As part of the international campaign “16 Days of Activism Against Gender-Based Violence”, the #REAct team held a series of webinars to support, protect and prevent violence against women and girls, especially from vulnerable groups.
At the webinars, among other materials, the participants were presented with the “Wheel of Violence” model, which reveals the reasons why women often return to the abuser, what strategies of psychological violence are most often used before the use of physical violence and what lies at the root of violence. The psychological portrait of the abuser was considered and it was discussed why gender stereotypes can become the basis for violence in the future. This information is a very valuable tool in the effort to end violence against women and girls from Eastern Europe and Central Asia.
“An interesting fact is that 20% of the participants were men. It was men who actively participated in the discussion in the webinar chat, and are now actively testing to get a certificate. I am pleased that men want to learn more about the causes and preconditions of gender-based violence – said Victoria Kalyniuk, REAct regional coordinator.
Almost 500 participants from 16 countries joined the webinars: Albania, Belarus, Bosnia and Herzegovina, Belgium, Armenia, Georgia, Kyrgyzstan, Moldova, Montenegro, Tajikistan, Serbia, North Macedonia, Poland, France, Uzbekistan, Ukraine and Georgia.
Victoria Kalyniuk noted that understanding the value of this information, easy and understandable format of its presentation is very important to ensure coverage of the maximum number of countries in the region: “We provided translation into 5 languages, the speakers spoke in Ukrainian and the translation was in English, Albanian, Bosnian, Georgian and Russian. And as a result, we saw the active involvement of participants from the countries of the region in the training. The webinar recordings are also available in all five languages.”
Trainer Marta Chumalo shared the key tools for effective assistance to the victim and stabilization of her condition.
Marta Chumalo uses research and scientific basis in her work, she gives social workers and those who work with victims of domestic violence a toolkit to explain to victims in simple words what violence is, why it happens and why, unfortunately, it is repeated.
“I was lucky to get to the offline training of Ms. Marta in Lviv and then I realized that her lectures should be heard by everyone. I really liked the format of teaching: not theory, but clear facts and research that really open the eyes to the preconditions that fuel violence against women and girls,” Victoria shared.
Since women are often afraid to report an act of violence that has happened to them or even blame themselves, one of the important goals of the webinar series was to give social workers clear theses and simple words that can be said to the client so that she understands that the violence that has happened to her is not a normal situation, it should not be so.
“We had an idea to help our social workers in the countries of the region, to learn how best to start this conversation, how to get the victim to open up and talk about her situation so that we could provide the necessary assistance. Through these webinars, we wanted to spread the idea that any gender-based violence is not normal, it is not “ok”,” Victoria added.
The webinars also presented a study by Dobash&Dobash, which explains that it is the deep stereotypical beliefs of perpetrators about the role of women in society and their functions in a couple that are the main cause of violence, not social. Material or psychological background of offenders. The study “The Jane Monckton-Smith Murder Graph” describes what may be the signals that indicate the danger of violence in relationships. After all, the most effective prevention of violence against women is intervention before the first blow is struck.
The most important issues from the webinars were put to the test in order to fix in the memory of the participants the main theses, simple formulations, which, we hope, they will continue to carry them to the masses and change gender stereotypes in the countries of Eastern Europe and Central Asia.
If you have not yet had time to attend the webinar, you have the opportunity to view the recordings until January 31, 2023. Everyone can listen to them and after passing a short test – get a personalized online certificate.
Learn more: https://react-aph.org/uk/zapys-seriyi-vebinariv-po-protydiyi-genderno-motyvyrovanomu-nasyllyu/

Alliance for Public Health and the Malaysian AIDS Foundation (MAF) have held an expert discussion ‘HIV, Harm Reduction and Islam’ to share the experience and present successful mechanisms for implementation of harm reduction and HIV prevention programs in Islamic countries.

Andriy Klepikov, Executive Director at Alliance for Public Health, said that a half of the 14 countries of SoS_project 2.0, the geographically largest Global Fund’s regional project, are Islamic. That is why it is important to study the best practices in HIV response and ensuring more sustainable response through support and coordination with Islamic religious groups and their leaders. This cooperation would be productive and help to significantly accelerate the progress of defeating the HIV/AIDS epidemic in such countries.

