Background:
The NGO Labyrinth was founded in June 2002. The main goal of Labyrinth is the prevention and the treatment of drug addiction in Kosovo. From 2002 through 2004, Labyrinth has offered services including: counseling for families, individuals, and other NGOs; psychiatric services (i.e. diagnosis, psycho- pharmacotherapy, clinical interventions); Individual, group and family psychotherapy; rapid drug testing, and psychosocial training for NGOs and the government. Furthermore, Labyrinth has also cooperated with the Institute of Public Health; HIV/AIDS Office within the Ministry of Health; youth Centres; Ministry of Education, Science and Technology; and the US Office in Prishtina.

Project title:
Preventing HIV, Hepatitis B and Hepatitis C among prisoners in Kosovo

Duration:
January 10, 2008 - January 9, 2009

Target groups:
Prisoners

Budget:
€ 13,100 Fondation PH Suisse’s contribution
€ 5,580 Labyrinth’s contribution
€ 3,900 Correctional Service System/Health system
Total: € 22,580

Baseline information:
The Kosovar penal system includes two prisons and five detention centres with 1,500 prisoners. In these prisons, health care is available for prisoners, who are considered at-risk. However, there is no routine evaluation or screening for STIs, TB or HIV. Condoms are not available within the prison, and information on sexual practices of inmates and sexual health care do not exist.

According to a study completed by the Department of Health, 5% of inmates were addicted to drugs, mainly heroine in 2006. So far, no interventions to prevent STI/HIV transmission in prisons have been undertaken, despite the fact that it is well-known that prisons play an important role in the transmission of HIV to the general population.

In January 2008, Labyrinth launched a new project with support from the Trust Fund of the Western Balkans HIV and AIDS Programme to increase knowledge on HIV transmission and prevention among prisoners and also to advocate for STI/HIV/AIDS services and substance abuse treatment in prisons. This was achieved by initiating coordination between the Ministry of Health and the Penal System management to study possibilities of providing STI/HIV services (including VCT services) in the prison system.

Results:
The project started with the implementation of a KAP survey, the first of its kind in the prison system in Kosovo. The training included prevention against HIV, Hepatitis B and Hepatitis C and also living with PLHIV.
In the next phase of the project, staff was trained in VCCT. In the later months, IEC materials were produced. Prisoners were being provided with condoms for visits and home leave, and condoms were also given to those who had completed their sentence.

Centre for Social Group Development (CSGD)

Background:
Because of strong societal attitudes, with substantial stigmatization, homophobia and denial of the existence of people with different sexual orientation, men having sex with men (MSM) are marginalized in all sectors of life in Kosovo. To change this situation, CSGD was established and began its activities in 2002. Early on, from June until August 2003, CGSD worked with PSI and conducted the first study of its kind on examining the level of knowledge about HIV, AIDS, STIs, and risk behaviour among MSM. CGSD also worked with IOM on a project entitled “HIV/AIDS National Capacity Building and Awareness Raising Activities in Macedonia and Kosovo.” In 2004, CSGD was granted a project by the Olof Palme International Centre, which included some small elements of HIV and AIDS prevention. From 2004 to 2005 CSGD implemented the project “Prevention of HIV and AIDS among MSM in Kosovo” with the support of Fondation PH Suisse. The purpose of the project was to lower HIV infection risks among MSM by increasing their awareness, changing their sexual behaviour and promoting the use of condoms and lubricant.

Project title:
VCCT Center for MSM in Kosovo

Duration:
December 15, 2007- November 15, 2008

Target groups:
Men who have Sex with Men community

Budget:
          € 15,000 Fondation PH Suisse contribution
          € 20,780 CSGD contribution:
Total: € 35,780

Baseline information:
The Kosovar health care institutions do not provide access to health services for homosexual communities, and they are left without medical and health treatment, only because of their sexual orientation. Given the realities of the HIV epidemics and the very few reported cases in Kosova, CSGD assumed that there was a very high possibility of a larger number of cases. Due to stigmatization and homophobia, MSM in Kosova do not regularly get tested for HIV, and therefore no one knows the number of HIV cases among MSM. Findings from studies conducted in Kosovo reveal the existence of several factors that can rapidly increase the spread of HIV infection and other STIs through MSM. These include foremost low levels of knowledge and risk perception, low condom and lubricant use, high rates of partner change, and low rates of HIV testing among MSM, etc.

