HIV/AIDS prevention and care among injecting drug users and in prison settings in Estonia, Latvia and Lithuania Riga, 29 May 2008 Sintija Šmite, UNODC Baltic States, National Project Officer

Information about the project Duration: 2006 – 2010 Government Focal Agencies: MOH, MOSA, MOJ Budget: USD Overall goal: to halt and reverse the HIV/AIDS epidemics among IDUs and in prisons, and to avoid generalised epidemic

Project objectives: Build national and regional consensus on effective implementation strategies to address HIV/AIDS among IDUs and in prison settings Increase coverage of comprehensive HIV/AIDS prevention and care services Generate and share strategic information to respond appropriately to evolving HIV/AIDS epidemics

Project strategy: Involvement of all governmental and non-governmental stakeholders in project design, implementation and monitoring Comprehensive baseline measurements and needs assessment Review of the legislative, administrative and operational environments Development and introduction of relevant training curricula, accreditation and quality control protocols Training of HIV prevention service providers Introduction of comprehensive interventions for IDUs and in prisons

Main achievements to date: Objective 1 – HIV strategies and action plans New national HIV programme for for Latvia RAR on drug use in prisons in Latvia and Lithuania MMT evaluation in Estonia and Latvia Legal assessments in Latvia and Lithuania Government of Estonia committed to finance activities supported by the Global Fund Evaluation of Estonia’s response to HIV in prisons (UNODC did situation analysis and evaluated implementation of national HIV strategy)

Main achievements to date: Objective 1 – HIV strategies and action plans (cont.) Increased participation of MOJ and Prison Administration in planning and implementation of HIV programms Improved coordination and collaboration of national drugs and HIV programmes Involvement of civil society organizations (in policy planning, implementation and monitoring)

Main achievements in 2007: Objective 2 – service coverage and capacity building 21 training seminars, 460 participants 5 study tours, 47 participants 6 conferences/meetings, 400 participants Professional networking: participation in 6 international events, 24 persons

Capacity building Substitution therapy for prison medical staff - doctors and nurses (Lithuania and Latvia) Reduction of health risks for IDU in prisons: social workers and nurses in Latvia Adaptation and translation of manual “Risks Reduction for Drug Users in Prisons” in Latvia and Lithuania Study tour to Germany on HIV prevention in prisons (LV, LIT, EST) NGOs, MOJ and doctors in prisons (policy makers and practitioners). Participation in international conferences and expert meetings

All training events evaluated, positive feedback received Exchange of experiences and best practices of NGOs working in prisons (LV, LIT, EST)

Opioid substitution therapy EstoniaLatviaLithuaniaWHO/UNODC recommendation Number IDU in OST Number of DU % IDU in OST % % (4300) 5.03% moderate: 10-19% good: 20-39% Coverage indicators

Main achievements in 2007: Objective 2 – service coverage and capacity building Financial support for service providers through small grants programme 20 grants to governmental and non-governmental organisations (Latvia and Lithuania, Estonia as of 2008): –2 new methadone programmes started in Lithuania –6 projects in prisons –Integration of services (TB and NSP) –Increased coverage through peer outreach

Plans for 2008: National HIV programme for Lithuania Scaling-up methadone maintenance therapy in Latvia Starting MMT in Tartu prison in Estonia Adaptation of training manual on risk reduction in prisons (continuing in Lithuania) Increase police involvement Assessment of ARV accessibility in Latvia and Lithuania

Plans for 2008 (cont.): Development of training modules on NSP, VCT (voluntaree counceling and testing), MI (motivational interview) Continued capacity building (priority – prison staff) Small grants to service providers Evaluation of small grants programme (Latvia and Lithuania) Evaluation of quality of OST in Estonia and Latvia Mid-term project evaluation Recruit national project officers in Latvia and Lithuania Create project website

Contacts: SINTIJA ŠMITE National project officer in Latvia UNODC Office for the Baltic states Tel.: