Background:
In January 2005 CAZAS established a Center for psycho-social support and assistance to PLHIV – People Living with HIV and AIDS. This Center operates within CAZAS’ premises in Podgorica. CAZAS AIDS info telephone service started in November 2003 as part of this Center.

This particular project seeks to strengthen capacities of PLHIV and provide psychosocial support to PLHIV, members of their families, friends and partners. Fight against stigma and discrimination represents one of the main activities that CAZAS has been conducting in the last few years.

Project title:
Strengthening capacities of PLHIV in Montenegro

Duration:
15th February 2009 - May 2010

Target group:
PLHIV, members of their families and friends

Budget:
Total 46.119 euro
FPH 29,594 - Co financing contribution 16,525 euro (GFATM 3,750 euro, Hivos 8,775 euro, CAZAS 4,000 euro)

Baseline information:
Area of activities:

1. Psychosocial support to PLHIV
2. Building PLHIV capacities in self-support network
3. Creating supportive environment to enable PLHIV active involvement in HIV related work in Montenegro

Results achieved to-date and conclusions:

1. 1st survey of 11 PLHIV finalised
2. 2nd survey of PLHIV commenced but not completed
3. 3rd survey of 26 health workers finalized

This kind of survey whilst very good, should be given a longer time period for completion. PLHIV participants found it hard to reveal personal information, particularly with regard to stigma and discrimination, and recollection of shameful situations is too painfull. However, three PLHIV engaged in all three surveys were encouraged to become involved in the HIV/AIDS research work.

• Training for 13 PLHIV and 6 CAZAS staff

To sum up, this training, the first of its kind, was a successful first step in educating the PLHIV on their rights and possibilities for them to get involved in fight against stigma and discrimination activities, but it was not without its challenges. It was quite hard to motivate PLHIV to attend the training - 5 of those who did not want to come told us that they did not want to be in a room with some of the persons they supposed will be present. Stigma and discrimination among themselves was very strong, as well as fear from the unknown. Also, approximately 25 PLHIV were not interested in any kind of involvement in the training or for the surveys. One of the training goals was to explore the possibility of organizing the PLHIV in a team working within a NGO on HIV prevention and fight against stigma and discrimination issues, unfortunately we found that PLHIV were not interested in this.

The 6 members of CAZAS staff were trained in sensitization and obtaining necessary skills and knowledge when it comes to working with PLHIV, and on reduction of stigma and discrimination towards PLHIV.

• 22 self-support sessions held with 19 PLHIV and 21 of their families and friends. Support includes psycho-social and legal support and medical advice

The goal of these self-support sessions was to build capacities of PLHIV and empower them to take action in asserting their human rights: we have learned that this process will take more than expected, in time and encouragement.

In general, the PLHIV who came to the sessions are not proactive in this sense. The group is always very diverse, the members come from very different backgrounds and they are not coherent as a group and interested in organizing themselves in a group which could actively and independently respond to stigma and discrimination.

The project team and IDS are creating and developing all the conditions for them in this direction and we are rather positive about their joint actions. One purpose of these meetings was getting the information from PLWHA and members of their families about their current problems, getting information about their health condition and trying to joint our efforts in making the group a sort of “association of citizens” in order to step forward as a group if any kind of problem occurs. The programme also included development of the skills and gaining the knowledge in regard to the human rights issues, distribution of the relevant information from UNAIDS, WHO and other organizations.

A few of PLHIV who came to the sessions were interested in getting involved and wanted to be more engaged in CAZAS’ activities on fight against stigma and discrimination, but they were discouraged somewhat, since the rest of the group was quite negative about the consequences the of stigma and discrimination. Additional problems for them are lack of time and inadequate education and communicational skills at the moment for working actively and independently on the issue of fight against stigma and discrimination.

• 60 individual counseling and support sessions with PLHIV

These sessions were focused on individual experiences, personal issues and concrete needs. Support and help given through these sessions were psychological, social and economical. Since this was the only place and time in the country when PLHIV could get professional support and help in regard to their personal processes as a person living with HIV, they were very interested and usually came with many questions and stories they would like to share. PLHIV need to be together and share their thoughts, concerns, emotions and problems with each other. This was unique opportunity in Montenegro for them to get that opportunity.

