Credit: © UNICEF/UKRA01115/Pirozzi
UNICEF wants to help Ukraine’s many young injecting drug users protect themselves against HIV
Oksana is a teenage mother with a very young baby. She is also living on the streets of Kyiv, Ukraine’s capital. Having lost touch with her mother, who was sent to prison, she ran away from home to escape her abusive stepfather. She spends most of her day at the central railway station or the underground tunnels nearby but dreams of one day having a settled home for her son. These dreams are unlikely to be realised any time soon.
She is one of the many young people eking out a living on Ukraine’s streets who get no care and support. An unsafe social environment and high risk behaviour such as sex work and injecting drugs make young people living in the streets of Ukraine vulnerable to HIV. They are at the heart of an epidemic in the country worst affected by HIV in Europe and yet rarely have access to HIV prevention and treatment services.
One of the central aims of UNICEF in Ukraine is to try to help these most-at-risk young people, especially those who are homeless, to better protect themselves against HIV. Key activities include supporting outreach teams working with street children and adolescents, training social and health care workers and providing access to basic health services, education, training and housing.
According to the latest statistics, in 2006 more than 60% of injection drug users in Kyiv were living with HIV. In 2009, UNICEF conducted a study among street-based adolescents in several regions of Ukraine, which found high rates of drug use by injection, with two thirds of those having reported sharing needles. The study also revealed that one in ten male street adolescents had had sex with another male, often in exchange for money, clothes, or drugs.
Olena Sakovych is a UNICEF youth and adolescent development officer, who works closely with street children, as well as other most-at-risk adolescents. She is fully aware of the extent of the problem, with some young people initiating drug use by injection as early as age 13, and both boys and girls living on the streets often engaging in sex work at a similar age.
“These young people are the missing face of the HIV epidemic in Ukraine,” says Olena. “They need better care and more services. The situation here is critical. One of our main objectives at UNICEF is to make them visible to Ukraine’s political agenda and its AIDS response.”
The findings of the research informed the development of interventions and provision of health and social services to better address the needs of and help adolescents injecting drugs and engaging in sex work. In the city of Mykolyav, for example, outreach workers now recruit young female sex workers to a drop-in centre that offers a safe space, HIV counseling, and referrals to governmental health and social services centres, and non-governmental organizations that provide HIV prevention services, care and support.
Social workers accompany the women to those services, when necessary, which include gynaecological and infectious disease specialists, HIV treatment centres, and legal aid. Demand has far exceeded expectations. It was hoped that 50 under-aged sex workers would be recruited in the first six months. To date, well over a hundred adolescent girls have received services. A client satisfaction survey showed an increase in knowledge about HIV, as well as in motivation to seek help.
"UNICEF will continue to advocate for, and to support, country efforts to increase understanding of the epidemic and HIV prevention, protection, care and support services for most-at-risk adolescents,” says Susan Kasedde, UNICEF Senior Specialist on HIV Prevention among Adolescents. “In countries like Ukraine, until such services are made available, national epidemics cannot be stopped."
To this end, UNICEF promotes mobilization of governmental leadership; national and local political and community support; legislative and policy changes to enable wider access to HIV prevention and care services for most-at-risk adolescents, and strong partnership between the United Nations, government, civil society, young people themselves and people living with HIV.
“Ensuring that those most vulnerable to HIV infection like, young people on the streets, injecting drug users, those engaging in sex work, and men who have sex with men, have access to HIV prevention, treatment, care and support services is both a human right and a way to finally reverse the spread of the HIV epidemic,” says UNAIDS Country Coordinator Ani Shakarishvili. “Ukraine is continuing to make progress towards universal access but far more needs to be done. Strong political leadership and commitment will guarantee success. “
