HIV/AIDS prevention and care among injecting drug users ... · Latvia and Lithuania Main...
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HIV/AIDS prevention and care among injecting
drug users and in prison settings in Estonia,
Latvia and Lithuania
Main achievements in 2007 – 2008
Signe ROTBERGA, UNODC, Baltic States
29 January 2009
Information about the project
• Duration: 2006 – 2010
• Government Focal Agencies: MOH, MOSA, MOJ
• Budget: 5 000 000 USD
• Overall goal: to halt and reverse the HIV/AIDS epidemics among IDUs and in prisons, and to avoid generalised epidemic
Project objectives:
• Build national and regional consensus on effective implementation strategies to address HIV/AIDS among IDUs and in prison settings
• Increase coverage of comprehensive HIV/AIDS prevention and care services
• Generate and share strategic information to respond appropriately to evolving HIV/AIDS epidemics
Obj.1: Build national and regional consensus on effective
implementation strategies to address HIV/AIDS among
IDUs and in prison settings
• New national HIV programmes for Latvia and Lithuania
• Evaluation of national response to HIV in Estonia (WHO/UNODC)
• Rapid assessment and response on drugs in prisons in Latvia and Lithuania
• Assessment of legal barriers for effective HIV prevention in prisons in Latvia and Lithuania
Obj.1: Build national and regional consensus on effective
implementation strategies to address HIV/AIDS among
IDUs and in prison settings
• Evaluation of pharmacotherapy in Latvia and Estonia
• Assessment of availability of syringes in Lithuania
• Estimation of IDU population size in Lithuania
Obj.1: Build national and regional consensus on effective
implementation strategies to address HIV/AIDS among
IDUs and in prison settings (cont.)
• Increased awareness on HIV among decision makers in MOJ and Prison Administration
• Policy dialogue promoted between MOJ and MOH
• Coordination and collaboration between national drugs and HIV programmes
• Involvement of civil society organizations
Objective 2: Increase coverage of comprehensive
HIV/AIDS prevention and care services among IDUs and in
prison settings
Outputs:
2.1. Improved institutional and professional capacity to addressHIV/AIDS among IDUs and in prisons
2.2. Increased access to HIV/AIDS prevention and care services for IDUs and in prison settings
Capacity building in 2007 - 2008
• 39 training seminars, 819 participants
• 8 study tours, 60 participants
• 19 conferences/meetings, 1188 participants
• Professional networking and training: participation in 18 international events, 103 persons
Capacity building
• Training needs assessment
• Training topics: pharmacotherapy, needle and syringe programmes, outreach, ASI, advocacy, monitoring and evaluation, estimating IDU prevalence
• Target groups: physicians, nurses, social workers, prison staff, policy makers, NGOs, police
• All training events evaluated, positive feedback received
Information and education materials
• Training module on pharmacotherapy developed and approved in Lithuania
• Handbook on reduction of health risks for drug users in prisons (in Latvian)
• Information materials in Lithuanian and Russian on HIV and TB, STI, hepatitis and drug overdose
• Directory on health and social services for drug users in Lithuania
Information and education materials
• Handbook on VCT in Lithuania
• Legal aspects on drug use in Latvia and Lithuania
• Information about harm reduction programmes
• NGO Convictus work in prisons
Output 2.2.: Increased access to HIV/AIDS prevention and care
services for IDUs and in prison settings
SERVICES SUPPORTED BY SMALL GRANTS PROGRAMME
• Needle and syringe programmes
• Methadone maintenance therapy
• Information and education in prisons
SMALL GRANTS PROGRAMME 2007 - 2008
Country Number of applications received
Number of projects supported
Total budget in US$
Estonia 4 2 48,000
Latvia 52 36 745,900
Lithuania 41 28 702,700
Scaling-up pharmacological treatment of opioid
dependence in Lithuania
Grants provided for harm reduction services - Latvia
Indicators to measure access to services
• Availability (Y/N? number of sites per 1000 IDUs )
• Coverage (% IDU using services)
• Quality (Adhering to WHO/UNODC guidelines)
Quality combined with scale-up will make a difference on the intervention’s impact on the epidemic.
Source: WHO/UNODC/UNAIDS TECHNICAL GUIDE for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users
Pharmaco-
therapy
(PT)
Estonia Latvia Lithuania WHO/UNODC
recommendation
2006 2008 2006 2008 2006 2008
Number
IDU in PT
Number of
IDU
% IDU in
PT
Number of
PT sites
555
13 800
4.0%
8
670*
13 800
4.8%
8
124
10 000
1.00%
4**
164
10 000
1.6%
8**
402
4 000
(8000)
10.00%
12
512
3 200
16.0%
17
moderate:
10-19%
good: 20-39%
Coverage of long-acting opioid maintenance treatment
* Does not include drop-outs, etc.
** Out of these only one site providing MMT
Needle syringe
programmes
NSP
Estonia Latvia LithuaniaWHO/UNODC
recommendation2006 2008 2006 2008 2006 2008
IDUs in contact
> once per
month in last
year
Number of IDU
% IDU
regularly
reached by
NSP
No. syringes
distributed
Number of IDU
No. of syringes
per IDU per
year
7169
13 800
52%
1 606 989
13 800
116
N/A
13 800
N/A
2 033 243
13 800
147
600-800
10 000
5-8%
117 237
12000
10
690
10 000
7%
182 019
10000
18.2
3400*
4000 (8000)
85%
258 650
4000 (8000)
64.6
3200
187 227
3200
58.5
moderate:
20-39%
good: 40-59%
moderate: 50-99
good: 100-199
NSP coverage indicators
* There is no shared definition on the indicator “regular client”
Objective 3: generate and share strategic
information, lessons learned
• Participation in expert meetings / conferences
– International harm reduction conference in Vilnius
• Project website created
• Mid–term evaluation
UNODC Project Office for the Baltic States website
http://www.unodc.org/unodc/en/baltics/index.html