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Drug users’ perceptions of HIV prevention programs in North-West Russia

Drug users’ perceptions of HIV prevention programs in North-West Russia. Peter Meylakhs, Centre for Independent Social Research, St. Petersburg Aadne Aasland, The Norwegian Institute for Urban and Regional Research, Oslo

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Drug users’ perceptions of HIV prevention programs in North-West Russia

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  1. Drug users’ perceptions of HIV prevention programs in North-West Russia Peter Meylakhs, Centre for Independent Social Research, St. Petersburg Aadne Aasland, The Norwegian Institute for Urban and Regional Research, Oslo Arne Grønningsæter, Fafo Institute for Labour and Social Research, OsloXVIII INTERNATIONAL AIDS CONFERENCE - VIENNA 18-23 July 2010

  2. Project: The governance of HIV/AIDS Prevention in North-West Russia • Financed by the Research Council of Norway and the Ministry of Foreign Affairs of Finland • Project web-page: http://guango.nibr.no/

  3. Background: • The growing HIV epidemic in Russia is driven largely by people who use drugs. • Little is known, however, about how people belonging to this group perceive the local and federal prevention efforts and utilize knowledge that is transmitted through prevention messages. • One of the purposes of the study was to address this issue.

  4. Methods: • 24 semi-structured interviews were collected in 3 regions of North-West Russia: • 2 with a high prevalence of HIV among drug users (St. Petersburg and Leningrad Oblast region); • 1 with a low prevalence of HIV (Arkhangelsk region).

  5. Results: • No regional differences were observed between high HIV prevalence and low HIV prevalence regions in our informants’ attitudes and experience with HIV prevention efforts. • However, such differences were observed when we compared cities and small towns. • In small towns IDUs are particularly vulnerable with respect to: availability of HIV-services; NGOs presence; confidentiality. It leads to avoidance of seeking HIV-services in some cases

  6. Sources of preventive information • Media, public campaigns (newspapers, TV, radio, brochures, posters in clinics) • Peers • School programs (elements of sex education) • NGOs (for SPb but not for Leningradskaya obl. and Arkhangelsk region) • Most informants do not differentiate, whence information comes – ‘some leaflet’

  7. Perception of preventive measures • For some media campaigns are ‘dull’ and they feel they do not concern them • Some indicate that it is a fear campaign, especially early media campaigns, when HIV was portrayed as a ‘plague’ with no chance of surviving. Many informants avoided watching them so as not to ‘spoil the mood’ • Many propose a trade-off between scare and ‘objectivity’ • Also several informants underscore that personal example and personal communication is much more efficient than mere information. People are much more receptive to specific experience of other people.

  8. Perception of preventive measures (cont.) • Apart from information campaigns no one has experienced other governmental prevention measures • While having no, or very little prior contact with harm reduction services, most informants underscored the necessity of ‘special programs’ for IDUs on the large scale (such as syringe exchange programs) • Almost everybody thought that the state had the potential to organize good prevention policy but that political will was lacking • They said that NGOs would do a better job than the state, provided they had the funding, as they are ‘really working’ with risk groups.

  9. Trust in prevention information and following prevention recommendations • Whereas all informants trusted HIV-prevention recommendations, most of them failed to follow them and continued high-risk practices (such as needle-sharing). • Apathy and fatalism were evident in the narratives of many informants when they told about their drug use; for them drug use meant that there was no point in taking care of their health. • Needle-sharing was also associated with drug withdrawal and absence of clean syringes.

  10. Conclusion • HIV prevention campaigns targeted at the general population are insufficiently effective for IDUs. • Rapid expansion of harm reduction programs specially tailored for IDUs’ needs is required. Coverage should be substantial, otherwise it will not affect the epidemiological situation with HIV in all the regions. • Training programs and outreach work with IDUs combating their fatalistic attitude towards their health are needed. • Special prevention programs that address IDUs residing in small towns and villages are needed.

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