UNDP assists local organizations to help IDUs help themselves.
The public organization “Svon+” located in Kulyab city, Khatlon oblast, has been established by the initiative of injecting drug users (IDUs) in 2011 with the purpose of reaching IDUs with quality harm reduction services. This is the second public organization in Tajikistan that has been founded by former (and active) IDUs who wish to support their peers in recuperating healthy lifestyles and re-cultivating practical skills. Taking into consideration the novice initiative and keen enthusiasm of the group, the UNDP Steering Grant Committee has selected “Svon+” as a sub-recipient to provide HIV low-threshold services (such as meals, laundry, recreation, accommodation, and daily information sessions, group meetings, counseling, referral to other health facilities, social support of clients via outreach and self-help groups) to around 300 IDUs in and around Kulyab city.
- UNDP Steering Grant Committee selected NGO “Svon+” as a sub-recipient to provide HIV low-threshold services to around 300 IDUs
- Coverage of IDUs with proper awareness-raising activities
- Increased number of clients under antiretroviral therapy, stronger adherence to methadone-based therapy and safe injecting practices
The management of “Svon+” believes strongly that only peers are able to closely and better interact with targeted people, since the staff itself has endured addiction for long periods of their life. The case of Bahodur, a drop-in centre client, can be considered as a remarkable example of behavior change among IDUs. At his first visit to the drop-in centre, it was revealed that he is HIV-infected and has been injecting heroin for 11 years. The following weeks he kept visiting the centre but, simultaneously, he continued using drugs, because according to him: “there is no purpose in life with HIV and, anyway, I am going to die”.
After attending a number of mini-trainings and peer self-help discussion groups on HIV prevention and ARV treatment, Bahodur decided to discontinue using drugs, and to begin to "live like everyone else." He even got hired by “Svon+” as an outreach worker to "benefit peers in distress." It is already four months that Bahodur stopped using drugs and takes better care of his health. In short, “Svon+” staff is greatly helping Bahodur to find the strength to say NO to drugs and reconsider his behavior. With the support of "Svon+" Bahodur is currently under medical supervision of an infectious diseases specialist and receives antiretroviral therapy (ART). To the question how the drop-in centre/project has helped him, he simply replied that "he learned to value and love himself”.
This shows, coverage of IDUs with proper awareness-raising activities has an enormous impact on safe injecting and sexual behaviors among most at-risk groups and, in turn, helps them to restore their faith in themselves. In general, the significant involvement of community-based organizations, timely harm reduction interventions and improved access to HIV prevention services have resulted in quality coverage of IDUs and positive behavior change, and therefore in increased numbers of clients, that are under ART, stronger adherence to methadone-based therapy and safe injecting practices. According to a national behavior sentinel surveillance conducted in 2011, 93.5% of IDUs used sterile injecting equipment the last time they injected as compared to 69% IDUs in 2010.
UNDP in Tajikistan, as a Principal Recipient of Global Fund grants, provides various harm reduction services to more than 40% of IDUs via 6 public organizations working with IDUs, 16 Trust Points, coordinated by the National AIDS Center, 2 pilot needle/syringe exchange points in detention centers, 5 anti-retroviral therapy clinics and four opioid substitution therapy centers. They provide low- and high-threshold services nationwide. These service delivery points are continuously supplied with medical/health commodities (including nearly 2 million syringes on yearly basis), and information-education-communication materials on HIV prevention, overdose, safe injecting practices, anti-retroviral therapy and opioid substitution therapy.