During a nine day tour of five countries of the Commonwealth of Independent States, a group of HIV advocates met with policy makers and civil society organizations to raise awareness on women and AIDS in this part of the world.

Women against AIDS tour was conceived in the
midst of a growing concern that women are
increasingly at risk of HIV infection in many parts of
Eastern Europe and Central Asia.

Women against AIDS tour was conceived in the midst of a growing concern that women are increasingly at risk of HIV infection in many parts of Eastern Europe and Central Asia. The percentage of adults living with HIV who are women has risen from 11% in 1990 to 28% in 2006.

The tour was sponsored by the AIDS Infoshare organization, UNAIDS, the Global Coalition of Women on AIDS and the United Nations Development Program. Ten AIDS advocates from the region with special guests joining at various points travelled together to learn about the realities of women and AIDS in different parts of the region and also to mobilize local policy makers to act on these issues.

In each of the capital cities of Armenia, Moldova, Kazakhstan, Russia, and Ukraine—the tour group joined with civil society organizations and groups of People Living with HIV (PLHIV) to talk about some of the most difficult issues such as stigma and discrimination and their consequences including losing children’s custody, being thrown out of the home and losing jobs.

“These are real issues,” said Deborah Landey, Deputy Executive Director of UNAIDS who joined the last part of the tour. “We have a collective responsibility to make a difference for women ,” she added.

The predominant mode of HIV transmission in the region remains through the use of non-sterile injecting drug equipment. However an increasing proportion of HIV infections — 37% of reported cases in 2005 — are estimated to occur during unprotected sexual intercourse. In Ukraine, the proportion of people infected with HIV through heterosexual transmission increased from 14% of new cases between 1999 and 2003 to over 35% of new cases in the first six months of 2006.

“We must look at every AIDS plan and strategy and ask whether it works for women,” emphasized Ms Landey. “This is our chance to curb the epidemic in this region,” she added.

The Women Against AIDS also produced a set of
issues to be considered and recommendations when
developing national AIDS strategies in the region.

The tour ended where it started, with women. Sergei Golovach a renowned photographer and a guest on the tour took photos of his fellow advocates for an exhibit to be held called Love, Live and Dream. Through portraits h e wanted to emphasize that it does not matter who is HIV-positive.

“Just look at this photo,” said Ms Landey, remarking on one of the portraits of a mother and her daughter that has been turned into an advocacy poster. “It is all about a mother’s love—which has nothing to do with one’s HIV status.”

Moved by these portraits and what she learned from the tour participants, Elena Vasilieva, Editor in Chief of the Russian Cosmopolitan magazine promised to publish an article about the Women Against AIDS tour in the November edition. To help break down stereotypes she said “a glossy magazine is the right place to raise socially important topics.”

The Women Against AIDS also produced a set of issues to be considered and recommendations when developing national AIDS strategies in the region. Highlighting the critical importance of translating these recommendations into actions, Anna Dubrovskaya, from 'Golos anti-SPID' in Russia said “our wonderful recommendations will not work if there is nobody to demand from policy makers that they keep their promises. The most important thing is to not let this initiative die.”

All photo credit: UNAIDS/Serge Golovach

Links:

View photo gallery
Listen to interview with UNAIDS Deputy Executive Director Deborah Landey
Visit the Global coalition on women and AIDS' web site
Visit UNDP's web site
Visit AIDS Info Share's web site

Women against AIDS tour was conceived in the midst of a growing concern that women are increasingly at risk of HIV infection in many parts of Eastern Europe and Central Asia. The percentage of adults living with HIV who are women has risen from 11% in 1990 to 28% in 2006.

The tour was sponsored by the AIDS Infoshare organization, UNAIDS, the Global Coalition of Women on AIDS and the United Nations Development Program. Ten AIDS advocates from the region with special guests joining at various points travelled together to learn about the realities of women and AIDS in different parts of the region and also to mobilize local policy makers to act on these issues.

Moscow, 27 May - The team is at Sheremetievo Airport. Could not wait to look at the posters and unpacked them right before flying to Almaty (Kazakhstan).

Kazakhstan, 27-28 May - Elnara Kurmangalieva (State Centre for Healthy Life Style) informing about HIV prevention programmes among youth.