The best experience of stopping the spread of HIV

Islam can help to stop the spread of HIV and to provide essential services, including harm reduction ones. Tetiana Deshko, International Programs Director at Alliance for Public Health, said that Malaysia currently has been the most successful in this regard.

Professor Adeeba Kamarulzaman, a member of the Global Commission on Drug Policy, told about the experience of Malaysia: ‘When we did the advocacy for implementation of harm reduction services, this experience seemd controversial, yet we understood it was necessary. HIV spread among the people injecting drugs was on the rise, and we had too quickly respond and introduce syringe exchange programs and methadone therapy. We encountered resistance from authorities and religious organizations, but we explained and discussed the concept with all stakeholders. We launched a pilot project that proved that such programs are needed and that we can provide the necessary treatment to stop the spread of HIV among people using drugs in Malaysia.’

Role of religious leaders

Using methadone at Ar-Rahman mosque was allowed by religious authorities as it is considered a medication that can be used to tread drug addiction.

‘In Malaysia, we enable the mosque community to develop joint thinking for further improvement of rehabilitation from addictions using innovative methods of the Islamic spiritual influence program,’  told Professor Rusdi Abd Rashid. ‘In particular, we implemented Spiritual Enhanced Drug Addiction Rehabilitation (SEDAR) program in 2010. The goal of the program is to help the government to expand harm reduction intervention in the context of drug use and HIV prevalence among people who inject drugs by involving mosques as a new platform in addition to existing institutions of the Ministry of Health, private clinics, prisons, and the National Drug Agency.’

Nizam Yussuf, treasurer at Ar-Rahman mosque, said that the mosque committee had agreed to adopt the program because it helped people to improve their lives.

Dr. Fazidah Yuswan from the Ministry of Health of Malaysia shared convincing national statistics. In particular, she noted that at the early stages of the epidemic back in 1990s, upt to 90% of all new HIV cases in the country took place among people who use drugs. At the national level, introduction of harm reduction programs began in 2005-2006, and the trend of prevalence of the epidemic started to decrease. By 2021, the number of new HIV cases among people who use drugs had dropped below 5%.

And in 2000s, the epidemy was on the rise. According to estimates made in 2021, introduction of harm reduction had allowed to reduce HIV incidence by 70%. Dr. Yuswan is confident that the harm reduction program has proven its effectiveness in reducing the HIV incidence and opioid dependence.

Dr. Yuswan also mentioned that the responsibility for implementation of the syringe exchange program was placed on the HIV Council under the Ministry of Health of Malaysia. It is the MoH that leads the methadone therapy efforts in the country. These programs were implemented thanks to the support from the religion department, National Drug Agency and the police.

Bamar Gueye representing the National Alliance of Religious and Medical Experts in Health and Development from Senegal told about the experience of his country in implementation of harm reduction programs. In different countries, the programs face similar discussions about how harm reduction programs can be implemented in Islamic states. The example of Senegal is a story of a persistent and open dialogue between various specialists aimed at preserving people’s lives. Now these programs successfully operate and expand.

Religious leaders have a unique role to play being much closer to people

Central Asian countries are making their first steps, but the religious community is not yet ready to accept the HIV response programs.

Kadyr Malikov of Independent Analytical Center ‘Religion, Rights, and Politics’ noted that countries of Central Asia are not yet prepared for either decriminalization or methadone-based substitution therapy because of stereotypes and community’s reluctance. Islamic rules make harm reduction programs difficult or sometimes almost impossible to implement, therefore comprehensive efforts are required as well as political will of local authorities. It takes meetings that have to be used to present international experience and convincing arguments.

Because of their stigma, people living with HIV often avoid seeking aid or disclosing their HIV-positive status and remain helpless. Religious leaders have a unique role to play as they can break the silence and speak up about the suffering of people with drug dependence and offer them a helping hand.

According to Pavel Bém, a member of the EECA Commission on Drug Policy, religious leaders are much closer to people. It is known that HIV is preventable, but the prevention requires leadership and commitment at all levels of the society. It is wrong to rely solely on public authorities and expect them to change the epidemic situation. He says that religious space is an important platform for introducing experience, evidence base, good practices and information communication with the most-at-risk populations, including families of the members of such populations. Religious space is exactly where an open dialogue is possible, where people can speak up about their problems, needs or fears. Developing this level of communications will significantly improve the situation in Islamic countries.

