La historia de Tatiana Semikop comienza en 1994, cuando trabajaba como oficial de policía criminal en Odessa. En ese año, se encontró con un niño de tan solo 11 años que vivía con el VIH y no sabía dónde o a quién acudir para pedir ayuda. Entonces Tatiana no sabía prácticamente nada sobre el sida, pero estaba decidida a ayudar al niño, por lo que se puso a investigar sobre la enfermedad y sobre cómo podría encontrar una forma de cuidar al niño. Sin embargo, cuanto más buscaba, más se daba cuenta de lo poco que había disponible.

“Estaba realmente sorprendida”, dijo Tatiana”. “No podía creer que en la región o en la ciudad nadie pudiera darme la información que buscaba, nadie sabía nada, como si la enfermedad no existiera”.

Investigando

Mientras seguía buscando más información sobre el sida, Tatiana oyó hablar de un taller de trabajo organizado por el ONUSIDA para informar sobre la prevención del VIH a las fuerzas del orden. A través de este taller, Tatiana aprendió mucho sobre los complicados temas relacionados con el sida en Ucrania y los diferentes tipos de intervenciones que se necesitan en el país para ayudar a frenar la propagación de la enfermedad.

Ucrania sufre una de las peores epidemias de sida de Europa. A finales de 2005, unas 400.000 personas vivían con el VIH y se calcula que la prevalencia del VIH entre adultos era de un 1,4%. La epidemia en Ucrania se concentra principalmente entre las poblaciones clave de mayor riesgo, y el 60% de las personas que viven con el VIH consumen drogas inyectables.

“El uso de un equipo de inyección no esterilizados es la principal causa del contagio por el VIH en este país”, afirmó Anna Shakarishvili, Coordinadora del ONUSIDA en el País. “Más del 45% de las nuevas infecciones por el VIH registradas en la primera mitad de 2006 se dieron entre consumidores de drogas inyectables. Sin embargo, la transmisión sexual de la infección por parte de consumidores de drogas está aumentando rápidamente y el número de niños que nacen de madres VIH-positivas sigue creciendo”, añadió.

Un enfoque sin precedentes

Debido a su trabajo como policía, Tatiana se encontraba con consumidores de drogas inyectables a diario, y por ello pensó que tendría sentido empezar centrando aquí los esfuerzos de prevención del VIH. Con su ayuda, comenzaron a asentarse los primeros proyectos para reducir los daños del consumo de drogas inyectables.

Una característica única de estos programas fue la cooperación con las fuerzas del orden y un acuerdo con el alcalde de Odessa que permitió que estas actividades tuvieran lugar, un avance realmente significativo para el país en aquella época.

“No podíamos creer que nos hubiéramos realmente atrevido a dar un paso tan innovador para afrontar la epidemia”, afirmó uno de los siete miembros del pequeño grupo que inició el proyecto piloto. “Esto no se había hecho jamás en Ucrania”.

Desde estos modestos inicios, hoy hay programas que se centran en el consumo de drogas inyectables y el VIH en todo el país, que se han convertido en herramientas de prevención del VIH muy respetadas.

Doce años más tarde

Doce años después de su primer encuentro con el sida, Tatiana Semikop ha ascendido al rango de teniente-coronel, es autora de una disertación científica sobre las características psicológicas del trabajo policial en relación con el sida, y es la presidenta de una de las organizaciones no gubernamentales más importantes de Ucrania, Vera, Nadezhda, Lubov (“Fe, Esperanza y Amor”). En marzo de este año, Tatiana recibió su segundo galardón “Mujer del Año” de las fuerzas del orden de Odessa por su compromiso y dedicación a la respuesta al sida.

Inspirados por el ejemplo de su madre, los hijos de Tatiana han seguido sus pasos. Su hija Nina, de 16 años, da charlas sobre el sida en su instituto, participa en varios proyectos y escribe artículos sobre el sida para un periódico local. Su hijo Evgeny, de 24 años, ya es coordinador de uno de los proyectos de servicios del VIH en Odessa.