Kazakhstan, 27-28 May - Group photograph.

Armenia, 29-30 May - Oganes Madoyan (Real World - real People) opens the discussions. None of the HIV positive women from Armenia was ready to talk openly and express the needs of the community.

Moldova, 30 May-1 June - Aleksander Shishkin (actor and DJ) first on the right side, joined the round table discussions to support implementation of gender specific programmes in Moldova. He also reiterated the need to carry out information campaigns on HIV prevention for young people.

Moldova, 30 May-1 June - Igor Kilchevski (Credinta) offers to discuss the recommendations of the project participants. High stigma and discrimination is perceived by women living with HIV in Moldova.

Ukraine, 2-5 June - Welcoming remarks by Anna Grekova (All-Ukrainian Network of PLHIV) at a press event.

Ukraine, 2-5 June - A cameraman filming for the national TV channel. The media can play a critical role in reducing stigma and discrimination towards women living with HIV.

Moscow, 6 June - UNAIDS Deputy Executive Director Debbie Landey plays a key role in addressing gender dimension to the response to HIV. She actively participated in the Tour.

Moscow, 6 June - Round table participants: (from left) Natalia Ladnaya (Federal AIDS Centre), Sergei Golovach (Photographer), Anna Dubrovskaya ('Golos Anti-SPID' NGO, Ufa, Russia), Elena Tamazova (UNAIDS, Russia), Anna Grekova (All-Ukrainian Network of PLHIV), Debbie Landey (DExD, UNAIDS), Vladimir Pozner (President of the Russian TV Academy), Lyudmila Untura ('Childhood for All' NGO, Moldova), Maria Ivannikova (AIDS Infoshare, Russia), Tatiana Stupak ('Victoria' NGO, Kazakhstan), Larisa Dementieva (Federal Service for Protection of Consumer Rights and Human Wellbeing)

All photo credit: UNAIDS/Serge Golovach

Natalia, a young Ukrainian woman, has been injecting drugs for the last five years. Injecting drug use is a serious problem in Ukraine and is further compounded by high HIV prevalence among people who inject drugs. In Kiev for example the Ukrainian Ministry of Health estimated that in 2006, 49% of people who were injecting drugs in the capital were also infected with HIV.

However, Natalia is one of the luckier ones. She is one of the 110,000 people who accessed harm reduction services in Ukraine in 2006 and has enrolled in a programme of substitution therapy which is helping her to regain a normal life.

Participants at the 2nd National Conference on Harm Reduction
that took place in Kiev between 21 and 24 March 2007

Natalia was also one of the guest speakers at the 2 nd National Conference on Harm Reduction that took place in Kiev between 21 and 24 March 2007. She addressed an audience of almost 400 participants speaking about her experiences and about the importance of harm reduction programmes in Ukraine. Among her audience were the different stakeholders in Ukraine’s response to AIDS, from government officials to health and social care practitioners, communities of injecting drug users, law enforcement agencies, correctional institutions, and the media. In her speech she said, “With the help of a substitution therapy programme I am now able to live normal life again. It has been six months since my programme started and I am already back home, I contribute to raising my niece and I have a job that I love. None of this would have happened if harm reduction programmes did not work in this country”.

Natalia’s story is a familiar one in Ukraine and highlights the importance of harm reduction programmes in countries which are faced with HIV epidemics that are predominantly fuelled by unsafe injecting drug use. The statistics speak for themselves––while, according to official reports, the proportion of people in Ukraine who inject drugs among all new cases of HIV has decreased (from 60% in 2001 to around 45% in the first half of 2006), there is no evidence that the epidemic among people who inject drugs is declining. Sentinel surveillance conducted in several regions in 2006 showed that the prevalence of HIV infection among injecting drug users ranged from 10% in the city of Sumy to over 66% in the city of Mykolayiv.