Results:
The aim of this project was to lower the risk of HIV infection among MSM, increase their awareness about HIV and encourage MSM to undertake HIV counseling and testing. Condom and lubricant use was also promoted. A high priority was the continuing operation of an already established VCCT center specifically for MSM for testing and prevention education. Since outreach activities link the target group with the VCCT center, outreach was an essential component of this project.

During outreach, peer educators provided counseling and promotion of testing for HIV, and education about HIV, and they distributed safer sex kits at the locations where MSM usually gather. This kit included condoms, lubricant, information about HIV and the VCCT center and highlighted the importance of being counseled and tested for HIV. By the end of the project, 216 MSM were reached, 2100 condoms and lubricants distributed and 124 MSM were counseled and tested for HIV (see table below). From the total of the 124 who were counseled and tested for HIV, two were found HIV positive, 154 (61.6%) of them had visited the VCCT for the first time and 96 (38.4%) have revisited the VCCT

Organization against alcoholism, narcotics, smoking and AIDS (Anti DANS) 

 Background:

Anti–DANS was founded in Prishtina in 1999 and its mission is to better the health behavior of the Kosovar population regarding the phenomena of alcoholism, smoking, drugs and AIDS. Their main activities are promoting preventive activities, organizing trainings seminars and cooperating with other organizations and institutions dealing with above mentioned subjects. Anti–DANS staff is regarded to be the only professional staff in Kosovo for counseling and testing for HIV/AIDS. Anti–DANS has implemented various projects on HIV/AIDS and has worked in partnership with the Ministry of Education, science and Technology, the Kosovo AIDS Committee, the World Health Organization (WHO), Health Education Group, Kosovo Municipality Association, Kosovo Family Planning Association, and Infective Clinic and Psychiatric Clinic of the University of Prishtina. Anti-DANS has received funding from Kosovo Foundation for Civil Society, the European Union, Soros Office in Kosovo, UNDP Kosovo, Assembly of Prishtina, Assembly of Obiliq and Assembly of Gjakova.

Project title:

Voluntary Counseling and Testing Centre of HIV/AIDS

Start Date:

December 1, 2004

Anticipated duration of project:

November 30, 2005

Target groups:

VCT Activities for high risk groups (such as youth, commercial sex workers, clients of commercial sex workers, homosexual and bisexual and drug users) as well as those in the general population who wish to be tested and counseled

Budget: 

Project HOPE: €33.833.60

Anti - DANS contribution €5.975

Total: €39,885.60

Baseline information:

Out of 58 reported cases with HIV/AIDS identified until now, 12 were identified during 2001. One of those cases is a family infected (child born infected from her mother). The problem of the abuse of narcotics and HIV infection are two most worrying problems present in the post war Kosovar society. The only services for counseling and testing HIV are located in Prishtina (at the private and institutional level) and in the institutional level in Ferizaj. From six hundred (600) clients of VCT in clinic of infection diseases that were consulted and tested for HIV virus, 60% were from other regions and 40% from Prishtina. Such figures indicate that needs for opening such services in other regions of Kosovo is evident, where 56% of the clients are young people. The towns which are covered with the piloting project of VCT are Prizren, Gjilan and Peja which are near to Kosovar borders and are the most affected places of drug abuse by youth.

Results to-date:

Anti-DANS and MoH agreed and signed the Memorandum of Understanding which includes responsibilities for the activities that have to be implemented in three regions: Gjilan, Prizren and Peja. Before opening the VCTC in Gjilan, Anti-DANS met the representatives of the Regional Office of the Institute of Public Health in Gjilan and they made an agreement that the physicians from this office may observe the activities in the VCTC. In the meetings with the representatives of the Public Health Institute in Ferizaj and Prizren, Anti – DANS representatives discussed the need for additional of I.P.H. local medical staff for trainings on the VCT. I.P.H. medical staff in two centres supported this idea saying that they will participate on the trainings, because they do need refreshment of their knowledge of VCTC on HIV/AIDS.

The Pilot VCTC in Gjilan was launched on February 2005 in close cooperation with the Institute of Public Health, and there were 2 counselors in the VCTC working there. There were 46 clients counselled and tested on HIV/AIDS, during 2 months of piloting, none of them was positive on HIV test.

The Pilot VCTC in Prizren was launched on April 2005, and there were 38 clients (most of them young people) counselled and tested on HIV until end of May 2005. All of the tested clients were negative on HIV test.

The Pilot VCTC in Peja was launched on June 2005. During two months period the VCTC was visited by 44 clients, and all of them were negative on HIV test.