• 4 meetings with Institute for Public Health

From the beginning of the project, CAZAS had focused on, and continuously works on, advocacy and lobby activities on the relevant institutions in order to allocate funds for the purpose of supporting the Center, which contribute to sustainable provision of professional support and care to PLHIV. The results of the meeting were official support for the work of the Center; appreciation of the efforts of CAZAS and FPH on psycho-social support and care for PLHIV and their associates; and deepened cooperation with these institutions.

• Developed, printed and distributed 1500 brochures and 200 guides for PLHIV and their families, to the VCTs, medical institutions and centers and our partners
• Developed brochure for health and social workers working with PLHIV

This material will be also distributed during the World AIDS Campaign (WAD) and during all project activities.

• 2 presentations organized for various donors, agencies and representatives of the business sector

The project team will present the project aims and try to get support from the business sector during the WAD when it is the most appealing to them to fund some of our activities.

Additional achievements:

• Sensitized and trained 15 general practitioners and nurses from five towns with skills and knowledge to work with PLHIV by reducing their stigma and discrimination towards PLHIV
• Sensitized 15 psychologists, social workers and social-work students and trained with skills and knowledge to work with PLHIV by reducing the level of stigma and discrimination towards PLHIV being present among members of these professions
• Webpage updated monthly

The CAZAS AIDS INFO telephone help line is continually being promoted and operates everyday. Evaluation of the work of the AIDS INFO line shows the majority of calls are made by younger people (15-30) enquiring for themselves or their friends, but often parents call to check the validity of information heard elsewhere. Approximately 65% of callers are females and 35% males. A significant amount of people who call are interested in test results and want to double check the results and information they have received from their doctors and counselors in the VCTs – these callers report they are “not clear, or sure about” what was told to them. From time to time, people are interested in getting tested at CAZAS since they “have more confidence in an NGO than in a public institution”.

Background:
The number of reported HIV/AIDS cases in Montenegro until 20th September 2004 was 54 of which 25 are AIDS deceased. However, the latest data (end of December 2005[1]) is that this number increased to 65. It is estimated that the real number of HIV/AIDS cases in Montenegro is between 500 and 800. Serbia and Montenegro have more registered cases than all countries in the sub region (except Romania) and with the migrations, tourism and increase in risk behaviours among young people (early unprotected sexual relations, substance abuse) have unfortunate potential for further spread of the epidemic.

The problem of stigma and discrimination is very present. In Montenegro, young adults who need accurate information about sexual health face limited options. Schools do not offer even basic sexual education classes and social/cultural norms inhibit any public or private discussion of these issues. Also, there are a lot of things related to these problems that are still not known to wider public and for that reason produce prejudices that are even more painful for PLWHA than HIV infection itself.

Start date:
20/01/2005

Anticipated duration of project:
12 months

Target Groups:
The name of our project is “Establishing a VCT Centre and Centre for psycho-social and legal help to people living with HIV/AIDS (PLWHA) in Montenegro”. Target groups of the project are general population, experts working in the field of HIV/AIDS, representatives of governmental institutions and NGOs, and vulnerable groups (young people in general, IDUs[2], MSM[3], CSW[4], sailors, etc.) when it comes to VCT Centre, and PLWHA, members of their families, friends and partners when it comes to PLWHA Centre.

Budget:
41,442 €

Baseline information:
Voluntary counselling and testing (VCT) on HIV represents an essential link between HIV prevention and HIV care and support. VCT promotes and sustains behaviour change, and links with interventions to prevent mother-to-child transmission (PMTCT), prevent sexually transmitted infections (STIs), and prevent and treat tuberculosis (TB) and other opportunistic infections (OIs). VCT also facilitates early referral to comprehensive clinical and community-based prevention, care and support services, including access to antiretroviral therapy (ART). VCT improves quality of life and plays a pivotal role in reducing stigma.

The main aim of Centre for people living with HIV/AIDS (PLWHA) is to provide psycho-social and legal help and support to these people and empower them to take action in defence of their human rights in their own hands.

Result to-date:
Within the project “Centre for Voluntary and Confidential Counselling and Testing (VCT Centre)” which is conducting in partnership with Institute for Public Health of Montenegro and CAZAS, every Monday and Tuesday at 4:00-8:00 p.m. is possible to come on counselling and testing for all interested citizens. VCT Centre is headed in the premises of IPH in Ljubljanska Street bb and is working on Mondays and Tuesdays from 16-20h. In the VCT Centre work trained medical staff that passed through several trainings from this area, so as young trainers of CAZAS. All of them have acquired necessary knowledge and skills, so as diplomas with title of “counsellor for voluntary and confidential counselling and testing” on trainings from this area organized by CAZAS and IPH.

