Transcript Treatment, care and support

PROGRAMME UPDATE
OVERCOMING HIV/AIDS
EPIDEMICS IN UKRAINE
Activities and Results in Priority Oblasts
Presentation at the 4th Stakeholders’ Meeting on the GFATM Grant to Ukraine
by Mikhail Minakov in Kyiv, January 28, 2005
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.
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
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.
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.
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.
DNEPROPETROVSK OBLAST
TREATMENT
In cooperation with Dnipropetrovsk AIDS Centre the Alliance
has started treatment for 157 patients. Among them: 145 adults
and 12 children.
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.
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.
DONETSK OBLAST
TREATMENT
In cooperation with Donetsk AIDS Centre, the Alliance has
started treatment for 248 patients, among which 229 adults and
19 children.
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.
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 wellestablished 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.
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.
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.
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.
MYKOLAIV OBLAST
TREATMENT
In cooperation with the local AIDS Centre 109 patients are
treated in Mykolaiv. Among them:
~ 95 adults, and
~ 14 children.
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.
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.
ODESA OBLAST
TREATMENT
Odessa AIDS Centre and the Alliance now provide with
treatment 163 patients, among them:
~ 126 adults, and
~ 37 children.
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.
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.
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.
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.
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, IvanoFrankivsk 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.
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.
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
Some relevant figures…
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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