Combating HIV/AIDS and stigmatisation

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Goal and objectives Indicators Sources of verification Programme goal Health of vulnerable people has improved. Programme objective Georgian Red Cross has strengthened capacity to improve health of vulnerable people. Project objective The spread of HIV/AIDS as well as discrimination of people living with the disease has reduced by increasing awareness of the communities, particularly young people, via Red Cross promotion and education campaigns. Capacities of selected communities have strengthened. The number of vulnerable people in target communities has reduced Morbidity and mortality has reduced. Living conditions of people in need have improved. The Georgian Red Cross meets the characteristics of a wellfunctioning national society. It has strong branches delivering sustainable, focused and responsive assistance to vulnerable people. It is accountable to its beneficiaries and partners, and has active, trained volunteers across the country providing volunteer services and participating in the national society governance. By the end of 2005: The Red Cross has established two youth centres in Batumi and Tbilisi to advocate against discrimination of people living with HIV/AIDS and encourage the youth to learn about the disease, change their attitudes and develop safe behaviour. The national society has three trained staff in each centre and a mobile team of five staff and volunteers spreading information on HIV/AIDS prevention among the youth and public at large. An estimated 2,000 people visited the centre to receive information on the disease. Another 2,000 people have been reached by a Red Cross mobile awareness team in Tbilisi. 3,000 young people have received information on the HIV/AIDS prevention through discussions organised by Red Cross peer educators. The Red Cross actively cooperates with the Georgian AIDS and Clinical Immunology Centre. Georgian Red Cross monitoring reports. Feedback from beneficiaries. State statistics and reports on humanitarian situation in Georgia. UN agencies reports and assessments results. Other NGO reports. National Society programme progress and final reports. Self-assessment reports. Federation monitoring & evaluation reports Data on volunteers. Community development reviews. Red Cross annual report. Red Cross mobile team and youth centre activity records. Reports from the Georgian AIDS and Clinical Immunology Research Centre. Government statistics.

Project expected results Indicators Sources of verification Project expected result 1. By the end of 2005, the Red Cross has: Red Cross project progress and monitoring The Red Cross has established two youth established two youth centres in Tbilisi and Batumi. centres and built a network of trained staff trained two staff members in each centre on HIV/AIDS reports. Reports from the youth centres. and volunteers to spread information on prevention to respond to inquiries from the public as well Feedback from beneficiaries. HIV/AIDS prevention and advocate as their colleagues. against discrimination of people living trained one staff member in each youth centre as peer with the disease. educators to work with young people. Project expected result 2. Some 3,000 young people have increased awareness on HIV/AIDS prevention through Red Cross peer education efforts. Project expected result 3. The Red Cross has established a mobile team to out-reach another 2,000 people in local communities and help them reduce the risks of HIV/AIDS. An estimated 2,000 people visited the centre to receive information on the disease. By the end of 2005, 3,000 young people have attended discussions organised by Red Cross peer educators and received condoms as well as educational and promotional materials such as brochures, posters and t-shirts with messages on HIV/AIDS and stigma associated with the disease. By the end of 205, the Red Cross has established a mobile team of five staff and volunteers. The team has visited local communities (an estimated 2,000 people) to talk about the disease prevention and stigmatisation of people living with HIV/AIDS. It distributed thousands of information materials and condoms to target groups. Red Cross workshop records. Federation monitoring reports. Red Cross project progress and monitoring reports. Mobile team activity reports. Feedback from beneficiaries. 2

