We believe that the end of AIDS is possible if there is more focus on key populations. Our project in Tajikistan addresses barriers faced by the PWUD community related to their sexual and reproductive health and rights. Driven by community champions, we work to realize integrated and structured systems of services for PWUD financed by the government; increased access to justice; humanisation of the Criminal Law; NGOs have access to prisons and increased access to services and treatment for PWUD (male, female, young, migrant and in prison).
Povery, corruption and migration issues
Tajikistan is among the countries where HIV prevalence has increased by more than 25% over the last 10 years, though it still manages to keep the epidemic in a concentrated stage (less than 1% of the general population). Tajikistan is at the early stage of an HIV/AIDS epidemic, with an estimated 16,000 people living with HIV at the end of 2015. Although the proportion of new HIV cases diagnosed among PWID seems to have fallen dramatically over time (down to 22.4% in 2015), PWID still bear a disproportionate number of HIV infections. HIV prevalence in prison increased and varied from 6.2% in 2005 to 8.3% in 2015. Most of the prisoners are PWUD.
In Tajikistan the number of sterile needles and other commodities per PWID per year is still very low. OST covers only 1% of the total PWUD community. In prisons, there is no access to OST treatment. Tajikistan suffers from corruption, low capacitiy of local agencies to analyse newly introduced reformed and programmes and there is insufficient government budget for health and preventive medicines. PWUD also face economic barriers, such as increasing poverty , migration and returning migrants, unemployment, and access to finance. PWUD face high levels of stigma and discrimination often in small controled communities. Women are often economically dependent on husbands and other family members.
PWUD claim a right-based HIV and SRHR response
Bridging the Gaps works with a Theory of Change approach. A Theory of Change is a description of a list of events that is expected to lead to a particular desired outcome. It is a visualization how change is believed to happen. In 2016, representatives of the PWUD community developed a specified Theory of Change that consists of short-,medium, and long term outcomes. The Theory of Change describes how we plan to realize integrated and structured systems of services for PWUD financed by the government; increased access to justice; humanisation of the Criminal Law; NGOs have access to prisons and increased access to services and treatment for PWUD (male, female, young, migrant and in prison).
Through innovation and by building on previous work, we will strengthen civil society organisations’ ability to:
1. We facilitate community development
- Conducting an investigatory assessment to advance the Stigma Index Research;
- Strengthening communication and collaboration between key population and PLHIV networks;
- Forming a Civil Society platform on key populations’ needs and rights in Qurgonteppa;
- Joining forces between LGBT people and PWUD organisations where this strengthens their advocacy and services delivery;
- Conducting research and Advocacy on ART Adherence by PWUD (The Missing the Target Research);
- Training of PWUD to conduct the research on advocacy on ART adherence.
2. We advocate for the continuously strengthening of services and upholding human rights
- Exchanging good practices at EECAAC 2016.
3. Deliver inclusive, rights-based and gender sensitive services
- Providing online services, including counseling and information, by a team of national health experts, coordinators and a lawyer;
- Providing HIV prevention and client management services for PWUD;
- Providing HIV and STIs prevention trainings and referrals to HIV and STIs testing and follow up treatment;
- Providing gender sensitive services and legal support for female PWUD;
- Raising awareness and follow up TB counseling and screening activities;
- Providing supplies in emergencies.
4. Fostering global and in-country processes and partnerships that reinforce results
- Conducting a needs-assessment among PWUD;
- Conducting a needs-assessment among female PWUD, ex-prisoners and sexual partners of PWUD;
- Conducting an assessment of the situation of labor migrating PWUD.
Our project builds on the strong advocacy work of our partners AFEW Tajikistan, Vita and Hayoti Nav to put PWUD’s health issues on the political agenda and get them included in national plans. Their work is internationally supported by AFEW, GNP+ and ITPC.
Our other projects in Indonesia
Bridging the Gaps also has a LGBT people in Tajikistan.