Vera, Nadezhda, Lubov

La organización de Tatiana Vera, Nadezhda, Lubov ofrece diferentes servicios en toda Odessa y los distritos vecinos, entre los que se incluye un punto especial móvil de asesoramiento y pruebas, que realiza pruebas del VIH y de otras enfermedades de trasmisión sexual a las profesionales de sexo en su lugar de trabajo y que ayuda a las mujeres que sufren violencia por motivos de sexo.

La organización cuenta con más de 100 miembros y ofrece servicios de información y capacitación sobre el sida y otros temas relacionados en los centros educativos de la ciudad y de las áreas rurales. Vera, Nadezhda, Lubov también publica un periódico dirigido a los usuarios de drogas inyectables, los profesionales del sexo y las personas que viven con el VIH.

Tatiana se siente especialmente orgullosa de la creación de un centro comunitario para personas que viven con el VIH y para las poblaciones clave de mayor riesgo. “Organizamos excursiones al campo, vacaciones y tenemos exposiciones de fotografía especiales, un grupo de autoayuda y un club social”, afirmó.

Trabajar en temas relacionados con el sida se ha convertido en una fuente de inspiración para Tatiana y sus colegas. Muchos empleados de la organización tienen experiencias personales de drogadicción y entraron en contacto con la organización cuando buscaban apoyo. Ahora, tras haber recibido una formación y adquirido experiencia profesional, se han convertido en empleados imprescindibles, comprometidos con la ayuda a otras personas que tienen una situación personal similar.

“La explicación de nuestro éxito es muy simple”, declaró Tatiana. “Creemos en lo que hacemos y recogemos los frutos de nuestro esfuerzo todos los días"

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Enlaces:

Leer más acerca de Ucrania
Leer más sobre la Conferencia europea sobre el sida: Responsabilidad y asociación - Unidos contra el sida.

Increasing access to HIV prevention, treatment, care and support services for drug users and their partners is crucial to addressing the issue of growing HIV infections related to injecting drug use in the Middle East and North Africa region.

This was the overwhelming conclusion reached by regional representatives from law enforcement agencies, national AIDS programmes, NGOs, researchers, community representatives, people living with HIV and UN organizations who joined at a regional workshop on the issue of HIV and drug use in the region, held in Cairo, Egypt from 5 – 8 November.

Throughout the 3-day discussions, participants from the Arab countries, Afghanistan, Iran and Pakistan affirmed that drug use is an important risk factor in facilitating spread of HIV that calls for immediate action. Joint efforts of police, national AIDS actors, NGOs, drug users and of people living with HIV were recognized as fundamental elements in the prevention of HIV among drug users and their partners.

While significant efforts are being undertaken in a number of countries to reach out with HIV preventive services to drug users communities, limited capacities coupled with discrimination against drug users hamper implementation of wider-scale programmes.

“From my personal experience and my field work on reducing harm related to drug use, I suggest training more drug users and ex-drug users –to build their skills in order to promote and implement [HIV preventive] programs in the region,” an ex-drug user and outreach worker said in the workshop.

New initiatives for building capacities of civil society actors on implementing harm reduction measures and networking in the region were discussed and examined.

“Participation in this workshop has allowed an exchange of international experiences among NGOs and governments, and a discussion of the strategic approaches to planning at the national level to protect against the harms and risks of drugs and related HIV. It has created cooperation between [national stakeholders]…and encouraged civil society actors to assist and support alternative programs for drug users,” police participants from one of the Gulf countries said.

As part of the workshop, UNAIDS and UNODC launched the finalized Rapid Situation Assessment on Drug Use and HIV in Algeria and Morocco, as well as facilitate consensus on programmatic follow up for all participating countries. WHO and the International Harm Reduction Association launched a project on strengthening the role of civil society in harm reduction for injecting drug users in the Middle East and North Africa.

Although the main mode of HIV transmission in the Middle East and North Africa remains unprotected sexual contact, injecting drug use is an increasingly important factor in the region’s epidemics.

Although the main mode of HIV transmission in the Middle East and North Africa remains unprotected sexual contact, injecting drug use is an increasingly important factor in the region’s epidemics.

The spread of HIV among drug users appears to be closely related to evolving patterns of drug use in the region in recent decades. Evidence suggests increase in number of drug users, decrease in the age at first use of drugs and some indication of an increased percentage of women using drugs in several countries.