Activities Resources Sources Activities to achieve project expected result 1 Personnel. Federation appeal. 1.1. Identify premises for the youth centres in Tbilisi and Batumi. Equipment. Partner national 1.2. Renovate the premises and equip the centres with basic furniture and equipment. Transport. societies. 1.3. Assign staff to manage the centres. Stationery. Other international 1.4. Train two Red Cross staff members on HIV/AIDS prevention to respond to inquires from Training materials. agencies, present in the public as well as their colleagues from the youth centres. Consultants/trainers. the country. 1.5. Train another staff member in each centre as peer educators to work with young people. Office furniture. Local government and/or nongovernment Activities to achieve expected result 2. 2.1. Red Cross peer educators will organise discussions on sexually transmitted illnesses and HIV/AIDS prevention as well as the stigma associated with it with some 3,000 schoolchildren and university students. 2.2. Develop, print and distribute educational and promotional materials such as brochures, posters and t-shirts with messages on HIV/AIDS and stigma associated with the disease. 2.3. Procure and distribute 10,000 condoms to young people. Activities to achieve expected result 3. 3.1. Establish a Red Cross mobile team in Tbilisi. 3.2. Assign a vehicle, equipment and staff/volunteers to the team. 3.3. In cooperation with the Georgian AIDS and Clinical Immunology Centre, organise trips to local communities to talk about the disease prevention and stigmatisation of people living with HIV/AIDS, and distribute information materials as well as condoms. Personnel. Consultants. Office equipment & furniture. Training, educational and promotional materials. Condoms. Transport. Stationery. Personnel. Equipment. Vehicle. Stationery. Awareness and training materials. agencies. Federation appeal. Partner national societies. Technical expertise form the Federation Regional delegation in Ankara. Local government and/or nongovernment agencies. Federation appeal. Partner national societies. Other international agencies present in the country. Local government and/or nongovernment agencies. 3

1. Background 1.1. Context Official statistics show that 305 people in Georgia are HIV infected of which 67 have developed AIDS; 44 people have died. In the absence of a proper surveillance, however, the reality is thought to be much worse. The World Health Organisation estimates the number of those infected has exceeded 1,500. The disease is spreading at an alarming rate. Poverty combined with poor public awareness, traditional low demand on condoms and inadequate health and care exacerbate the threat. Another factor that contributes to the startling increase in infection is increased population movement. Because of poverty men leave homes to sell their labour in more affluent places, primarily Russia. Away form home, behaviour changes, sex and drugs ease despair and dislocation and more than money return to their households. Most infections (71 per cent) have been found among injecting drug users who share needles 1. In 2001, over 87 per cent of all new AIDS instances were detected in people of 26-35 years old. Over 46 per cent of HIV infected people live in Tbilisi, the capital with a population of 1.5 million. 18 per cent is reported in Samegrelo, a region in the western Georgia with the highest density of internally displaced people from neighbouirng Abkhazia. 16 per cent of people with the disease are in Ajara region, a major seaport, also in western Georgia. To reduce the spread of the disease, the Georgian Red Cross has been working to undermine one of the factors lack of awareness. It has been educating the population on HIV/AIDS prevention through a network of volunteers. Success, however, has been undermined by the uncertainly in the national society leadership in 2001 that led to scaling down of the Federation presence in the country and suspension of virtually all activities. Since 2003, with the support of the Federation and partner national societies, the Georgian Red Cross has launched a process to rebuild the organisation to address the most pressing humanitarian needs in the country. Reducing the spread of HIV/AIDS as well as stigmatisation of people living with the disease is a priority for the national society. This project will assist it to re-establish a network of trained staff and volunteers to spread information on HIV/AIDS prevention among the population with a focus on young people. Two youth centres will be set up in Tbilisi and Batumi, the capital of Ajara region, to advocate against discrimination of people living with HIV/AIDS and encourage the youth, both within and outside the organisation, to learn about the disease, change their attitudes and develop safe behaviour. 2,000 people are expected to visit the centre to receive information on the disease. Additionally, Red Cross trained staff and volunteers will conduct discussions with some 3,000 schoolchildren and university students. A number of educational materials will be developed, printed and distributed too. To reach larger groups, the national society will also set up a mobile team of five. The team will be based in Tbilisi and in cooperation with the Georgian AIDS and Clinical Immunology Centre will visit various communities to discuss the factors that put them at risk of sexually transmitted illnesses and HIV/AIDS. It will distribute condoms and brochures with more information on the disease. The team is expected to reach another 2,000 people. 1.2. Problems and needs Main problem(s): Risk of rapid spread of HIV/AIDS and discrimination of people living with AIDS. Causes: Disrupted health care system and limited public access to services. 1 Source: World Bank HIV/AIDS in Georgia. Addressing the Crisis 5