The expert discussion was conducted with the support of SoS_project 2.0, a regional project funded by the Global Fund and implemented by the Alliance for Public Health and a consortium of organizations.

‘Build the world we want: a healthy future for all’ is the slogan of this year’s Universal Health Coverage Day #UHCDay which is celebrated worldwide annually on December 12.
For a country which has been resolutely resisting the full-scale russian aggression and essentially fights for peace and democratic future for the whole world, this slogan takes a special meaning. ‘We in Ukraine are really building the world we want without trade offs. A world where every person has their rights, including the right to affordable quality health care’, says Zahedul Islam, Director of Treatment, Procurement and Supply Management department at the APH and a member of the Advisory Group of the Civil Society Engagement Mechanism for UHC2030.
For years, the Alliance for Public Health has been drawing attention of the authorities and the society to the topic of universal health coverage. In all areas of our work, we try to improve access to health and medical social services, especially for vulnerable populations. Two years ago, the APH made a review of the national legislation of Ukraine on HIV/TB/hepatitis and other aspects of protection of the rights and ensuring the access to health services for vulnerable populations. The review focused on legislation’s compliance with recommendations and commitments from the Political Declaration of the UN GA High Level Meeting on #UHC. Based on this review and in cooperation with the key national stakeholders, recommendations were produced and submitted for potential implementation to responsible central executive authorities and committees of the Parliament, as well as to international and non-government organizations for further advocacy.
‘Even though the situation in Ukraine now is very difficult because of the war and the energy terror which have already caused an acute humanitarian crisis and undermined the capacity of the health care system, we need to make our best efforts to ensure that every Ukrainian can receive affordable quality health services wherever they need them. And ahead of the new UN GA High Level Meeting on UHC in September 2023, we once again stress the importance of providing legal guarantees of unhindered access to health care services for all the citizens in the country’, Mr. Islam sums up.
We would like to thank all our partners from public authorities, health institutions and non-government organizations for their dedicated work to ensure access to diagnostic and treatment of socially dangerous diseases for people despite the hostilities and occupation, rocket attacks against peaceful cities and villages, traffic havoc, power shortage, and interruptions in heating and communications. Jointly, we will build the world we want!
#HealthForAll

We continue using every opportunity and every platform to draw international attention to the war in Ukraine and the problem of tuberculosis in war time.

This year, Alliance for Public Health has again participated in the Union World Conference on Lung Health that took place from 8-11 November 2022. During the four-day online event, the APH together with their partners organized topical sessions and discussions on TB response both on the main stage of the conference and in Community Connect, a special section for civil society and community members.

The activities included: “The effective collaboration and resiliency of TB program, community and Civil Society Organizations to end TB under the challenging war conditions in Ukraine”  session chaired by Zahedul Islam, Director of Treatment, Procurement and Supply Management department at the APH and involving speakers Iana Terleieva (Head of TB Management and Response department of the Public Health Center of the MoH of Ukraine), Liliana Caraulan (Stop TB Partnership) and Olha Tsvilii (senior project manager at the APH); “Challenges and lessons learned from the implementation of the tuberculosis program during the COVID-19 pandemic: Experience from Cambodia, Ecuador, India, and Ukraine” session organized by the APH as part of the Frontline AIDS partnership, chaired by Zahedul Islam, Director of Treatment, Procurement and Supply Management department at the APH and involving partners from Khana Cambodia, Corporación Kimirina, LEPRA Society and Evgenia Geliukh, senior HIV/TB project manager at the APH who presented our experience in TB response during the pandemic; and “Combining efforts and conducting joint advocacy activities between civil society and various government bodies: The executive (government), parliamentarians, and local authorities” panel discussion organized by the APH and chaired by Zahedul Islam, Director of Treatment, Procurement and Supply Management department at the APH.

Besides, our employees moderated and spoke at other session and and expert discussions during opening and closing of the conference, including a presentation of E-posters, oral abstract session on strengthening national and global policies and lessons learnt, discussion of case-finding and treatment, where Evgenia Geliukh, senior HIV/TB project manager at the APH shared our experience of active TB case-finding among at-risk populations during the hostilities in Ukraine.

