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Educating and Empowering Vulnerable PopulationsThe Context The governments of Central Asian countries have come a long way since the beginning of the epidemic until now to work against the AIDS epidemic. Denial has been overcome by all countries, except Turkmenistan. Governments have taken responsibility to establish prevention programs for injection drug users (IDU). The AIDS centers have established laboratories for HIV testing, and AIDS treatment is becoming available. The UN Theme Group on AIDS includes HIV/AIDS prevention among vulnerable populations high on its agenda with full participation of both government and international agencies. Four countries have applied for and received grants from the Global Fund, and funds are being used to implement prevention programs. In addition to the Global Fund, many other multilateral and bilateral donors are pouring funds into the region. Many NGOs are also working with vulnerable populations to implement HIV prevention programs. Although more funds are needed to be allocated specifically for comprehensive prevention efforts among vulnerable populations, governments of the region have a unique opportunity, now, to garner efforts against the HIV/AIDS epidemic before HIV spreads to the general population. HIV/AIDS programmers and experts in Central Asia have a good sense of what population sub-groups are most vulnerable to HIV/AIDS, either because of the results of sentinel surveillance, or because of an understanding of the types of risk behaviors in which they engage. Most at risk are injection drug users (IDU), who account for approximately two-thirds of all HIV infections in the region. Following IDUs, sex workers are the next group most at risk for HIV infection. While these are the target groups of most interventions currently being implemented, coverage among these vulnerable populations remains too low to be effective at preventing growth of the HIV epidemics. Risk behaviors of drug users include the sharing of drug injecting equipment and engaging in unprotected/unsafe sex. Sex workers are at risk due to engaging in unsafe sex. In addition, many sex workers also inject drugs and may do so by sharing injection equipment. Unfortunately, there are no good size estimates of these vulnerable populations in the Central Asian countries. Coverage among vulnerable populations is low. Targeted prevention activities are currently fragmented and implemented in a non-strategic way. There is a narrow understanding by NGOs, civil society and government service providers and donors, of the spectrum of potential HIV prevention services. Risk reduction trust points set up by government institutions are not working as effectively as they could. Indicators and targets of achievement are missing among most service providers. In general, there is little understanding or appreciation of the need to establish a prevention to care continuum. Prevention services need to be linked to care services in order to bring PLHIV into prevention. There is also limited experience and involvement of NGOs and civil society, including PLHIV themselves, in the development and provision of prevention, care, and support services for PLHIV and other vulnerable populations. Overall, there is a lack of experience of governments and civil society working together on a practical level. CAPACITY’s Approach CAPACITY approachs this strategy with an aim to support and promote wide and adequate coverage of vulnerable populations. Principally, this is being accomplished through the development of the “60 Plus” approach, whereby with feeback from interested stakeholders, a technical paper has been developed describing the need for high coverage among vulnerable populations in order to achieve impact against HIV/AIDS, and describing methodologies by which high coverage of quality behavior change interventions can be achieved. Following the 60 Plus approach, CAPACITY has developed, is implementing and testing, through local institutions, model HIV prevention interventions. Focal target populations of these models include IDU, sex workers, and vulnerable youth, as these are vulnerable groups that are important to the growing AIDS epidemic in the CAR, not adequately covered by interventions, and within the comparative advantage of CAPACITY partners. NGOs and civil society needs to be one of the major vehicles for delivering HIV prevention services. Therefore, CAPACITY is implementing the civil society mobilization strategy (CSMS). The purpose of the CSMS is to build capacity among a large number of AIDS service organizations, both NGO and government, in the areas of management, operations, fund raising, budgeting, strategic planning, program development, and technical implementation, to increase the number of organizations able to implement targeted, comprehensive interventions to increase coverage, change risky behaviors, and reduce HIV transmission. Additionally, special emphasis will be given to increasing demand among vulnerable groups for VCT and HIV/AIDS care and support services. In order for increasing numbers of AIDS service organizations to be able to implement, with high coverage, proven effective, comprehensive preventive services to vulnerable populations, resources need to be mobilized from international and national sources. CAPACITY is working with other international stakeholders to advocate for increased allocation of resources to HIV prevention among vulnerable populations. CAPACITY is also providing training and technical assistance to civil society organizations and to national governments to prepare proposals for funding of these prevention efforts. Illustrative Interventions To promote the 60 Plus approach for achieving high coverage among vulnerable populations, including IDU, sex workers, and vulnerable youth, CAPACITY is implementing the following interventions. • Development and dissemination of 60 Plus technical working paper. Anticipated Results • National and regional stakeholders aware of importance of achieving 60 Plus coverage among target populations. |
BulletinPartnerswww.rcaids.kz www.ncc.tj www.afew.org www.caap.info www.cdc.gov www.ddrprogram.org www.theglobalfund.org www.projecthope.org www.soros.org www.undp.org www.unicef.org www.unodc.org www.usaid.gov www.euro.who.int www.zplus.kz |
© 2008 Capacity Project
