1. Residential Support for HIV- Positive and Street-Involved Girls in Ukraine Living, Loving, Working: HIV and Sex Work July 21, 2014, Melbourne, Australia 20th International AIDS Conference Halyna Skipalska Ukraine Country Director, HealthRight International Executive Director, Ukrainian Foundation for Public Health

2.  HealthRight International is a global health and human rights organization working to build lasting access to health for excluded communities.  The Ukrainian Foundation for Public Health (UFPH) is a Ukrainian charitable organization, founded by HealthRight International in 2008, with the aim of building local sustainability. Overview

3. 30 to 100 thousand youth live on the streets in Ukraine Donetsk, 2010

4. Street Youth and HIV 18.4% HIV prevalence among street youth (HealthRight/CDC 2009) Voly n Rivn e Zhytomyr Kyiv Chernigiv Sum y Poltava Kharkiv Donetsk Zaporizhia Kherson AR Crimea Kirovograd Mykolaiv Odessa Vinnytsi a Lviv Ternopi l Khmel - nytski y Iv.- Frank. Zakarpatska Chernivt si Cherkasy Dnipropetrovsk Luhansk Donetsk: 9.8% (N=307) Kyiv: 18.6% (N=311) Odesa: 26.7% (N=311) HIV prevalence rate in three cities 18.4%

5. Street-Involved Girls Street girls and young women are a small (25%), but highly vulnerable sub- group of the larger street youth population

6. In 2010, to respond to the extreme vulnerability of street-involved girls, and the high prevalence of HIV among them, HealthRight and UFPH launched a service model for street-involved women and girls in Kyiv. Continuum of Care for Street-involved and HIV-positive Women and Girls

7. Outreach Drop-in servicesHalfway House Independence or family Case Management Referral

8. Street Outreach   Mapping of sites   Psychosocial counseling   Client referral   Voluntary HIV counseling and testing   STI, Hepatitis testing. In 4 years:  598 girls and women received services in outreach  313 were tested for HIV  11 HIV-positive.

9. Drop-in Center for Women and Girls  Shower, laundry, food  Legal, social, psychological  Material support  HIV, STIs and pregnancy testing  Referrals (advanced medical care)  STEPS HIV prevention and education trainings  Case management  Psychological intervention for survivors of VAW and partner perpetrators  Services for children  Basic services for client’s partners.

10. Drop-in Center for Women and Girls June 2010 – May 2014:  1 160 girls served  247 (21.3%) HIV-positive  98 pregnant (including 14 HIV- positive)  655 tested for STI, 30 with positive result  329 tested for Hepatitis, 13 with positive result  147 tested for pregnancy, 7 with positive results  744 children received services, including 152 HIV-positive  107 clients partners received services.

11. In 2013, HealthRight added a halfway house to the continuum of care for especially vulnerable women and girls. Residence Based Support at the Halfway House

12. Residence Based Support in the Halfway House

13. Since May 2013, 17 women and 19 of their children have been engaged in residential care.   2 HIV-positive   5 had lived in an orphanage   10 had lived on the street   12 had abused substances   All had survived abuse. All clients have kept parental rights for their children. Five clients with their children were supported to transition to independent living. Four returned to partners and family members, 3 were referred to rehabilitation centers and 5 continue to receive services. Residence Based Support at the Halfway House

14. HealthRight and UFPH intend to develop a career and financial literacy program to help clients improve their prospects for independence. Conclusions/Next Steps A residential program is a critical part of the continuum of care, allowing a secure transition to independence and prevention of child abandonment.

15. Thanks to our donors!

16. Thank you! HealthRight International Representative Office in Ukraine 3, Stanislavskoho St., Office 7, Kyiv, 01001 Tel.:/Fax: + 38 (044) 278 2358 Halyna.Skipalska@healthright.org www.healthright.org www.healthright.org.ua