street youth in ukraine: focus on girls and hiv prevention xix international aids conference in...
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Street Youth in Ukraine: Focus on Girls and HIV Prevention
XIX International AIDS Conference in Washington D.C., USA Satellite Session “Two Steps Forward, One Step Back: the HIV Crisis
among Street Youth”July 22, 2012
Halyna Skipalska, Country Director in Ukraine
Street Youth and HIV High HIV prevalence among street youth
(18.4% on average according to 2008 HealthRight and CDC study)
Volyn Rivn
e Zhytomyr
Kyiv
Chernigiv
Sumy
PoltavaKharkiv
Donetsk
Zaporizhia
Kherson
AR Crimea
Kirovograd
MykolaivOdessa
Vinnytsia
LvivTernopil Khmel
-nytski
y
Iv.-Frank.Zakarpatska
Chernivtsi
Cherkasy
Dnipropetrovsk
Luhansk
Donetsk:9.8% 30/307)
Kyiv: 18.6% (58/311)
Odesa:26.7% (83/311)
HIV prevalence rate in three cities 18.4%
Street Youth
Among 929 youth survey participants (according to HealthRight/CDC study):
28.7% had six or more sexual partners during last year
47.3% did not use a condom at last sexual intercourse
73.2% have at least one experience of drug use 25.4% did not know that condoms protect from
HIV 19.2% did not know that a healthy-looking person
may be HIV-positive
Street Girls
Street girls and young women are a small (24%), but highly vulnerable sub-group of the larger street youth population
Main Survey Recommendations Bring HIV prevention, testing and follow up to
street youth through outreach Introduce new interactive programs for reducing
risk behavior Introduce additional services for street-involved
women and girls Implement a continuum of care model and case
management for street Coordinate government and NGO services, ensure
access of street youth to state services.
Street Outreach
Mapping of sites Psychosocial counseling Client referral Voluntary HIV counseling
and testing STI testing 1,315 street youth received
outreach services in 2010-2011 in Kyiv and Donetsk
A Kyiv outreach team with clients, 2010
Drop-in Centers
Drop-in Centers Low-threshold services:
– Shower/laundry – Psychosocial support– Leisure activities– Group trainings on HIV prevention– HIV, STI counseling and testing
921 clients served in 2 drop-in centers in Donetsk during 2010-2011
245 clients improved their lives
Referral networks of partner organizations in Kyiv (63) and Donetsk (70) to enhance access to services
Involved main Ministries and state services Introduced case management
Referral Network
A round table in Kyiv, 2012
STEPS training program for street youth In 2010-2011, trained 77 trainers on STEPS from 35
NGO and state organizations 2,335 at-risk children and youth were trained in
outreach and 146 in Drop-in Centers in Kyiv and Donetsk
Behavior Change Communication Intervention
STEPS trainings in Kyiv, 2011
HealthRight’s Service Center for Girls and Women
Opened: April 2010 Partner: Kyiv City Center for
Social Services Funders: Elton John AIDS
Foundation and Olena Pinchuk ANTIAIDS Foundation
Staff: Center Manager, Social Workers/Outreach, Psychologist, Lawyer
Service Center Clients 89% are 17-24 years old 36.54% live on the street 10.76% double orphans 39% have children 25.6% have HIV 5.7% use injecting drugs 8.1% abuse alcohol 9.1% sexually abused
HIV-related: VCT, escorting for confirmatory testing, registration with AIDS Center, referrals to HIV service organizations, PMTCT and ART adherence
For clients with children: birth certificate, government allowances, medical referrals and psychosocial support
For IDUs: supported referrals to detox and harm reduction services, substance abuse counseling, counseling about substitution therapy.
Specialized Services
Service Center Statistics (N=789)Services # clients %
Tested for HIV By rapid test at the Service Center At AIDS Center
PrimarySecondary
35031040
31063
44.3588.57 of 350
HIV+ test result 53 17.09of 350
Newly tested and registered at the City AIDS Center
48 90.56 of tested HIV+
Clients who new HIV+ status before coming to the Center
149 18.88
Service Center Statistics (N=789)Services # clients %
Pregnant clients 60 7.61% of total number of clients
HIV+ pregnant clients 10 16% of all pregnant clients
Received PMTCT
Including those who do not have documents
10
3
100% of all HIV+ pregnant clients
Delivered babies 34 56.67% of pregnant clients
Challenges Engagement of partners Residential services, particularly for pregnant women
and women with children Sustainability Violence against street-involved women Employment Referral to other cities Social adaptation of recently released prisoners.
Future Plans Halfway house for girls in Kyiv and one for girls
and one for boys in Donetsk Engagement of male partners Empower women to resist violence Disseminate STEPS throughout Ukraine Advocate for policy changes to improve access
to care.
Thanks to Our Donors:
Elton John AIDS Foundation Olena Pinchuk ANTIAIDS Foundation World Childhood Foundation Johnson & Johnson U.S. Agency for International Development (USAID) Open Society Foundations International HIV/AIDS Alliance in Ukraine
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