Project “HIV/STD Prevention Among Sex
Workers”
supported by Family Health International
interim report
01.04.2002 - 30.11.2002
Service provider:
NGO AIDSi Tugikeskus (AIDS Information & Support Center)
Project leader:
Juri Kalikov - the Head of AIDS Information and Support Center
Responsible Project workers:
Irina Mironova - outreach worker, medical nurse, 3 years working in
Meretaht-Seastar I, project leader of Harm reduction Project among Sex
Workers IDU-s (2001)
Toomas Vessin - doctor, dermatologist-venerologist, 3 years working
in Meretaht-Seastar I, 1 year in Harm reduction Project among Sex Workers
IDU-s (2001)
Project started in April 2002 with creating of system of voluntary testing
on HIV/STD: pre- and post consulting, treatment of STD, confidential, anonymous,
culturally and linguistically appropriate services for sex workers, referrals
to other service providers - both governmental and NGOs.
Medical advice, necessary testing on all STD and HIV are free of charge,
but we prefer before the testing propose to the sex workers receive professional
consultation from our doctor-venerologist or other specialists (for avoiding
overspending of resources).
We immediately start with referrals to other necessary specialist: for
legal consultations we collaborate with Legal human Rights Center (Lilia
Ivanchenko, Larissa Semjonova), for psychological consultation, consultation
of family doctor (Liivi Melesko), for appointments as necessary with gynecologist,
narcologist. In the first 3 months we used also additional consultation services
of dermatologist, because of growing number of sex workers, visited our
project and restricted reception hours of our dermatologist-venerologist.
Altogether during 8 months 52 hours of gynecologist; 30 hours of psychologist;
38 hours of narcologist; 47 hours of therapist and in first free month 31
hour of dermatologist consultations were provided.
Everyday services were organized in premises of AIDS Tugikeskus:
in October we opened additional venue: in two separate small rooms daily
service center for sex workers (working now 3 hours in day) with wide range
of services (shower, coffee/snacks, safer sex literature/condoms).
We copy and distribute special literature on safer sex, condoms and
lubricants, provide safer sex education, promotion the use of safer sex
techniques for girls. At the moment work out (text, translation, adaptation)
on pocket-size brochure “How to stay safe” (Russian and Estonian languages)
but the printing and dissemination still delay because the Tallinn City
government taking financial responsibility for this action don’t fulfil
they promises. We receive the promise of health department to print it in
January 2003.
The contacts with possible peer-educators from the sex workers were
created with the aim in future create some small self-help groups. Trainings
for peer educators and peer education events are made on base of the center
(in future in drop-in center). Once a week our team (project leader, med.
nurse and volunteers) goes on outreach work. We visit well-known brothels,
saunas and clubs where we are already accepted and also try to create contacts
with new places. It is really very difficult, cause our prostitution scene
is totally criminalized. The finding of constant peer-educators is also very
problematic because of very short time, which the girls usually stay working
in sex business. The fluid body of prostitution, several changes in location
(moving to capital, in short term to Parnu, going for the working abroad)
makes working with per educators not very regular, but the opening of drop-in
center probably improve this situation.
We continue to work with mass media:
Newspapers, magazines
weekly magazine Eesti
Express
newspapers Den za Dnjom,
Molodjez Estonii.
TV :
late show ”RED ROOM”
with Margus Saar 21 0f December 2002
6 part film of Haridusmeedia,
supported by Nordic Council of Ministries - 2 films about prostitution
and trafficking - interview, expert view on web-page
bilingual late TV show
”Sleepless” - round table about legalization of prostitution 8 of October
2002
lecture about moral
criteria’s and human rights aspects writing on sex work and prostitution
- on seminar for journalists, provided by Nordic Countries anti-trafficking
campaign
Radio interviews:
Voice of America (for
Neeme Raud); Freedom, 100FM for reducing of the level of stigmatization
of sex workers in society and increase awareness about sex work issue.
