” programme included information about the project activity into their news issues.

  13. KYIV CITY TREATMENT In cooperation with Ukrainian and Kyiv AIDS Centres, as well as with Lavra Hospital, more than 215 patients are treated in Kyiv: ~ 206 adults, and ~ 9 children.

  14. KYIV CITY CARE, SUPPORT AND PREVENTION To support activities in treatment, the Alliance and its partners developed a number of projects: ~ nine care and support projects ~ five projects in HIV prevention among vulnerable communities ~ PLHA rights advocacy ~ project gathering alternative information re HIV/AIDS ~ Kyiv Info & Resource Centre (SOCIUM XXI), etc. In partnership with nine civic organizations and activist groups the Alliance, International Renaissance Foundation and PLHA Network together support 17 projects in the oblast. The projects received financial support exceeding $390,000.

  15. KYIV CITY LIFE STORY STEPS Rehabilitation Centre Since the beginning of project implementation 21 clients were attracted to the services. 19 people (16 men, 3 women) have passed the complete course of rehabilitation in accordance with the protocol for IDU living with HIV/AIDS. Self-help groups were attended by 324 people, and some of them became regular clients. On the 19th of September the organization has taken part in the information fair of NGOs which provide services for PLHA. This fair took place as part of a bigger event “Run for Life” which was supported by UNDP, HIV/AIDS Alliance and All Ukrainian network of PLHA. During the fair a poster was presented by Kyiv municipal department RC “Steps” and information materials about the services offered along with contact information were spread around. On the 28th of September 2004 CF “Steps” together with Social Service for Youth and Community centre of comprehensive support for PLHA did a presentation for representatives of Kyiv municipal administration with the purpose of stressing the necessity to launch similar rehabilitation centres in other districts of Kyiv.

  16. MYKOLAIV OBLAST TREATMENT In cooperation with the local AIDS Centre 109 patients are treated in Mykolaiv. Among them: ~ 95 adults, and ~ 14 children.

  17. MYKOLAIV OBLAST CARE, SUPPORT AND PREVENTION In addition to treatment, the Alliance and its partners implement other projects, such as: ~ three care and support projects ~ six projects in HIV prevention among vulnerable communities ~ children living with HIV/AIDS rights advocacy ~ project gathering alternative information re HIV/AIDS ~ Mykolaiv Info & Resource Centre (BLAGODIYNIST Foundation), etc. In partnership with five civic organizations and activists groups, the Alliance and PLHA Network together support 14 projects in the oblast. The projects received financial support exceeding $290,000.

  18. MYKOLAIV OBLAST LIFE STORY CHAS ZHYTTIA Association of HIV-positive people Two multidisciplinary teams, consisting of one infectious diseases specialist, two nurses, psychologist – social worker and three peer counsellors, started to work in the region. The project succeeded in developing training modules on adherence to ART. These trainings were carried out by PLHA. Also 8 trainings for PLHA and their close environment, as well as one workshop for doctors of narrow specialities were conducted. New treatment methods learned showed their effectiveness by motivating 67 people to begin treatment in short space of time, at the same time the percentage rate of ART adherence among the project clients came to 97-99 % for the month surveyed. The project has printed high-quality materials that help clients of the project to form adherence to ART: “personal diary of peer counsellors dedicated to forming adherence among the clients of the project, “assessment of the objective state of health” and “medical supervision of the project client’s state of health”, “diary of client’s state of health”, “medico-psychological card of project client”. Doctors of AIDS Centres, psychologists, nurses and peer counsellors have provided 1164 individual multidisciplinary consultations for the project clients and their close environment.

  19. ODESA OBLAST TREATMENT Odessa AIDS Centre and the Alliance now provide with treatment 163 patients, among them: ~ 126 adults, and ~ 37 children.

  20. ODESA OBLAST CARE, SUPPORT AND PREVENTION Along with treatment, the Alliance and its partners undertook other projects, among which: ~ six care and support projects ~ five projects in HIV prevention among vulnerable communities ~ newspaper for key populations ~ project gathering alternative information re HIV/AIDS ~ Odesa Info & Resource Centre (in cooperation of 2 NGOs: ‘NASHI DITY’ and ‘DOROGA DODOMU’), etc. In partnership with seven civic organizations and activist groups, the Alliance, IRF and PLHA Network together implement 14 projects in the oblast. The projects received financial support exceeding $340,000.