Dialog between AIDS workers and the media facilitated by TV
star Savik Shuster. Photo credit: International HIV/AIDS Alliance
(Ukraine) / N. Kravchuk

“We know that the HIV epidemic can only be reversed if people who inject drugs have access to a comprehensive set of harm reduction interventions, including information, access to sterile injecting equipment, condoms, drug substitution treatment, and HIV treatment, care and support. In countries and cities where harm reduction programmes have been implemented early and on a large scale, HIV prevention programmes have been successful in reducing HIV prevalence among people who inject drugs––down to less than 5% in some cases. This is why harm reduction is officially supported by the UN system,” said Mr. Paul Bermingham, World Bank Country Director for Ukraine, Moldova and Belarus, and Chair of the UN Theme Group on HIV/AIDS in Ukraine.

During the conference both groups working on the ground and high level governmental officials also stressed the importance of harm reduction interventions, including drug substitution therapy, for an effective national AIDS response in Ukraine. The Head of the Ukrainian AIDS Centre, Professor Alla Shcherbynska said, “ Ukraine has decided to scale up harm reduction programmes with the aim of moving towards universal access to HIV prevention, treatment, care and support by 2010. That has now become our national goal. How quickly we reach this goal will depend upon how efficiently we scale up and improve the quality of harm reduction services, including drug substitution therapy.”

Activists representing communities of people who inject drugs
seized the stage and expressed their frustration for being
sidelined by society and discriminated against.

During the conference activists representing communities of people who inject drugs who seized the stage and expressed their frustration for being sidelined by society and discriminated against. They asked, “Why don’t they hear us? We are not a problem; we are part of the solution”.

Participants also discussed and promoted strategies for better involvement of communities of people who inject drugs and local governmental entities in harm reduction programmes and decision making. Participants praised the successes of pilot projects implementing drug substitution therapy and discussed ways to scale-up programmes across the country.

“We must begin to integrate planning and action for the future into the response as from today,” said Dr. Ani Shakarishvili, UNAIDS Country Coordinator in Ukraine. “First and foremost, we need to find ways to ensure that AIDS, harm reduction and drug substitution therapy, gender issues, reduction of vulnerability, stigma and discrimination towards people who inject drugs, people living with HIV and others remain a top political priority in Ukraine, year in and year out, and this conference is a big step towards achieving that.”

At the close of the conference, the community of people who inject drugs presented a joint statement on behalf of all the participants addressed to the Government of Ukraine, donor communities, and civil society calling for key actions and decisions.

The day after conference the State Department of Ukraine on Enforcement of Sentences issued a decree establishing a working group tasked with implementing an action plan on harm reduction measures in Ukrainian prisons. Providing needle and syringe exchange services in penal institutions is likely to be one important, tangible and immediate outcome of the conference.

Tatiana Semikop’s story begins in 1994 when she was working as a criminal police officer in Odesa. That was the year Tatiana met an 11-year-old boy living with HIV who did not know who or where to turn to for help and support. At the time Tatiana knew very little about AIDS but wanted to help the boy, so she set out to learn more and to find out how he could get support. However, the more Tatiana looked, the more she realized there was little available.

“I was shocked,” said Tatiana. “I couldn’t believe that no-one in the oblast or even the city could give me the information I was looking for, no-one seemed to know anything, it was as if the disease didn’t exist,” she added.

Finding out more

During her efforts to find out more about AIDS, Tatiana heard about a workshop being organized by UNAIDS to provide on HIV prevention for law enforcement groups. Through this workshop she gained vital knowledge on the complex issues related to AIDS in Ukraine and the different kinds of interventions needed in the country to help stem the spread of the disease.

Ukraine is facing the most severe AIDS epidemic in Europe. At the end of 2005, nearly 400,000 people were living with HIV in Ukraine and adult HIV prevalence was estimated at over 1.4%. Ukraine’s epidemic is primarily concentrated among people considered to be most ‘at-risk’—and 60% of the people living with HIV inject drugs.

“Using non-sterile injecting equipment is the major driver of the AIDS epidemic in Ukraine,” said Anna Shakarishvili, UNAIDS Country Coordinator in Ukraine. “More than 45% of new HIV infections reported in the first half of 2006 were in people who inject drugs. But sexual transmission of the infection from drug users is also rapidly increasing and the number of children born to HIV positive mothers continues to rise,” she added.