Poor surveillance and reporting. Lack of awareness among young people of HIV/AIDS prevention. Lack of adequate promotional and educational materials. Prolonged socio-economic crisis and widespread poverty. Misconceptions/cultural beliefs on safe sex. Low demand on condoms. Effects Increased number of people infected by HIV/AIDS. Discrimination of people living with HIV/AIDS. Unsafe sexual behaviour increasing vulnerability to the disease. 6

1.3. Stakeholders International Federation Red Cross Society of Georgia Georgian AIDS and Clinical Immunology Research Centre Interaction Potential Interests Problems Stakeholders Rapid spread of HIV/AIDS. Increased stigmatisation and discrimination of people living with HIV/AIDS. Limited capacity of the national society to respond to the growing crises. Reduce the spread of HIV/AIDS and discriminating of people living with the disease. Strengthen national society capacities to respond to the growing crises. Help the national society improve image as a key partner of the government in fight against HIV/AIDS. Commitment to support the Georgian Red Cross to re-establish its institutional capacity to promote healthy lifestyle and fight against discrimination of people living with HIV/AIDS. Access to international resources and global network. The Federation, through its delegations in Tbilisi and Ankara, will: work closely with the Georgian Red Cross to help it improve services to vulnerable people through effective volunteer management and youth structure. promote the national society efforts to implement awareness campaign. offer technical support. Limited capacities of the Red Cross to effectively respond to needs of the public, particularly youth and alleviate their suffering;. Strengthen the capacity of the national society to reduce the spread of HIV/AIDS and advocate for tolerance and co-existence in the communities. Knowledge and experience. Human resources and branch network. Willingness to cooperate with NGOs and Movement components. Links with local communities to mobilise volunteers. Red Cross Society of Georgia will be directly responsible for project implementation, monitoring and evaluation. It will cooperate closely with governmental and non-governmental organisations working on HIV/AIDS related issues. Increased risk of discrimination of people living with AIDS. Low access of infected people to treatment. Poor cooperation with NGOs involved in reducing the population s vulnerability to HIV/AIDS Share knowledge and experience with other actors working to increase HIV/AIDS awareness, public education and fight against discrimination. Prevent the spread of HIV/AIDS. Contribute to Red Cross efforts in promoting healthy lifestyle by sharing knowledge and experience as well as relevant materials. The AIDS and Clinical Immunology Research Centre will offer the Red Cross access to research analysis and statistics. It will assist the national society to facilitate public awareness activities, including workshops. 7

Target group Young people People living with HIV/AIDS Problems Interests Potential Interaction Lack of information on sexually transmitted diseases and HIV/AIDS. Unemployment. Migration to foreign countries to find employment opportunities and better life. Lack of HIV/AIDS information centres in regions and districts. Avoid the risk of HIV/AIDS infection. Access information on HIV/AIDS and sexually transmitted diseases, as well as generally on healthy life style. Socio-economic stability. Decrease the spread of HIV/AIDS and sexually transmitted diseases. Willingness to receive and share new information. Promote respect to human dignity. Motivation to participate in Red Cross efforts to fight against stigma and discrimination. Young people will participate in Red Cross activities to disseminate information on HIV/AIDS and STD. Widespread poverty. Poor access to health services. Low public awareness on stigma and discrimination of people living with HIV/AIDS. Lack of public education on HIV/AIDS transmission. Increase community awareness on HIV/AIDS transmission as well as discrimination of people living with the disease. Access health services. Change attitudes and behaviour of communities towards people living with the disease. Willingness to contribute towards community education in HIV/AIDS and efforts to fight against discrimination. The People infected with HIV/AIDS will support Red Cross efforts to fight stigma and discrimination. 8