This year, the Union Conference for the first time included a creative session where the APH presented two videos about our innovative project on supporting mental health of people living with TB and a joint video with Frontline AIDS on TB response during the COVID-19 pandemic in different countries of the world.

During the last panel discussion of Community Connect session, at the end of the Union Conference 2022, a new composition of Union Community Advisory Panel/UCAP was announced, where Zahedul Islam will represent the European region and the position of civil society and communities affected by TB.

On the International AIDS Day, Dr. Andrey Klepikov, Executive Director of the Alliance for Public Health, paid an official visit to Ireland to share his experience in the HIV/AIDS response.

The program of the visit, which lasted on December 1-2, 2022, included a series of meetings and speeches, where Dr. Klepikov spoke about the unbreakable struggle of Ukrainians against Russia’s terrorist aggression in Ukraine, the huge losses of medical infrastructure, innovations and changes in approaches to the work of the Alliance’s team since the beginning of the large-scale war in Ukraine, which the Alliance team has made.

The program of the official visit to Ireland started with a meeting at the Embassy of Ukraine in Ireland.

At the meeting with Mrs. Larysa Gerasko, Ambassador of Ukraine to Ireland, the difficulties faced by Ukrainians in Ireland in accessing medical services and receiving treatment were discussed.

Andriy Klepikov told the Ambassador about the work of the international hub HelpNow, which helps Ukrainians to access HIV treatment by coordinating requests from Ukrainian patients in more than 35 countries. In Ireland, the hub works with the local organization HIV Ireland (https://www.hivireland.ie). During the entire period of the hub’s work, one third of all requests for treatment in Ireland came from Dublin.

The meeting also discussed ways to strengthen the information field and focuses for the most effective broadcasting of information on the situation on the public health front, as well as reputable media and possible channels for the organization to raise additional funds.

It should be noted that the Alliance for Public Health, with the support of more than 100 non-governmental organizations from around the world, initiated and organized the emergency launch of the international coordination hub HelpNow. The hub began its work on March 1, 2022 in response to the crisis, which was facilitated by Russia’s large-scale invasion of Ukraine.

The official website of the hub with a list of all services is https://helpnow.aph.org.ua. So far, 13,000 cases have been supported with treatment and/or other critical services at the new location.

The next step was an official meeting with the Senators and Chairman of the Joint Committee on Foreign Relations Defense

Andriy Klepikov, Charles Flanagan, the Chairman of the Committee and Senators Gerard Crowell, Joe O’Reilly discussed the pressing issues for Ukrainians today, in the context of the impact of the full-scale Russian invasion on people living with chronic diseases and fighting for their lives every day. Migration issues, humanitarian problems, problems in access to support and treatment services, as well as the consequences that the whole world is already seeing in the de-occupied territories were discussed separately.

Separately, the issue of the cold season and ways to help, to provide support to Ukrainians who need it in humanitarian, medical and consulting contexts were raised.

Mr. Charles Flanagan expressed his admiration for the courage of Ukrainian civil society, and stressed that the meetings and information presented by Andriy Klepikov help to keep the topic of support for Ukraine “at the top of the agenda”.

Lecture for students on the resilience of Ukrainians

Also, the Executive Director of Alliance for Public Health gave a lecture for students of Trinity College Dublin.

At the lecture, Andriy Klepikov spoke about the war in Ukraine, its impact on the work of NGOs and the challenges they heroically overcome to help people living with chronic diseases.

Students were also presented with the general situation on HIV detection and treatment, as well as the work of the international hub HelpNow, which helps Ukrainians with access to HIV treatment, coordinating requests from Ukrainian patients in more than 35 countries.

Alliance for Public Health expresses its sincere gratitude to partners Irish Aid and Global Health Network for organizing the official visit, and to thank everyone for their interest in the problems in Ukraine due to the full-scale invasion of Russia and the constant support of Ukrainians around the world.

1st of December 2022 is different from any other World AIDS Day. In Ukraine we are summing up HIV response during russian war against Ukraine.