A big contribution to the success of the piloting VCCTs was given by the local media such as: TV Man and Radio Energy in Gjilan; TV Opinion, Radio Helix and Radio Prizreni in Prizren; TV Dugagjini and Radio Peja in Peja; as well as country media such as: RTK, TV 21, Radio Kosova. Also, the daily newspapers had written many articles about pilot VCTC on HIV/AIDS on time when they were operating in respective regions such as: “Lajm”, “Zëri” and “Kosova sot”. In total there were 3148 radio and TV advertisements.

A questionnaire was developed for the survey of youth on their knowledge for awareness and general information on HIV/AIDS and the need for establishing the VCTC in their cities respectively. The questionnaire was developed in closed cooperation with the office for HIV/AIDS in Ministry of Health and F.P.H. H.I.S. From the beginning the questionnaire was tested by a group of youth, the necessary supplementary was made and the survey had started on February 2005 initially in Gjilan. More than 900 questionnaires are filled by youth in regions of Gjilan, Peja and Prizren.

Based on the youth needs and recommendations that come during the survey regarding the publication and distribution of an informative leaflet, Anti-DANS with the permission of the F.P.H., has published a leaflet about the Piloting VCTC and it was distributed to the most frequently coffee-shops and other frequent places. In total 1500 leaflets were distributed.

As foreseen refreshment training for VCT was organized by Anti-DANS in Prishtina on dates 23-26 of November in the Clinic for Infection Diseases in Prishtina. There were participated 13 participants from the I.P.H. of Prizren, NGOs from Prishtina, I.P.H. from Ferizaj and Gjilan.

Non-anticipated benefits (co-financing, new partnerships etc.): N/A

Centre for Social Group Development (CSGD)

 Background:

Based on the society that CSGD lives in, with lots of stigmatization, homophobia and denial of the existence of people with different sexual orientation, homosexuals are marginalized in all fields of life in Kosovo. Based on these findings, CSGD began their activities in 2002, in order to change the situation. CGSD worked with PSI from June until August 2003 and conducted the first study of its kind on examining the level of knowledge about HIV/AIDS and other STIs and risk behaviour among MSM. CGSD also worked with IOM on a project entitled “HIV/AIDS National Capacity Building and Awareness Raising Activities in Macedonia and Kosovo.” In 2004, CSGD was granted a project by the Olof Palme International Centre, which included some small elements of HIV/AIDS prevention.

Project title:

Prevention of HIV/AIDS within MSM in Kosovo

Start Date:

December 1, 2004

Anticipated duration of project:

November 30, 2005

Target groups:

MSM

Budget:

Project HOPE: €26,642

CSGD contribution: €1,200

Total: €27,842

Baseline information:

The Kosovar health care institutions do not offer health care access for homosexual communities and they are left without medical and health treatment, only because of their sexual orientation. Considering HIV/AIDS as a pandemic infection, and since there are very few official cases in Kosova, CSGD considers that the figures are not real and there is a very high possibility to a larger number of cases. Due to stigmatization and homophobia, MSM in Kosova do not regularly get HIV testing, and therefore no one knows the number of HIV cases among MSM. Figures from the studies done in Kosovo reveal a combination of several factors that have the potential for the rapid spread of HIV/AIDS and other STIs through MSM. These include low levels of knowledge and risk perception, low condom and lube usage, high rates of partner change and low rates of HIV test among MSM etc.

Results to-date:

The aim of this project was to lower the risk of HIV/AIDS infection among MSM, Increasing the awareness, changing sexual behaviour and usage of condom and lube as prevention mechanisms were also high priorities. Activities of this project included trainings, research, workshops, and focal discussion groups.

CSGD developed the questionnaire of 30 questions for further analysis of knowledge about HIV/AIDS, perception of condom and lube use, sexual behaviour, and HIV testing. The survey was implemented in several cities of Kosova (including rural areas of these cities). The overall number of interviewees was 200. At the end the report of the survey was published and distributed to relevant institutions and organizations such are: Partnerships in Health, Kosova AIDS committee, Ministry of Health, and other NGOs in Kosova who deal with HIV/AIDS.

Training for peer educators – a group of 17 persons (15 participants and 2 trainers) attended training for trainers. The same persons of 15 participants were trained in three modules and covered topics listed below:

• Basic HIV/AIDS knowledge
• Safer sex
• Risk behaviours

Each module lasted three days. The training was conducted by CSGD trained activists. These peer educators who attended the trainings continued the outreach, workshop, discussion groups and other activities with MSM starting from July 2005 until the end of November when project was finished.