The United Nations Office of Drugs and Crime (UNODC) estimates there are 400,000 injecting drug users in Arab countries and approximately 200,000 in Iran. These figures do not include a recent increase in numbers in Afghanistan which have been observed.

The sharing of contaminated injecting equipment among injecting drug users has become the predominant route of HIV infection in at least two countries since the mid to late 1990s – Iran and Libya –where a concentrated epidemic now appears to be well established.

“This is a real and growing issue for countries in the Middle East and North Africa. And although we are seeing increasing willingness to introduce HIV prevention and treatment programmes for drug users, focused efforts are needed urgently to ensure access to services for all drug users and their partners,” said Oussama Tawil, Director of UNAIDS’ Regional Support Team, Middle East and North Africa.

Over the last years, UNAIDS and UNODC have supported assessments on drug use and HIV-related risks in Algeria, Egypt, Libya, Morocco, as well as in Oman and Syria, as part of efforts to better understand trends and dynamics of the epidemics in the region and to increase HIV prevention efforts.

Main findings ensued suggest that needle sharing, ranging from 40 to 60%, coupled with low knowledge on AIDS, limited access to health and HIV-related services, stigma and discrimination, and other associated risk factors, are among some of the challenges faced by the region to reduce HIV risks and vulnerability among injecting drug users.

Within the assessments, researchers spoke to drug users about their thoughts and fears: “If I enter [a treatment center] I'll be marked, and my future is over. I will not be able to do anything, neither work nor life," said one of the participant.

“Drug use and other risk behaviors remain stigmatized in the region, which is why we must forge strong partnerships with different sectors, such as the national AIDS programmes, non-governmental organizations, drug users, people living with HIV and law enforcement agencies, to be able to better understand the epidemic and implement concrete solutions,” said Mr Tawil.

Foundations for an increased response to address HIV risks and vulnerability among drug users have been established in some countries and are underway in others. In Iran – considered a global best practice model – HIV-related initiatives for injecting drug users inside and outside prisons are now being scaled up beyond the pilot levels.

In an example of a bold movement to better tackle the issue of HIV and drug use in the region, representatives from law enforcement agencies, national AIDS programmes, NGOs, researchers, community representatives, people living with HIV, UN organizations and other partners will join at a regional workshop to be held in Cairo, Egypt from 5 – 8 November.

The workshop— “Towards Implementation of a Comprehensive HIV response and AIDS Response Among Drug Users in the Middle East and North Africa”— convened by UNAIDS and its cosponsors UNODC and the World Health Organization (WHO) as well as the German Technical Coorperation (GTZ), will welcome participants from 16 countries and aims to build capacities on programming and implementing HIV prevention, treatment and care interventions among drug users.

As part of the workshop, UNAIDS and UNODC will launch the finalized Rapid Situation Assessment on Drug Use and HIV in Algeria and Morocco, as well as facilitate consensus on programmatic follow up for all participating countries. WHO and the International Harm Reduction Association will also launch the project on strengthening the role of civil society in harm reduction for injecting drug users in the Middle East and North Africa.

“This gathering bringing together wide diversity of partners is unique for the region and a turning point for action on drug use and HIV in the region” Mr. Tawil said.

The guidebooks call it ‘remote’, ‘undiscovered’ – China’s south-western province of Guizhou is home to some examples of extreme natural beauty including China’s largest waterfall, the ‘Huangguoshu’ and the Zhijin Caves, famous for their massive-scale stalagmite stone pillars.

But despite its remote location and idyllic surroundings, the province, like every other in China, is increasingly affected by HIV. From a few individual reported cases in 1993, it is currently estimated that about 37,000 people in Guizhou are living with HIV. There are signs of the epidemic becoming progressively generalized and increasingly women are becoming infected.

A joint HIV prevention and care project, run by Guizhou provincial authorities, and UNAIDS` Cosponsor UNICEF is making some headway towards tackling the growing figures and at the same time involving people and groups from all sectors in the AIDS response. Established in 2001, the project focuses particularly on young people, tackling the often difficult issue of injecting drug use and its crossover with HIV, as well as providing care and support for people living with HIV.

“The initiative contains three key areas – development of a strategic plan on AIDS involving high-level advocacy and media mobilization; HIV prevention among children and young people in and out of school and within drug rehabilitation centres; and care and support to children living with HIV and their families,” said Christian Voumard, UNICEF Representative and chairman of the UN theme group on AIDS in China.

