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YouTubeWeb outreach expands the access to HIV testing and immediate HIV treatment initiation among people using new psychoactive substances and stimulant drugs (NPS/S): the experience of Uzbekistan
Starting from 2018, based on the study of the growing number of specialized Internet forums and websites dedicated to drugs use and harm reduction, with the support of the UNODC Regional Offices in Eastern Europe and Central Asia, a pilot project using the web outreach method among service providers working with people who use drugs (PWUD) was initiated.
This method includes a systematic, comprehensive, and targeted work of involving PWUD to harm reduction programmes and implement them via websites, social networks, messengers, specialized forums, including «DarkNet» platforms and open segments of the Internet.
Covid - 19 has brought many changes to the nature of the outreach work both globally and in Uzbekistan. “We used to work with representatives of the target group via direct contacting, in locations where they usually meet. The online format of work offered by UNODC has taught us a lot: it has expanded the scope of information and involvement not only of the target groups representatives into harm reduction programs, but also the population in general," Utkur Pulatov, Monitoring and Evaluation’ specialist of the Web Outreach pilot project in Uzbekistan shares with us his experience.
Web outreach tool seems difficult at first, but when putting it in everyday practice, you realize the effectiveness of this method. He noted that he enjoyed this work and felt the responsibility and the need to transfer his experience to young outreach workers.
Utkir also noted: "Since the beginning of the project, we faced the difficulties with publishing posts, as the social channels and pages admins did not understand and were afraid to post them. Also, the owners of some chat rooms followed by tout target audience were not ready to contact us and refused to post messages with information about the project (i.e. darknet, online shops-non-commercial «nets» of the Internet or the so-called «shadow» Internet communication and technology). UNODC trainings helped us with in the choice of chat rooms and post technology, which made our work easier. The web outreach Team’s questionnaires named as: "Do you need to take an HIV test?" were also helpful, they encouraged the followers to look at the history of their behavior and promote them to take HIV test. Posting these messages has helped to increase the appeal of NPS/S regarding the use of these drugs, as well as on HIV".
"I would especially like to acknowledge the good work of a friendly doctor, his name is Farrukh Khamroev from the Republican Center for the Fight against AIDS (RCAIDS). His attitude towards the clients was inspiring them to stay in the programme and get tested, start the timely treatment and receive it comprehensively. Sometimes it wasn't easy to register some clients having positive status without a residence permit, in this case, we had to delay the start of treatment. Due to the support of the AIDS services management, these clients were given a chance to commence the antiretroviral therapy (ARVT)".
He also mentioned that the fear of problems from law enforcement agencies held them back from continuing online communication, for this reason, they are more willing to communicate offline, and in most cases after consultations delete the messages stories. Frequent questions about NPS/S consumption were: "Why do you think we’re addicts? Aren't they just pills? What happens if we get caught? Is there free legal aid? What are the consequences of prolonged use of NPS/S?" Medical questions on complications of use of NPS/S: "What if I test positive for HIV?", "What is ARVT?", etc.
Utkur shared with us the story of one of the clients: “The client approached us via telegram at the end of November. In one of the telegram channels for dating, he saw a post about a free consultation and the opportunity to be tested for HIV and STIs (sexually transmitted infections) anonymously. He started using NPS/S for the first time at the age of 16, while living in Russia in St. Petersburg city for work, later he used salts, tropicamide, lyrica, phenobarbital, betamethadol (new psychoactive substances and stimulants). For almost 8 years, he periodically had been using these substances and met with different partners. Two years ago, due to health problems, he returned to Uzbekistan. After communication via telegram, the program participant independently visited the Republican AIDS Center and took all the tests". According to the client: “On my way here, I was really worried on being judged and was afraid to be detained. But when I spoke to Farrukh-aka, I realized that no one was going to harm me here, so I felt released while taking all the tests and then left».
The client was given an advice on HIV and STI prevention. He was also tested for HIV, hepatitis C and RV. At the end of December, his results were positive for HIV. After taking a commission analysis, he was redirected to the Regional AIDS Center. He said he couldn’t work because of frequent illnesses and therefore could not get a full examination and start ART. But he always keeps in touch, and often asks for counseling and psychological support. He was also given a promotion package. At the present period, the client has started taking ARVT and has been treated in an infectious hospital, his health has stabilized and consultations on adherence to therapy are ongoing.
The web outreach helps to reach out the ones, who would never approach us directly and whom we would not be able to reach through their Key Population Gathering Point. The new tool, helping to reach more clients, gave us the opportunity to learn new skills of consulting. Being a truly innovative tool it allows the project to reach new clients and accomplish identified goals. With every post and a client appeal, a team of outreach workers as well as monitoring and evaluation specialists, has learned something new, for instance, the new ways of distributing NPS/S, new clients' points and their problems, especially of the ones who have just turned 18 years old and had started using NPS/S at an even younger age. They are as follows: in what way the involvement takes place, the scheme of involvement and what kind of interest the NPS/S arouses among young people for the moment.
The web outreach method expands the scope of counseling possibilities, because in the Internet, one can be more self-conscious and outspoken. Thanks to this pilot project, it has become possible to use the links of all available partner organizations and to broaden the package of services for the beneficiaries, as well as to give a more detailed description of the organization and the project. The access of clients is so wide in geographical terms that it has become possible to advise and assist key population representatives from other regions and cities.
