HIV/AIDS prevention, treatment and care for female injecting drug users and female prisoners in Pakistan

Brief Description

The primary goal of this project is to enhance the quality of services available to female injecting and non-injecting drug users (including those involved in sex work and spouses of male drug users) in the community and in prison settings by improving female access to existing harm reduction services and developing new female-specific services and effective referral systems to female health service providers. Key outputs include trained staff and outreach workers at existing harm reduction services, the establishment of gender-sensitive drop-in-centre services, three mobile units exclusively devoted to accessing female IDUs and at-risk spouses of male IDUs, institutionalisation of a training course in gender-specific harm reduction service delivery for prison staff and prison peer counsellors, and establishment of harm reduction services in two female prisons.

Output  1:

To determine the characteristics and service needs of female injecting and non-injecting drug users, spouses of  male injecting drug users and female prisoners, for provision of comprehensive HIV prevention, treatment care and support.

Output 2:

To develop an enabling environment, which provides conditions that support gender and culture sensitive approaches to HIV prevention, treatment, care and support services to female injecting and non-injecting drug users, spouses of male users and female prisoners.

Output 3:

Establishment of physical infrastructure for female injecting drug users.

Output 4:

Capacity building and training for medical practitioners and service providers from governmental and civil society organizations, in provision of gender- sensitive services to female injecting drug users and spouses of male injecting drug users.

Output 5:

Direct service provision of the comprehensive package in a gender and culture-sensitive manner.

Output 6:

Service delivery to female prisoners.

Output 7:

Monitoring and Evaluation.

Activities

1. Rapid situation assessment and need analysis of female injecting drug users and female prisoners

An in-depth situation assessment was carried out with the target population to identify the magnitude of the problem and to identify needs. Assessment consisted of in-depth interviews with female IDUs, harm reduction service providers, outreach workers for IDUs and FSWs, drug treatment centres, other medical practitioners especially female specific services.  The assessment determined both needs and the barriers to access to services for female IDUs.

2. Identification of NGOs & Implementing sites

The situation analysis with the highest prevalence in Sargodha (51.3%) followed by Karachi (30.1%) aimed to implement the project activities in Sargodha and Karachi divisions.

In line with the project strategy, the activities were linked with NGOs already working for female sex workers. Nai Zindagi was identified having a vast experience of establishing interventions for male IDUs specifically in Sargodha and its surroundings to implement the activities. On the contrary, Sukkur Blood Bank was selected to carry out the project activities female prison Karachi.

3. Study Tour

The study tour to India was organized in collaboration with an on-going project "Prevention of Transmission of HIV among drug users in SAARC Countries" TD/RAS/03/H13, which is linked with this project.  The delegates were senior government prison officials who visited the OST sites and harm reduction services to get the better understanding of service needs for injecting drug users, spouses of drug users in community and prison setting.

4. Provision of services

The harm reduction services including VCT, baseline CD4 diagnostics, treatment of OIs, basic health care, counseling and psycho social support, marital counseling, home based palliative and supporting care, reproductive health care, nutritional and social support, STI prevention, diagnostic and syndrome management, condom provision, sterile syringes, home based detoxification for spouses, referral services are being provided. In addition to these, indoor sports facility was provided to female prisoners in female prison Karachi. The computer lab and female common room have been upgraded.

5. Project Steering Committee Meeting

PSC meeting was held at Ministry of Narcotics Control (MNC), Islamabad Pakistan on Wednesday 22 October 2008. The meeting was chaired by Mr. Hasan Mahmood, Sr. Joint Secretary, MNC. All members/representatives of the Committee  were present in the meeting.

The Committee reviewed the progress on the ongoing project activities.  The study findings were presented by Dr Asma Bokhari, Consultant, on Assessment of Female Injecting Drug use & Female prisoners. The future implementation was reviewed and it was suggested to expand the project activities.