The project aims to build and involve all key officials and provincial groups in the AIDS response. Vice Provincial Governor of Guizhou Wu Jiafu underlines how the initiative has helped bring people together. “As government officials, we now know how we can work together with multiple sectors to confront AIDS and support people living with and affected by HIV. This network is now implementing the national policies and local policies to support young people, people living with HIV and their families to fight against the disease and its social impact,” he said. 

“Though the resources here are very limited, we’re confident that we can get ahead of the HIV epidemic with the participation of all these young people and people infected and affected,” he added.

Results so far have been extremely encouraging. Provincial policies on HIV have been put in place and training sessions with authorities and project managers are already underway. Since the project’s inception, 45 high schools have developed curriculum on HIV and drug use prevention in eight of the province’s prefectures, reaching more than 70,000 children and young people.

Voluntary testing and counselling services have been set up within seven drug rehabilitation centres across the province. 

“By knowing my HIV status and with all the knowledge of prevention of HIV, I will stop sharing needles with my friends and engaging in high risk sex,” said one young man at the Tongren prefecture drug rehabilitation centre.

Through the initiative, gradually people living with HIV are being brought to the forefront of the response in the province. A number of self-help groups of people living with HIV have been developed with the participation of 50 people living with HIV. More than 100 family members and 26 children and their families participated in care and support campaigns in the prefectures of Guiyang and Tongren, receiving community based care for family life and schooling.

“I never imagined it could be possible that authorities and big organizations would care about us –people living with HIV—and our children,” said one man living with HIV from Tongren prefecture who has been involved in the programme. “I lost my hope because of the pain of disease, social discrimination and poverty, but this is helping to restore the hope by supporting me and my children.”

UNICEF was the first major donor on AIDS in Guizhou province and provided some of the ground work for other donors’ work in the area. Programmes supported by the US Center for Disease Control and the Global Fund to Fight AIDS, TB and Malaria (Round 4) have since benefited from this in their support to Guizhou.

UNICEF will continue to support the project in their new 2006-2010 programme and activities will be expanded to include prevention of mother to child transmission of HIV (PMTCT) and increasing care and support for children affected by AIDS.

“This programme has been an example of bringing together a variety of different groups within the AIDS response – and crucially invovles young people and people living with HIV,” said UNAIDS Country Coordinator for China, Joel Rehnstrom.

“We are seeing the project help reduce numbers of new infections, as well as break down the barriers and taboos of involving people living with HIV – which in turn is breaking down stigma and discrimination related to HIV.”

UNAIDS Executive Director Peter Piot is visiting China from 7 – 12 September to encourage continued leadership and commitment and to mobilize a truly multi-sectoral response to AIDS in China. As part of his visit, Dr Piot is participating in a three-day mission to Guizhou, visiting the Hui Long community and Zhijing County. Dr Piot will meet with representatives of provincial government and city leaders and visit various key sites that focusing on HIV and drug use.

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Related links
UNICEF China website
More on China

Starting tomorrow, the second Eastern Europe and Central Asia AIDS Conference (EECAAC II), the largest AIDS-focused event to date in the region, will bring together a wide range of private and public groups at a critical time in the fight against AIDS.

The World Bank with United Nations and private sector partners today launched a competitive Development Marketplace aimed at identifying and funding innovative approaches to reduce stigma and discrimination associated with HIV and AIDS in the South Asia region, including Afghanistan, Bangladesh, Bhutan, India, Nepal, Sri Lanka and Pakistan.

Despite increased political commitment and funding for the AIDS response, most people who inject drugs are still being denied access to basic HIV prevention and treatment services, said UNAIDS at the 18th Conference on Drug Related Harm in Poland.

The Joint United Nations Programme

As commercial sex and unsafe injecting drug use are the biggest drivers of HIV in most Asian countries, supportive government policies that address these behaviours are urgently needed to slow the spread of AIDS, according to a series of three reports released today by the Monitoring AIDS Pandemic (MAP) Network

Today the co-sponsoring organizations of UNAIDS called for a broad-based response to the AIDS epidemic in the countries of the Commonwealth of Independent States (CIS).