1.4. Internal analysis of the Red Cross Society of Georgia Internal Strengths A countrywide network of branches at local and regional levels though varied in their level of capabilities and resources. Commitment of the Red Cross leadership to ensure effective services to vulnerable people by strengthening a volunteer network and institutional capacities. Access to education materials. Weaknesses Lack of trained volunteers in prevention of HIV/AIDS and sexually transmitted diseases. Absence of appropriate policies and procedures in HIV/AIDS prevention. Lack of peer educators. Lack of financial and technical resources. External Opportunities Increased support from the Federation and sister national societies. Access to the Federation s training materials, information and resources on HIV/AIDS prevention, stigma and discrimination. Better co-ordination with the UN, NGOs, international and national agencies. Threats Lack of funding: dependency on external support. Fluid political situation. 2. Programme goal: Health of vulnerable people has improved. Indicators: Capacities of selected communities have strengthened. The number of vulnerable people in target communities has reduced Morbidity and mortality has reduced. Living conditions of people in need have improved. Verification sources: Georgian Red Cross monitoring reports. Feedback from beneficiaries. State statistics and reports on humanitarian situation in Georgia. UN agencies reports and assessments results. Other NGO reports. 3. Programme objective: Georgian Red Cross has strengthened capacity to improve health of vulnerable people. Indicators: The Georgian Red Cross meets the characteristics of a well-functioning national society. It has strong branches delivering sustainable, focused and responsive assistance to vulnerable people. It is accountable to its beneficiaries and partners, and has active, trained volunteers across the country providing volunteer services and participating in the national society governance. Verification sources: National Society programme progress and final reports. Self-assessment reports. Federation monitoring & evaluation reports. Data on volunteers. Community development reviews. 9

4. Project objective: The spread of HIV/AIDS as well as discrimination of people living with the disease has reduced by increasing awareness of the communities, particularly young people, via Red Cross promotion and education campaigns. Indicators: By the end of 2005: The Red Cross has established two youth centres in Batumi and Tbilisi to advocate against discrimination of people living with HIV/AIDS and encourage the youth to learn about the disease, change their attitudes and develop safe behaviour. The national society has three trained staff in each centre and a mobile team of five staff and volunteers spreading information on HIV/AIDS prevention among the youth and public at large. An estimated 2,000 people visited the centre to receive information on the disease. Another 2,000 people have been reached by a Red Cross mobile awareness team in Tbilisi. 3,000 young people have received information on the HIV/AIDS prevention through discussions organised by Red Cross peer educators. The Red Cross actively cooperates with the Georgian AIDS and Clinical Immunology Centre. Verification sources: Red Cross annual report. Red Cross mobile team and youth centre activity records. Reports from the Georgian AIDS and Clinical Immunology Research Centre. Government statistics. 5. Project expected results 5.1. Project expected result 1. The Red Cross has established two youth centres and built a network of trained staff and volunteers to spread information on HIV/AIDS prevention and advocate against discrimination of people living with the disease. Indicators: By the end of 2005, the Red Cross has: established two youth centres in Tbilisi and Batumi. trained two staff members in each centre on HIV/AIDS prevention to respond to inquiries from the public as well as their colleagues. trained one staff member in each youth centre as peer educators to work with young people. An estimated 2,000 people visited the centre to receive information on the disease. Verification sources: Red Cross project progress and monitoring reports. Reports from the youth centres. Feedback from beneficiaries. 5.2. Project expected result 2. Some 3,000 young people have increased awareness on HIV/AIDS prevention through Red Cross peer education efforts. 10