During the project CSGD developed printing educational materials (brochures and leaflets). The materials were developed from CSGD staff. The outcome of the peer educators training resulted with ideas for the printing materials as well; in this case the brochure for basic information about STIs was developed and published.

Starting from July workshops on basic knowledge about HIV/AIDS were organized from peer educators, which were followed by workshops for safer sex and later on for risky behaviours.

Purchase of quality condoms and water-based lubricants was realized in August and immediately started distribution of them to MSM community in outreach activities, workshops and other gatherings of MSM persons.

Small groups of 10 to 15 people discussed about HIV testing, the importance of it, and what kind of testing are available in Kosova. CSGD facilitated each person who was ready to do HIV testing by supporting them socially and materially. CSGD had an agreement with private laboratory “BIOTICUS” and paid 15 Euros for each test that was undertaken.

Background:

The NGO Labyrinth was founded in June 2002. The main goal of Labyrinth is the prevention and the treatment of drug addiction in Kosovo. From 2002 through 2004, Labyrinth has offered services including: Counselling for: families, individuals, different NGOs; Psychiatric services, i.e. diagnosis, psycho pharmacotherapy, clinical interventions; Individual, group and family psychotherapy; Rapid drug testing and Psychosocial training for NGOs and GOs. During the two years of Labyrinth’s existence, 345 clients have benefited from the above mentioned services. Out of the 345 who visited our organization, 248 were drug users, 219 were heroin abusers and 98 were IDUs. Labyrinth has implemented the following projects: Psychosocial Training of Social workers – Correctional Service; Psychosocial Training of Probation Service staff; and Prevention of substance abuse and HIV/AIDS among high school pupils. In addition, Labyrinth has cooperated the Institute of Public Health, HIV/AIDS Office within the Ministry of Health, Youth Centres, Ministry of Education, Science and Technology and the US Office in Prishtina.

Project title:

Prevention of HIV/AIDS and Hepatitis B, C among IDUs.

Start Date:

December 1, 2004

Anticipated duration of project:

December 31, 2005

Target groups:

IDUs

Budget:

Project HOPE: €33,579.00

Labyrinth’s contribution:  €1,637.50

Total: €35,216.50

Baseline information:

Young adults in Prishtina reported using a range of drugs, some such as cannabis (29.5%), MDMA ecstasy (11.6%), heroin (7.0%) and cocaine (7.0%) at relatively high levels. A report made in January 2000 stated that 11.6% of young people interviewed in Prishtina have experimented with heroin. In addition, the population of drug users falls in the category of people who are at risk for developing sexual transmitted diseases especially those who are IDUs. In addition, very few IDUs have been tested for HIV/AIDS as they do not prefer to visit the available VCTs in public institutions. Labyrinth is one of two only NGOs who work with IDUs in Kosovo 

Results to-date:

Considering the drug abuse problem in Kosovo and its consequences for the future, NGO Labyrinth has taken an initiative to develop a preventive program. There are obvious indicators that a new generation of young people is engaging in risky behaviours with drugs, and more and more drug users are experimenting with injecting. These young people mostly coming from suburbs of the cities lack the appropriate information and services for help and counselling. The main aim was to develop a program, which will work with a population of IDUs, a high-risk population for contacting and transmitting HIV/AIDS, Hepatitis B and hepatitis C.  Also, build up a program that would be a more partnerships oriented and that will provide friendly services to IDUs.

In the general overview it could be said that the project has been implemented very successfully. This statement is supported by the number of IDUs reached through the project, the services provided and the feedback received from.

CPC - Kosovo highlights that for the staff of Labyrinth and also for IDUs the main achievement of this project has been the establishment of the VCCT centre for IDUs outside of the governmental public services. The IDU’ have been provided with a confidential, anonymous and free of charge counselling and testing on the last 10 months.

Also another huge achievement is that project has met its target group. IDUs have gained the trust in the services offered through this project. IDUs visited Labyrinth VCCT centre at the beginning with a doubts and questions, and as the project went on, more and more IDUs came for counselling and testing.

Another important achievement is the IEC materials that have been developed exclusively for IDUs and also very good relationship has been established with governmental and nongovernmental organizations throughout the project accomplishment.

The goal of the project is to decrease the transmission of HIV and hepatitis among intravenous drug users in Kosovo through specific activities. Project objectives were: to reduce risk behaviour among IDUs and stimulate use of clean needles and syringes, as well as contraceptives, to stimulate IDUs to be tested for HIV/AIDS and hepatitis, and encourage IDUs to seek treatment for their drug addiction.

Non-anticipated benefits (co-financing, new partnerships etc.): N/A