These 9 months of war caused the largest population move in Europe since WW2 ep –15 mln Ukrainians left their homes as internally displaced people (IDPs) or refugees; over 1000 Ukrainian medical facilities have been destroyed or damaged, about 20% of the Ukrainian territory occupied by russian invaders – committing war crimes against civilians, cutting access to essential services and treatment, torturing and killing people with HIV and TB.

Since the first days of war Alliance for Public Health (APH) has been working with other civil society and community organizations, medical facilities, governmental organizations and Ministry of Health to sustain HIV response.

“The is a latest report, not only summarizing huge challenges for nearly 300 of war, but rather providing some data and lessons learned on sustaining and in moreover accelerating HIV response (this time it focuses on HIV on the eve of World AIDS Day). While with such damage of energy sector and daily power cuts, life is getting more challenging, we are continue working addressing both health and humanitarian needs, – said Andriy Klepikov, Executive Director of the Alliance for Public Health. – Thank you for keeping supporting Ukraine, thank you for investing in community and civil society. Just a couple of highlights. It makes the difference! Every 2nd newly diagnosed person with HIV during the war was found and got tested within APH projects. 84% of new PrEP clients were navigated by APH and its implementing partners. When hospitals got destroyed by missiles and shelling, 40 mobile ambulances continue provision of essential services”.

With this report we are sharing our highlights based on unique experience of APH and is partners. We actually issued the Situation Report as well as a special brief video, please find the link below:

Report

We are pleased to finally share the results of the charity collection for ambulances for Ukrainian doctors, which we held at the 24th International AIDS Conference AIDS 2022, held in Montreal (Canada) from July 29 to August 3, 2022.

“Ukraine is unconquered, and Ukrainians are unbreakable. We will stand and win, because we have no other way. But we need the support of the world more than ever!
Personally and on behalf of the Alliance and all Ukrainians, I am sincerely grateful to everyone who contributed to raising funds for minibuses to evacuate the wounded from the war zone to the nearest hospitals, – said Pavlo Smyrnov, Deputy Executive Director of the Alliance for Public Health. And we managed to buy not 1 but 2 cars. I shake hands with everyone and report that we quickly managed to buy buses in the Netherlands. Both buses were successfully delivered to Kyiv, where they underwent the necessary repairs. Already in excellent technical condition they went to the zone of active hostilities. They were also camouflaged for greater safety of medics and wounded. Used cars now have a new mission – to #save human #lives at the front. And I really believe they will serve this mission as long as possible.”
So, a detailed story about how Ukrainians were supported by conference participants from all over the world, how we raised funds and talked about Ukraine, how and where the cars were purchased, brought to Ukraine, technically improved and transferred to the front line!

Many thanks to all participants of #AIDS2022 who supported with donations and not only, sincere thanks to all partners who helped at every step, the Alliance for Public Health team and #SoS_project – you are incredible, you always do more!

Thanks to everyone who helped to organize the whole process: from the ambitious idea “to raise funds for at least 1 car in a couple of days” and to organize everything to the final transfer of 2 cars to the front line.

A new report on the Global State of Harm Reduction 2022 shows an increase in the global use of solutions to reduce harm from HIV and the overdose epidemic.

According to the report, the number of countries implementing harm reduction services that prevent overdose deaths and the spread of infectious diseases has increased for the first time since 2014.

For the first time, the foreword to the report was written by a representative of the community of people who use drugs and he is Ukrainian – Anton Basenko, Community, Rights and Gender Advisor at the Alliance for Public Health and Program Manager at EATG.

Thus, he told the story of a woman from one of the eastern regions of Ukraine who uses drugs, which is an illustration of the strength and solidarity of the community of drug users. “Her story is one of many stories of networks of people who use drugs helping each other. Despite the number of destroyed facilities and displaced people who use drugs due to the war, I am proud to say that our global harm reduction family is unstoppable and our desire to help each other is so strong that we can only move forward…”

“…The report shows where we are today, colorfully and clearly, with facts and evidence. It shows the world we can create when people who use drugs, people who work in nongovernmental organizations, people who make laws and policies at the national and local levels come together; a world based on mutual respect that supports diversity, health, rights and freedom, a world free from judgment and stigma.”