Raadio2, ”Hard talk”
hour, discussion about sex work
To identify social and health service providers and to make services
available, appropriate and accessible to sex workers we make referrals to
anti-trafficking project STOP II (AIDS Information & Support Centre),
Methadone treatment program, needle exchange and rehabilitation centre (AIDS
Information & Support Centre in Tallinn - in Narva to NGO Rehabilitation
centre of Alcoholics and Drug Addicts - director Tatiana Magerova), Institute
of Human Rights (NGO - director Merle Haruoja), Legal centre for Human Rights
( project leader L.Ivantchenko), AIDS Prevention Centre (if the clients
need only HIV tests), IOM (International Organization of Migration (trafficked
women - The Head of Estonian Office Kristina Mauer), Tartu Child Support
Centre if needed.
We participate actively in International Conference against trafficking
of Women in Tallinn 29-31 of May, organized with support of Nordic Council
of Ministers, meeting with governmental representatives, NGOs, police of
Sweden in Stockholm in November 2002.
For changing experience in April 2002 project leader visited Prague,
makes visits to NGO R-R (Risk Without Bliss) - doctor Hana Malinova, specialised
on work with sex workers (shelter, mobile car unit for testing, social assistance,
drop-in centre), centre for child prostitution, LIGHTHOUSE - 24h services
house for HIV positive persons, including sex workers.
Two visits to Narva (main recourse for sex business, city of original
of nearly 35% of sex workers) and Parnu (summer destination of foreign
clients and prostitutes) was made for informational campaigns, dissemination
of condoms, lubricants, stickers, leaflets for sex workers and clients in.
For monitoring the use of services and to better understand the needs
sex workers, an anonymous questionnaire was administered and implemented
- both on Estonian and Russian language (final analysis should be included
in final report).
The questionnaire consist of data about age, education, ways of involvement,
sex work conditions (violence, sexual abuse questions), drug use, alcohol
use, condom use, location etc of the women in sex business will be collected
and analyzed.
Also the epidemiological data concerning HIV, STD is collected with
aim of analysis at the end of the project, comparing first and multiplied
visits (influence of safer sex education, condoms use). From the sex workers,
for the first time visited our project in 8 months nearly 35% has been founded
even one STI, from the multiply visitors only 5% has some STIs.
Regular information was collected about number of project visitors,
their location (mostly from Tallinn 60% and Narva 30%, time of involvement
in the sex business (from 1 month to 1,5 year mainly, age (16-25 y.o - 50%),
nationality (85% Russian speaking), educational background, condom use, alcohol,
drug and tobacco use etc.
During first 8 month of the project we have 164 first time visitors
and 104 multiply visits that receive even one medical procedure. Total
number of contacts with sex workers was closely to 350 including not only
medical services but also safer sex education and condom, literature, lubricants
distribution and visits for drop-in. For sex workers during reception, drop-in
center open hours, outreach work and using peer-educators the total number
of 4500 condoms were distributed (2300 - covered by project costs; 2200
- from other resources); 450 lubricants (covered by other resources).
With the aim to find additional resources for the services for sex workers
we take following measures:
we participate in writing
project proposal for the Global AIDS, Tuberculosis and Malaria Fund with
the help of international expert and in collaboration with CCM (Country
Coordination Mechanism group), which was created with participation of
Ministry of Social Affaires. The results should be announced in late January.
we participate in project
proposal competition for Health Department, announced by Tallinn’s City
Government with the purpose of providing services for sex workers in November
2002 for the period of 3 months. Unfortunately, for the several reasons
- not acceptance of NGO for the participation in principal; burocratic procedure
(24 documents requested); clear falsification of the official reason for
refusal, preference of other participant, which was financially connected
with some Tallinn’s City Government officials, breaking the rules of competition
- the winner, Lasnamae Poliklinik have not 3 years experience working with
sex workers, like it was in the rules - for this reasons we don’t receive
this additional financing. The first responses from the journalists and
experts say that opened service don’t fulfill requirements of the project
- just few visitors in period of 1,5 month, negative reaction of society,
because the wrong advertising policy in mass-media and society.
The project supervised by Dr Nelli Kalikova from AIDS Prevention Center
and Dr Tatiana Kurova from GENDERS center from Riga - doctor Tatiana Kurova
visited our center and project in May 2002. Activities with trafficked
women coordinated and supported by Kvinnoforum from Sweden and Caritas
Diocesana di Roma.
Project team together with involved volunteers and specialists come
together once in a 2 month to discuss about development of the project
and possible correction of the activities.