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For most drug users and people who work with them, overdose is an urgent issue. Many AIDS, harm reduction, and other drug service organizations have created programs to educate people who use drugs about overdose prevention and response techniques, to distribute naloxone and to document the extent of overdose and the success of responses. But funding has been limited. Recently, the Global Fund to Fight AIDS, Tuberculosis and Malaria issued guidance that they will support these kinds of overdose prevention activities. Other AIDS funders are beginning to follow the lead, and service providers should ensure that overdose services are available to their drug-using clients directly or through local referral networks. This document presents arguments that organizations can make to AIDS funders to show that overdose prevention and response matter for HIV programming.

The aim of this report is to provide insight into the ways to improve civil society participation in country-level planning and evaluation of the national response to HIV.  The report explores the nature of civil society involvement in the process of establishing national targets as well as the impact this involvement had on the targets established.  The target setting process is examined in 15 countries in the region of South-Eastern and Eastern Europe and Central Asia.

The HIV epidemic in Russia continues to grow. Groups most affected by the HIV epidemic are injecting drug users (IDUs), also sex workers, men who have sex with men and inmates as well as their sexual partners. Russia has a steadily increasing number of patients in need of antiretroviral therapy as well. Though much progress has been made to move towards established Universal Access Targets for 2008, there are many barriers to be overcome for Universal Access to be reached by 2010. Report provides thirteen issues raised by civil society representatives in the process of the Country Report preparation for UNGASS 2008 and recommendations.

This paper written by EHRN in 2008 examines the introduction of opioid substitution therapy (OST) in selected post-Soviet countries: Belarus, Ukraine, Lithuania, Georgia, Kyrgyzstan, Kazakhstan, Russia, Tajikistan and Uzbekistan. As of 2008, less than 2% of injecting drug users in the region had access to this life-saving treatment, with many OST programs still remaining in the perpetual pilot phase. The findings point to an urgent need to develop better epidemiological surveillance of injecting drug use in the EECA region; to improve availability of evidence-based treatment of injecting drug users including opioid substitution therapy; and to disseminate the information more broadly to policy makers, the medical community, and civil society organizations in order to move from policy to action.

Hepatitis C Among Injecting Drug Users in the New EU Member States and Neighboring Countries: Situation, Guidelines and Recommendations

To assess the situation with IDU access to HCV treatment in the region, the Central and Eastern European Harm Reduction Network (CEEHRN) carried out a survey in 13 countries of the European Union (EU) and the neighboring countries, looking at the availability of HCV prevention, treatment, care and support for IDUs.  The findings show that in most countries access to HCV care for injecting drug users remains limited. Stigmatization of drug use means that those with the greatest need for HCV support, treatment and care are often denied these lifesaving services. The current level of policy and advocacy efforts is not sufficient to achieve progress, meaning that more needs to be done in order to raise the profile of the issue with the policymakers. The report provides guidelines and recommendations for further action.

Hepatitis C virus (HCV) presents an important public health problem globally and particularly in the region of Central and Eastern Europe. The infection spreads rapidly among injecting drug users (IDUs) due to its high infectivity. Availability of HCV prevention, treatment, care and support for IDUs is often not satisfactory. The key finding of the fact sheet, based on a survey in 13 countries of the European Union (EU) and neighboring countries, is that in most countries HCV among IDUs is a neglected problem.

Working with vulnerable populations—injecting drug users (IDU’s), sex workers, people living with HIV, men who have sex with men, and prisoners—is associated with high levels of stress and burnout. This is particularly so for those working on the “frontlines”—harm reduction service providers, medical staff, social workers. This manual explores best practices in burnout prevention and management based on the experience of harm reduction projects in the region of Eastern Europe and Central Asia. The manual also includes a training module, strategies for stress management, as well as a suggested reading list.

In Central and Eastern Europe and Central Asia sex workers remain among the most marginalized members of society.  At the same time, the surging HIV/AIDS epidemic in the region places sex workers at increasingly greater risk of infection not only from HIV, but also from other potentially debilitating conditions related to sex work and drug use. This report provides an overview of these and other important issues that sex workers face in the region as well as of the political, economic, and social factors that influence policies and attitudes toward sex workers. It focuses primarily on the existing laws and policies and their consequences from the perspective of HIV prevention and treatment. The report also offers recommendations designed to uphold sex workers’ rights and remove barriers that reduce their ability or willingness to access health care and other social services.

For several years UNAIDS has been reporting that HIV is spreading faster in Eastern Europe and the Newly Independent States than in any other part of the world. In 1995 Lithuania was the first former Soviet State to introduce HIV/AIDS prevention measures among injecting drug users (IDUs) by adopting well-proven practices of Western, Central and South-Eastern European countries. The intention of this publication is to share the experience gained in the field of HIV prevention among IDUs and to provide the information about the lessons learned and successes achieved.

Injecting Drug Users, HIV/AIDS Treatment and Primary Care in Central and Eastern Europe and the Former Soviet Union

A survey of 132 organizations in Central and Eastern Europe and the former Soviet Union assessed the accessibility of HIV medications, basic health care and substitution treatment for injecting drug users (IDUs) in the region. Organizations surveyed include harm reduction programs acting to reduce the negative effects of drug use or to suppport such efforts and representatives of governmental HIV/AIDS programs. Report provides recommendations for further action.

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