Indicators: By the end of 2005, 3,000 young people have attended discussions organised by Red Cross peer educators and received condoms as well as educational and promotional materials such as brochures, posters and t- shirts with messages on HIV/AIDS and stigma associated with the disease. Verification sources: Red Cross workshop records. Federation monitoring reports. 5.3. Project expected result 3. The Red Cross has established a mobile team to out-reach another 2,000 people in local communities and help them reduce the risks of HIV/AIDS. Indicators: By the end of 205, the Red Cross has established a mobile team of five staff and volunteers. The team has visited local communities (an estimated 2,000 people) to talk about the disease prevention and stigmatisation of people living with HIV/AIDS. It distributed thousands of information materials and condoms to target groups. Verification sources: Red Cross project progress and monitoring reports. Mobile team activity reports. Feedback from beneficiaries. 6. Activities: 6.1. Activities to achieve programme expected result 1 1.1. Identify premises for the youth centres in Tbilisi and Batumi. 1.2. Renovate the premises and equip the centres with basic furniture and equipment. 1.3. Assign staff to manage the centres. 1.4. Train two Red Cross staff members on HIV/ AIDS prevention to respond to inquires from the public as well as their colleagues from the youth centres. 1.5. Train another staff member in each centre as peer educators to work with young people. 6.2. Activities to achieve programme expected result 2. 2.1. Red Cross peer educators will organise discussions on sexually transmitted illnesses and HIV/AIDS prevention as well as the stigma associated with it with some 3,000 schoolchildren and university students. 2.2. Develop, print and distribute educational and promotional materials such as brochures, posters and t- shirts with messages on HIV/AIDS and stigma associated with the disease. 2.3. Procure and distribute 10,000 condoms to young people. 6.3. Activities to achieve programme expected result 3. 3.1. Establish a Red Cross mobile team in Tbilisi. 3.2. Assign a vehicle, equipment and staff/volunteers to the team. 3.3. In cooperation with the Georgian AIDS and Clinical Immunology Centre, organise trips to local communities to talk about the disease prevention and stigmatisation of people living with HIV/AIDS, and distribute information materials as well as condoms. 11

7. Timetable for 2005. Activities January February March April May June July August September October November December Project expected result 1. 1.1. Identify premises for the youth centres in Tbilisi and Batumi. x x 1.2. Renovate the premises and equip the centres with basic furniture and equipment. x x 1.3. Assign staff to manage the centres. x x 1.4. Train two Red Cross staff members on HIV/AIDS prevention to respond to inquires from the public as well as their colleagues from the x youth centres. 1.5. Train another staff member in each centre as peer educators to work with young people. x Project expected result 2. 2.1. Red Cross peer educators will organise discussions on sexually transmitted illnesses and HIV/AIDS prevention as well as the stigma x x x x x x x x x associated with it with some 3 2.2. Develop x x x x x x x x x 2.3. Procure and distribute 10 Project expected result 3. 3.1. Establish a Red Cross mobile team in Tbilisi. x 3.2. Assign a vehicle, equipment and staff/volunteers to the team. x x 3.3. In cooperation with the Georgian AIDS and Clinical Immunology Centre, organise trips to local communities to talk about the disease prevention and stigmatisation of people living with HIV/AIDS, and distribute information materials as well as condoms. x x x x x x x x x x x x x x x x x x 8. Monitoring and Evaluation Monitoring of the project implementation will be carried out by a group of Georgian Red Cross and Federation staff. The group will: pay regular visits to the targeted regions/youth centres; analyse statistics received from youth centres, Red Cross branches and the mobile awareness team. Conduct beneficiary interviews to measure the impact of conduct of discussions and workshops. The national society headquarters staff will supervise the project implementation. 12

9. Precondition Red Cross leadership remains committed to re-engage the national society in HIV/AIDS education. The project receives adequate support through the Federation appeal and/or from partner national societies. 10. Risks/assumptions Lack of commitment from donors to support the project. Lack of cooperation from communities considering cultural and religious barriers. Unexpected political changes in the country. 11. Sustainability The capacity of the Red Cross Society of Georgia to develop a strong and sustainable health care system, including activities to reduce vulnerability to HIV/AIDS, is poor and demands support. What is realistic to achieve by the end of 2005 is to help the national society it train staff and volunteers and build trust and links with the community, particularly youth. Once the trust is built, there is a potential to increase the contribution of the key local stakeholders to the Red Cross work and reduce the organisation s dependency on international support. 13