Unprecedented approach

Through her police work, Tatiana encountered injecting drug users on a regular basis and to her it made sense to start focusing her HIV prevention work here. With her help, Ukraine’s first projects to reduce harm from injecting drug use were initiated and implemented.

A unique feature of the programmes was the cooperation with the law enforcement groups and an agreement by Odesa’s Mayor to say these activities could take place—a groundbreaking move for the country at that time.

“We couldn’t believe that we had really dared to take such an unprecedented and unique approach to tackling the epidemic,” said one of the seven members of the small team who started the pilot project. “This had never been done before in Ukraine,” she added.

From these modest beginnings, today there are programmes focusing on injecting drug users and HIV across Ukraine which have become commonly recognized and respected HIV prevention tools.

Twelve years later

Twelve years since first encountering the issue of AIDS, Tatiana Semikop has moved up to the ranks of police lieutenant-colonel, is an author of a scientific dissertation on the psychological characteristics of police work relating to AIDS, and is the Chairwoman of one of the most efficient non-governmental HIV-service organizations in Ukraine – Vera, Nadezhda, Lubov (“Faith, Hope and Love”). In March this year Tatiana Semikop received her second ‘Woman of the Year’ award from law enforcement groups in Odesa for her continued commitment and dedication to the AIDS response.

Inspired by their mother’s example, Tatiana’s children have followed in her footsteps. Her 16-year old daughter Nina, gives lectures on AIDS at her secondary school, participates in various projects and writes articles on AIDS for a city newspaper. Her 24 year-old son Evgeny has already become a coordinator of one of the HIV-service projects in Odesa.

Vera, Nadezhda, Lubov

Tatiana’s organization Vera, Nadezhda, Lubov provides a variety of services across Odesa and neighbouring districts –-including a special mobile voluntary counselling and testing outlet that tests female sex workers for HIV and sexually transmitted infections at the site of their work; and helps women who have suffered domestic violence.

The organization has more than 100 members and provides information services and training on AIDS and other related issues at educational institutions around the city and in the rural areas. Vera, Nadezhda, Lubov also publishes a newspaper for people who inject drugs, sex workers and people living with HIV.

Tatiana is particularly proud of the creation of a community centre for people living with HIV and people most at risk of HIV infection. “We organise nature trips, holidays and we have special visiting photo exhibitions, a self help group and a social club,” she said.

Working on AIDS issues has become a source of inspiration for Tatiana and her colleagues. Many of the organization’s employees have personal experiences of drug addiction and came to know about the organization when seeking support. Now, having received training and professional experience, they have become indispensable employees, committed to helping others going through similar life situations.

“The explanation for our success is very simple,” said Tatiana. “We believe in what we are doing, and we see the fruit of our efforts every day.”

Links:

Read more on Ukraine
Read more on the European AIDS Conference: Responsibility and Partnership – Together against HIV/AIDS 

Zalevskiy’s condom headdress was one of the highlights of the show
Photo Credit: Reuters \ ANTIAIDS Foundation

On the first day of Ukrainian fashion week, the art and fashion world came together to promote AIDS awareness at a gala event in Kiev. Top Ukrainian designer Alexey Zalevsiky unveiled his new spring-summer collection which featured men’s and women’s formal and casual wear with a difference.

Huge red hearts pulsed in the background as the models strode down the catwalk in their striking red and white outfits. The hearts were part of the set design, but the real show stopper was the headwear; bunches of condoms arranged stylishly as headdresses and Zalevsiky’s new take on hatpins; syringes sticking out at rakish angles around the model’s heads. This unusual show was part of an effort by the organisers to increase awareness around the main drivers of Ukraine’s AIDS epidemic; unsafe injecting drug use practices and unprotected sex.

It is the first time in the history of Ukraine that a top designer has made AIDS awareness a central part of one of the country’s major cultural and social events. The show was put on to raise awareness about AIDS and call for support for people living with HIV. Of the fifty models appearing in the show, five were living with HIV.

“This is actually my second collection dedicated to AIDS that I have presented in Ukraine,” said the designer, Alexey Zalevskiy. “I had my first show eight years ago, but this time I decided to do a really big project. And what was most significant for this show was that we had both professional and non-professional models living with HIV walking down the catwalk. I came up with this idea after talking with people working in HIV organizations just before the International AIDS Conference in Toronto. It was vital for me to say ‘here, HIV-positive people are also living among us and need our support’.”