Regarding the war, the report highlighted the extraordinary efforts of NGOs and civil society organizations in Ukraine and neighbouring countries since the Russian invasion of Ukraine in February 2022 to provide shelter, food, medicine and harm reduction supplies to Ukrainian regions that were cut off logistically or where people could not leave their homes. Support for the evacuation of people who use drugs from Donetsk and Luhansk was noted, as well as ensuring that community and civil society organizations could continue to provide harm reduction services in Donetsk.

To get acquainted with the Alliance’s situational reports on the work of the Humanitarian Committee, the situation with SMT, prevention, de-occupied regions, etc.

It should be noted that as of 01.10.2022, more than 19 thousand patients are on the state substitution maintenance therapy program in Ukraine, of which almost 1600 patients are IDPs. The largest number of IDPs as of 1.09.22 was in Lviv, Dnipropetrovsk, Zaporizhzhia, Ivano-Frankivsk, Kirovohrad regions. The percentage of patients receiving SMT for self-administration for 7-30 days increased to 91%, compared to 84.9% in early February.

Despite all the positive changes and development of the OST program during martial law due to the coordinated work of the Alliance, the Public Health Center, NGOs and patient organizations, unfortunately, the program is experiencing extremely negative consequences, so the % of retention in the OST program for at least 6 months from the start of treatment decreased from 83.1% (as of 23.02.2022) to 78.6% as of 01.10.2022. In July-September alone, about 676 patients in Kherson region stopped receiving OST without the possibility of continuing treatment, as the drug at most sites ran out and was seized by the occupying authorities, and it is almost impossible to leave Kherson region for safer regions. Also, since the beginning of the war, patients from the entire Luhansk region, Donetsk (Mariupol and Bakhmut) and Zaporizhzhia (Berdiansk and Melitopol) have partially left for safer regions to continue treatment, some of them have not managed to leave the temporarily occupied territories.

With the support of the Alliance for Public Health in Ukraine, NGOs provide comprehensive support to OST patients: psychosocial, humanitarian assistance, transportation services.

