AFISE “The Impact of VCT program within 10 months"

Baylor Black Sea Foundation – BIPAI Romania “The Impact of VCT program within 10 months from initiation” Issues The increase of addressability for the general population and specifically for the vulnerable groups and young people represents a priority for the new- ly established VCT centres. After establishing a free rapid VCT service, the team moved on to the stage of a more correct understanding of the dif- ficulties and orientation strategies of the services towards the clients. The past months’ interventions were aimed at identifying the features of such vulnerable groups and the way to make the services more accessible to these groups. Interaction was achieved with various groups with the following features: Ѻ Ѻ the young people in the community are category with As a result of the interventions of the VCT specialists’ team within all Dobrogea region, dur- the highest addressability:46% aged between 16 and 26 ing the 10 months, from the 5-6 types of population groups reported in the first months of the years old; the main feature of this group is the occasion- program, the VCT services were eventually accessed by 18 types of different groups. al practice of safe sex, even when they know about their Quick HIV tests were performed on 3,059 persons - 3,040 tested negative, 19 are reactive, out partner’s HIV infection diagnosis. of which 11 new cases, and 8 were previous cases from the Centre of Excellence records that Ѻ Ѻ the medical staff from the Dobrogea county hospital requested confirmation. 10 out of the 11 new cases with reactive result were confirmed by Eli- wards – they still reject contact with known HIV-infect- sa. The incidence is of 0.36%. ed persons. HIV information/education of this group is AJSP Constanta reports for 2007 = 5,200 HIV tests, 6 of which were reactive not sufficient. HIV testing among these professionals is a AJSP Tulcea reports for 2007 = 1,900 HIV tests, 1 of which was reactive (case referred by Tul- rare practice, and it is not always in conformity with the cea Baylor centre) testing guides as far as confidentiality is concerned. Ѻ Ѻ Roma – except for the adult men, women and children HIV tests were performed by both Constanta and Tulcea teams at the locations of Baylor do not usually leave their community. The team needs to quick HIV testing centres and in other 40 locations: universities, high schools, public institu- tions, social protection residential centres for children and adults, family physician practices travel in their areas - which usually involves certain risks. from villages and townships located far from the county seat, hospital wards. Ѻ Ѻ under-age pregnant women not tested until the labour – the family physician arrives in villages once a week and the pregnant women are not recorded and tested Cumulative report VCT Dobrogea Ѻ Ѻ The transmission of ITS within the communities of institutionalized persons with intellec- Nov 2007- Aug 2008 tual disabilities is often met because there are no sexual education programs and abuse is present. The centres have or had acknowledged HIV-positive person. HIV testing is not a suf- Total Testing groups ficient intervention, although it is necessary. + - Ѻ Ѻ During the summer season, on the seaside there is intense population traffic and the profes- M 10 STD F 4 sional sexual workers are very difficult to approach also due to their increasing number dur- M 42 ing this period and the fact that they travel along the sea coast and the Danube Delta, without TB F 11 a permanent address. It is necessary to find a special approach for this group. Pregnant womans F 500 Sailors M 11 Ѻ Ѻ The inhabitants of the poor and remote villages have low access to information, they Drivers M 1 choose traditional cures instead of the medical examination or they consider the disease itself Persons working abroad for M 6 F to be shameful (the case of isolated communities) more than 6 months Persons that lived abroad for M Ѻ Ѻ sailors , who need HIV tests but can obtain results from private laboratories without even F 1 more than 6 months having their blood sample taken On site testing in other medical M 2 144 Ѻ Ѻ poor under-age adolescent girls who have unprotected sex with untested adult partners F 149 units working abroad more than 10 months per year. M 4 424 Certain groups could not be approached due to a series of conditions: Ѻ Ѻ drug users – even if they went to Baylor testing centres, they did not admit that they use in- jectable drugs. Ѻ Ѻ persons undergoing haemodialysis and / or blood transfusions – HIV testing is per- formed within the respective wards. Ѻ Ѻ homeless persons – a group not approached yet Lessons learnt Next steps Authors: Simona ATANASIU Ana-Maria SCHWEITZER VCT Team: Mihaela MOCANU Ioana STOCHITA Monica MEACSU Negivan SEPTAR Mariana CONSTANTINESCU Marcela SULEA Marga EFTIMIE Iuliana AVRAM Ѻ Ѻ the need for simultaneous use of more promotional strategies: in cases where the specialized physician does not support Baylor’s VCT services, the promotion of services is successfully per- formed by means of the website, banners, flyers, posters. Ѻ Ѻ nurses in villages are key elements in the development of a client reference network for the VCT centres Ѻ Ѻ army employees are an important risk group that needs HIV testing. Ѻ Ѻ The VCT team must be permanently evaluated and trained in order to increase its efficiency Ѻ Ѻ project marketing: it must be approached as a product, its launch must be based on a correct strategy, with impact among the population Testing on demand Persons who had used IV drugs Sexual contacts of HIV persons Personnel from health facilities Neonatology Hemodialysis Persons with transfusions Prenuptial control Gay Sex workers Persons in prison Homeless F M F M F M BBBBBBBBB BB B̍BBBBKH[\][ۈ]H[H[Y\[H][ ҕJHوۜ[K[ܙ\][X]H\ۜH[]][ۜH[X[܈][[XX\[U][[ۈ[X]Y[ SNB n4n][[H]ZXY\[\[H܈U\[وHYYX[ \[]\HYوҕHۋB[KوHҕHۜ[H]Y[´n4n][[H\[HوXX\܈Y\[[\HوU\]]H\ۜHS[HU[X[[Hو^[[H]ҕHۜ[K]ҕHݚY[YYX[\X\HY\Y]Y[[]S\Z[H[[[[Y[܈Z\[YXY[X]Y[و\H]Y[ۜY]YYH\وXX[\Y\\[\]Z\Y[ۘ][ۜ܈H[\[Y[][ۈق[]\[X]][ۜ˂H\Yۈ[[\[Y[][ۈوHڙX][Y[]YH]U[U\ۙ[\XX[H[[Y\[ۜ[H[[[XK]XXܘ[\\H\[[ۈH\ۙ[YY[ۈH\X\ٙ\Y n4n][[[\]X[[Z\[ۈوU[X[ێݚY[H[X[X[Y[Y[و]KXܛ]U]]H[\˂n4nXܙX\[H\HݚY[T[^\\[HYۘ[H][HU[Hو^[[N´n4nݚY[U[^\\[HYۘ[H[H\][YZY؜]X[\[[ۜ%Y\\X[Y[Y] YZ´n4nݚY[[[[[ܙ\]YX\YY[˂˂H[\][ۈ]H[\[\\Y[وX[\\[H[[X[ۈ[ܙ\\HN [[\Y[[H[\Bۜ[H[H[H NH[[\Y[[H[\H[XH[K