VCT Centre marks excellent results. Since now we had approximately 80 clients of various age ranges. The cause of their visit to us was mostly their risky behaviour and unprotected sexual intercourses. All of them were referred to testing on HIV. Of these 80 persons, nobody was HIV positive. There were around 1800 calls during the past ten months (around 180 calls per month), mostly from young people aged 15–30 years. CAZAS also has a telephone line in VCT Centre and an e-mail address via which everyone who is interested in this issue can contact them. Also, distribution of printed material (brochures and posters) has proved to be very useful and necessary when it comes to promotion of VCT Centre. 7000 brochures, 1100 posters, 250 Guides and some other material were distributed. The biggest number of clients stated that they heard for VCT Centre via brochures or posters that have been distributed to public institutions (faculties, hospitals, health centres, etc.).

CAZAS organized four Trainings: training for staff of PLWHA Centre and the three trainings for staff of VCT Centre. There were 75 participants of these trainings, young people, trainers of CAZAS and medical specialist and technicians in the field of HIV prevention. Beside these trainings, IPH organized training for trainers on VCT where CAZAS had one representative, and their representative participated at training course in July 2005 on pre and post test counselling. Training was held by [5]Jim Simmons C. Psychol. AFBPsS, HIV Technical Support Officer, CAFOD. The purpose of all of these trainings was to train participants with the necessary skills for the provision of pre and post HIV test counselling with the purpose of preventing the further spread of the virus, and enabling people to access care and support in order to live positively with the effects of HIV.

Non-anticipated benefits (co-financing, new partnerships etc.):
CAZAS managed to reach larger number of people with this project than they initially predicted. They developed new partnerships with IAN and Student’s Policlinic from Belgrade, and deepened cooperation with IPH and other medical institutions in Montenegro.

[1] Data of Institute for Public Health (IPH), the Republic of Montenegro
[2] IDUs – Intravenous drug users
[3] MSM – Men having sex with men
[4] CSW – Commercial sex workers
[5] This is the full name and a title of Jim Simmons which we had to indicate in this form as it is.

Background:
The post war situation had a major impact on this region politically, economically and socially. The effects of these factors have made the current situation volatile and precarious, especially for the youth, with the increasing number of intravenous drug users (IDUs), victims of social violence and trafficking. These groups of people have become prime targets, and are at high risk of being infected with HIV/AIDS and sexually transmitted infections (STIs). In the recent years the region has experienced a growth in the spread of HIV/AIDS and other STIs. Due to the lack of reliable information it is very hard to estimate the actual number of people infected.

As it’s already known, there is a very high natality level present among Roma people. Since there is no national or community strategy for family planning they seem to have problem with rapid production, early marriage acceding, bad life conditions and lack of information about sexual transmitted diseases, as well as HIV/ AIDS. All of this indicates the need of realization of HIV/AIDS prevention program among them.

Start date:
January 2005

Anticipated duration of project:
January 2005 – May 2006

Target Groups:
Roma people – youth and families in Podgorica, Konik settlement (over 2300 beneficiaries)

Budget:
25.972 €

Baseline information:
The aim of the project is to prevent and decrees risky behaviour among target group in the context of STIs and HIV and AIDS. YCC Juventas has experience in working with Roma people as well as in the field of sexual and reproductive health and rights.
This Project focuses on Roma people’s needs. Throughout this Project they have a chance to have different experiences and to talk about their own.

Result to-date:
Created a team for realization of Project activities – within the YCC Juventas and Partner organization. Press Conferences – 2 organized, both with involvement of PH representatives. Press clipping available.
Research implemented – questioners, interviews and focus groups according to Project plan with slight moving in dates. Hard copy of the results is available.
Brochure developed and designed in 3 languages, as well as condom packages with notes about usage.
Website up-dated during the Project.
One TV Show broadcasted on IN TV – very popular TV station in Montenegro in best timing and as part of most popular regular show.
The first and the second phase of education of Roma educators carried out.
Handbook for Roma educators completed.

Non-anticipated benefits (co-financing, new partnerships etc.):
Medias show great interest for Project.
Good cooperation with relevant public and government institution.
Linkage with other projects implemented by our organization.