Link to the report: https://bit.ly/3UbKkt5

Despite the war, there is still an HIV epidemic in Ukraine. According to the national statistics, about 260,000 people are living with HIV, while one third of them are not aware of their status.
For five years, Alliance for Public Health in partnership with 100% Life Network have been implementing the HealthLink Project “Accelerating Ukraine’s Efforts to End HIV” supported by the United States Agency for International Development (USAID). The main aim of this project is to end the HIV epidemic in Ukraine by offering an opportunity of free, rapid and safe HIV testing and treatment. This is the biggest HIV testing project in Ukraine, which is aimed at improving service delivery in health facilities, partner organizations and communities as well as targeted marketing of the key services provided within the project.
The fifth year of the project was the most challenging one, due to the war, occupation of territories, ruined health facilities and constant migration of population. However, the project was able to reach almost all the target indicators:
• 59,985 people tested for HIV (157% of the indicator for the year),
• 1,991 people with newly diagnosed HIV infection (89%),
• 1,944 people registered at health facilities (80%),
• 1,981 people started ART (98%).
The general HIV testing yield within the project is 3.3%.
Challenging times call for extraordinary solutions, that is why the main efforts were aimed at implementing new ideas to find new clients and motivate them to test for HIV, building sustainable adherence to treatment (ART), motivating partners of PLWH for index testing, preventing new infections by offering PrEP to members of high-risk populations, distributing oral HIV tests, etc. A number of innovative approaches have been implemented, including:
Launch of the Video Doctor app to improve the index testing indicators. Doctors received tablets, which they used during their consultations to show videos to their patients, share useful information about HIV, explain further steps in case of HIV detection and give advice on how to invite a partner for testing. The app was actively used by health and social workers of the project. The videos were shown to 884 clients. The activities were implemented in the following regions: Kyiv and Kyiv region, Poltava, Kherson, Kirovohrad, Dnipropetrovsk, Mykolaiv, Odesa, Zaporizhzhia, Chernihiv and Donetsk regions.
Online services became very popular during the COVID-19 pandemic and especially during the war. The services offered at the https://oraltest.org.ua website are in high demand among the LGBT clients. On the website, they can order a SafeBox or take a survey on risk behavior and learn about the risks of getting infected with HIV, syphilis and hepatitis. SafeBox is a prevention package, which includes an oral HIV test, condoms, lubricants, information materials and trendy souvenirs. SafeBoxes are especially popular in smaller towns and villages, where the LGBT community is hidden. They allow people to protect their confidentiality and get tested for HIV at home using the guide provided in the box. In total, 3,286 boxes were ordered at the website in one year.
Besides, a Telegram bot Assistant Dan has been launched in the fourth quarter to carry out a survey among the clients on their use of oral HIV tests and their satisfaction with the website services. The survey responses were analyzed and the results were part of the research “Oral HIV tests.” Besides, the bot helped to form a group for online testing of the LGBT community members. In total, 1,692 people took part in the online survey, which proves the efficiency of the online tools. In addition, the Telegram bot is used for online outreach or navigation, leading the clients to online consultations of friendly doctors, psychologists and lawyers.
Another gem of the project is the Seducer simulation game for MSM. As we all know, there are no drafts in life, so it is important to make right decisions from the first time. Unfortunately, we do not always have time or experience to understand, which decision is right and what consequences it can lead to. Participants of the simulation game are able to put themselves in the shoes of the game heroes, try different scenarios, and see the consequences of their choices. The game is a very effective education tool. NGOs offer to use this tool in their workshops for MSM.
Vending machines were widely used to distribute oral tests. They allow clients to access HIV tests and do self-testing in a comfortable place. Also, there are free condoms available in the vending machines. The mechanism is quite easy: you go to the website, answer the questions, generate a QR code, scan it and get what you need. In one year, 1,107 oral HIV tests were distributed through such vending machines.
For successful project implementation, it is important not only to encourage new clients to get tested, but also care about motivation, awareness and support of the project staff. That is why supervision has been launched as an important project component to provide ongoing help and support to the NGO staff members and health workers engaged in the project. The key topics discussed at the supervision sessions:
• peculiarities of HIV testing and counseling (in particular using a questionnaire to screen clients for risky behaviors and medical indications for testing);
• motivational counseling with skill building exercises (including index testing);
• prevention of professional burnout among the staff;
• maintaining emotional and psychological stability during hostilities, etc.
Both face-to-face and online sessions were organized. Due to the war, the number of face-to-face supervision sessions – both in NGOs and in health facilities – reduced greatly. However, despite all the challenges, supervisors were able to carry out 74 supervision sessions in NGOs and health facilities. The face-to-face supervision sessions were attended by 146 NGO representatives and 547 health workers, including nurses and doctors of different profiles, offering HIV and hepatitis testing and counseling. The number of online supervision sessions – both group and individual – was much bigger. In total, there were 1,434 online supervision sessions.
Providing support to the newly diagnosed patients was another focus of our work. When patients learn about their HIV-positive status, it is much easier for them to cope with the challenges and overcome the obstacles they face when they are supported by a mentor, who has a similar experience, which he is ready to share. One of the innovative approaches used in the project was peer mentoring. Mentors received special training on such topics as living with HIV, providing psychological support, coping with stress, offering motivational counseling to build adherence to ART, etc. After being trained, mentors were supporting their mentees living with HIV who had risks of dropping out of treatment and helped them build their lives with their new status. As for the mentors, it gave them a chance to do things which were socially important, build their capacity and self-esteem through training and cooperation with the project. This approach received a lot of positive feedback both from the mentors and from the mentees.
We would like to separately recognize the adaptability and creativity of our partner NGOs in finding new clients and interacting with them. Due to the war, many clients had to leave their homes and look for shelter in new places, where they sometimes did not have access to ART. That is why social workers organized the delivery of ARVs to their clients living with HIV, in particular internally displaced persons. In total, there were 233 ARV deliveries organized within the project.
Most NGOs started working with internally displaced persons and offering humanitarian support within other projects. Thus, they were able to reach a new target audience. Now, when people come to NGOs to get humanitarian aid, they also get information about HIV and are offered HIV testing. Such information is also distributed in the places where IDPs live.
The donor decided to extend the project for the sixth year, so we continue fighting HIV despite all the challenges we are facing today.