Transcript Asian sex video

High Coverage of Most-at-Risk Populations
Reduces HIV Risk: Results from Central Asia
Anna Deryabina, David S. Hausner, Bibigul Aubakirova,
Yana Dobronravova, Saltanat Ashimova, Yelena Kudussova,
Zarina Musaeva, Rakhima Nazarova, and Lev Khodakevich
Global Health Council Conference
Washington, DC
16 May 2010
Learning Objective
To understand how to implement
comprehensive HIV prevention services
to vulnerable populations and to
understand the value of doing so.
Expected program outcomes
• Knowledge: Increasing level of
knowledge among vulnerable populations
about HIV/STIs, ways of HIV transmission
and prevention
• Behavior: Decreasing rates of highly
unsafe practices among target groups
• Disease burden: Decreasing rates of HIV
and STIs
Program Objectives
• To provide IDUs and sex workers with
individual means of protection
• To provide information and education on HIV
prevention
• To provide quality medical services when
needed
• To decrease stigma & discrimination related
to HIV and PLHIV
Main activities
Working with Partners
• Technical working groups were set up
at every site
• Partnership was developed with local
administrations, religious leaders, law
enforcement bodies, and others
• Agreements were signed with medical
institutions for the provision of medical
services to clients
Training
• Service providers, journalists, law enforcement
officers, religious leaders
– 1,571 people trained during 125 trainings
Drop-in centers for IDU
Aksu, Kazakhstan
Karasuu, Kyrgyzstan
Almaty, Kazakhstan
Kurgan Tube, Tajikistan
Drop-in centers for sex workers
Osh,
Kyrgyzstan
Outreach with IDU
Outreach with sex workers
Osh, Kyrgyzstan
Development and distribution
of IEC materials
• Brochures for clients
• Video clip for clients
and general
population
• Outreach guidelines
for outreach workers
Referrals to medical services
• Detoxification
• STI diagnosis and treatment
• Treatment for injection-related
complications
• VCT
• PMTCT
Detoxication
Outreach
STIs treatment
Drop-in
Center
Treatment for surgical
complications
VCT
Outreach
PMTCT
Ongoing
Monitoring of
Coverage
Cumulative number of contacts with clients
Cumulative number of contacts with clients
Cumulative number of clients by month
and type of contact
End-line
evaluation
Behavioral Survey
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•
Design: Comparison of project and
control sites at end-line
Sites: 5 intervention and 5 control sites
– IDUs: 3 intervention and 3 control sites
– Sex workers: 2 intervention and 2 control sites
•
Sample: 150–250 respondents per site
– Respondent design sampling
•
Timing: June 2009
Key Results:
Sex workers
Condom use behavior
Indicator
Project
Control
Always used condoms with
clients during the last month
79%
60%
Used condoms with the
last client
91%
69%
Diagnostic testing behaviors
Indicator
Project
Control
Had an STI test during
last 6 months
69%
36%
Had an HIV test during
last 6 months
57%
29%
Knowledge about modes of
HIV transmission
Indicator
Project
Control
Identified injecting drug use
68%
32%
Identified sex
94%
70%
Identified both injections
and sex and had no
misperceptions
47%
20%
Key Results: IDUs
Injecting behavior
Indicator
Project Control
Never shared needles and
syringes during the last 6
months
95%
60%
Did not use someone else’s
syringe during the last 1 month
98%
71%
Did not give a syringe to
someone during the last 1
month
99%
83%
Condom use and diagnostic
testing behaviors
Indicator
Project Control
Always used condoms
during the last 12 months
46%
27%
Never had HIV test
4%
33%
Knowledge about modes of HIV transmission
Indicator
Project Control
Identified injecting drug use
96%
58%
Identified sex
98%
64%
Identified both injections and
sex and had no
89%
52%
misperceptions
Conclusion
• TUMAR achieved a high level of
coverage in a short time period
• TUMAR clients had:
– Higher levels of HIV knowledge
– Lower proportion of reported needles and
syringe sharing
– Higher proportion of reported condom use
– Higher levels of HIV testing
Acknowledgements
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Central Asian AIDS Control Project (CAAP)
USAID
All community partners in the 7 sites
8 local sub-grantees
Outreach and Drop-in Center workers
Clients
JSI country staff in Central Asia