Fashion designer Alexey Zalevskiy with the models from the show
Photo Credit: Ukrainian Fashion Week \ K.Mohnach

During the fashion week, Zalevskiy challenged Ukrainian designers to address the issue of AIDS in Ukraine as their own personal problem, “Our fashion community should follow the lead of the international fashion community that has been engaged in raising AIDS awareness worldwide for many years.”

UNAIDS Country Coordinator Anna Shakarishvili said, “Ukraine is experiencing a very serious AIDS epidemic which is showing no signs of abating.…Zalevskiy has done a great job of getting people to talk about AIDS. If we are to have any chance of getting ahead of the epidemic in Ukraine we need to talk openly about the problem and educate people about AIDS.”

The project has been supported by the ANTIAIDS Foundation and its founding member Elena Franchuk, together with the All-Ukrainian Network of People Living with HIV and the International Renaissance Foundation.

One of the new designs by Alexey Zalevsiky
Photo Credit: Ukrainian Fashion Week \ K.Mohnach

“My organization was happy to be able to support Alexey Zalevskiy’s initiative,” said Franchuk. “The creation and display of a collection dedicated to AIDS awareness is another important way to say again that AIDS is everybody’s problem. We used to say that HIV is concentrated in risk groups – but now we say that it concerns everyone. It is necessary to know as much as possible about AIDS to be able to protect oneself.”

Sergey Fyodorov, one of the models in the show living with HIV, works in the All-Ukrainian Network of People Living with HIV. He was among one of the first people living with HIV in Ukraine to speak out about AIDS and his HIV status in the late 1990s. “AIDS touches everybody, regardless of whether or not you live with the infection or whether or not you dress fashionably,” he said.

“Not only people’s lives but also quality of life depends on our efforts. People living with HIV should not have to face discrimination. It is very important that HIV is associated with something positive – you can feel a lot of positive energy in Alexey’s collection. And that is essential.”

All-Ukrainian Network of People Living with HIV

Elena Franchuk ANTIAIDS Foundation

International Renaissance Foundation

GENEVA, 31 January 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) is concerned about reported government-led investigations of programmes run by the All-Ukrainian Network of People Living with HIV and other non-governmental organizations working in the field of AIDS across Ukraine. UNAIDS calls on the Government of Ukraine to ensure the investigations do not lead to a disruption of HIV services provided by these organizations to thousands of people.

The All-Ukrainian Network of People Living with HIV and other community and non-governmental organizations play a key role in Ukraine’s response to the HIV epidemic. Working together, the Ukrainian government and civil society organizations have achieved considerable success in providing services for HIV prevention, treatment, care and support to populations at higher risk of HIV infection and people living with HIV.

UNAIDS commends the Government of Ukraine on the recently endorsed State Law on AIDS that promotes a human rights-based AIDS response. The law guarantees harm reduction services—including needle exchange and substitution treatment—for people who inject drugs; confidentiality of HIV status for people living with HIV; post-exposure prophylaxis for health care providers and victims of sexual violence; and independent access to HIV-related services for adolescents.

This endorsement of the provision of harm reduction services for people who inject drugs—an evidence-informed measure that has proven effective in many countries, including Ukraine, and endorsed by UNAIDS, WHO and UNODC—will strengthen existing programmes run jointly by the government and non-governmental organizations.

“This law represents a major turning point for the AIDS response in Eastern Europe,” said UNAIDS Executive Director Michel Sidibé. “The new law must be fully implemented by all parts of the government in letter and spirit.”

With this law, Ukraine also joins a growing list of countries that have lifted entry, stay and residence restrictions for non-nationals living with HIV, aligning the country’s HIV legislation with international public health, social and human rights protection standards.

The new law represents an important commitment by Ukraine to the country’s HIV epidemic, which remains the most severe in all of Europe. HIV prevalence in Ukraine is estimated at 1.3% and annual HIV diagnoses in the country have more than doubled since 2001. Between 39% and 50% of the estimated 375 000 people who inject drugs in Ukraine are living with HIV.