  21. ODESA OBLAST LIFE + Self Help Club ART scale up in Odesa funded by GF started in late August. One of the biggest tasks at that time was to attract patients. The listed patients had to be called up. For those however who was not in the list, advertising materials were produced: a poster, and an audio ad which was aired on the local radio. In addition, a press conference was held at which the head doctor of Odesa AIDS Centre and the head of Life + organization presented the information about the beginning of treatment. After these measures were taken, a lot more calls were received and many more new clients were attracted to the new services. During this reporting period 19 individuals received phone counselling, and 181 individuals were consulted in person. Nine of these people were relatives of the clients. Ten people received extended assistance such as transportation, social assistance, etc. Despite the fact that many new patients are being offered ART and often these patients do not get extensive counselling on ART adherence, there were no major problems yet with adherence which remains rather high. More coordination and partnership is needed to improve operation of the multidisciplinary teams. But this issue is being worked on.

  22. CHERKASY OBLAST PREPARATION OF SCALE UP Although treatment hasn’t started in the oblast yet, the Alliance and its partners undertake all necessary steps to prepare site for the future scale up. Accordingly, the Alliance supports: ~ two care and support projects ~ project gathering alternative information re HIV/AIDS ~ four projects in HIV prevention among vulnerable communities In partnership with three local organizations, the Alliance, IRF and PLHA Network together implement 7 projects with funding of about $80,000.

  23. KHERSON OBLAST PREPARATION OF SCALE UP Treatment hasn’t started in Kherson oblast yet. Still the Alliance and its partners undertake necessary steps to prepare site for the future scale up. Accordingly, the Alliance supports NGO ‘MANGUST’ in development of two projects in HIV prevention among vulnerable communities and one project aiming at collection of alternative information. Some other activities are undertaken to prepare Kherson AIDS Centre to start treatment. Project in prisons has also been launched in the region. Total budget of activities undertaken by the programme and its partners is $94,000.

  24. ACTIVITIES IN SECOND LINE REGIONS The Alliance in partnership with IRF supported 14 projects in 13 second-line regions, including Zaporizhia, Lviv, Zhytomyr, Khmelnytzkiy, Poltava, Lugansk, Vynytsia, Kyrovograd, Chernygiv, Chernivtzi, Sumy, Ivano-Frankivsk and Zakarpattia. The main stress by the supported projects is made upon HIV/STI prevention projects among IDUs and CSW. Services provided by the projects include: — needle-exchange, — distribution of condoms and other necessary disposables, — provision of PLHA with wide range of social and additional medical services, — building up the social capital in the regions, — counselling and distribution of information materials. Funds allocated to support projects in second-line regions exceed $190,000.

  25. ACTIVITIES IN SECOND LINE REGIONS The supported NGOs have established good partnership with stakeholders in their regions. For example, a needle-exchange point, established by POVERNENNYA DO ZHUTTYA Foundation (Znamenka), works in Kyrovograd AIDS Centre and is coordinated by a specialist of the Centre. The Director of the Centre provides counselling to the project clients, and assists in distribution of information materials among the staff of STI clinics in Kyrovograd region. The developing projects apply to implement the peer education techniques and involve representatives of vulnerable communities in project work not only as clients, but also as outreach workers. It helps these people to raise their self-esteem and to assist those, who quitted or about to quit drugs. PORYATUNOK NGO (Kremenchuk) involved clients to work as outreach workers, assisting in conducting surveys, leading HIV/STI prevention activities among SW, and helping to attract new clients to the project.

  26. The Alliance activities and National HIV prevention programme The Alliance contributes 27 activities from the list of 36 actions of the National HIV prevention programme, among which: • monitoring implementation of legislation in area of HIV/AIDS • development of information and education programmes to prevent HIV spread at work place and educational institutions • provision the key populations with access to prevention programmes • advocacy for and preparation of the substitution therapy in Ukraine • creation of the resource centres at oblast level to provide population with Behavioural Change Communication information • PLHA rights advocacy • treatment to 1047 patients • development/support of Ukrainian AIDS Centre and 8 oblast AIDS Centres • researches in area of prevention and social impact of HIV epidemics in Ukraine • monitoring of HIV epidemic situation

  27. Some relevant figures… • 1052 people receive ARV treatment now • 2915 people living with HIV/AIDS provided with care and support services • 20 medical practitioners trained to provide diagnostic and treatment to people living with HIV/AIDS • more than 350,000 condoms distributed • over 40,000 IDUs reached by prevention services • more than 3,000 SW reached with HIV prevention services • about 1,300 prisoners reached with prevention services • 18,000 adults reached directly with Behavioural Change Communications • around 80,000 Behavioural Change Communication materials developed and distributed • 53 prevention projects • 52 care and support projects • more than $12,500,000 invested to strengthen Ukrainian national respond to the HIV epidemics

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