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European Journal of Medical Research - Deutsche AIDS ...

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June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH<br />

47<br />

A.55 (Vortrag)<br />

Children and young people living or working on<br />

the streets: the missing face <strong>of</strong> the HIV epidemic in<br />

Ukraine. A research report published by UNICEF<br />

Ukraine and <strong>AIDS</strong> Foundation East-West<br />

(November 2006)<br />

Teltschik A. 1<br />

1 Free-lance public health consultant (Eastern Europe &<br />

Central Asia), Odessa, Ukraine<br />

Objectives:<br />

1. To close an existing gap in research and to systematically<br />

assess and present:<br />

a) Needs and demands <strong>of</strong> the target group;<br />

b) Rights violations;<br />

c) National policy and legal frameworks;<br />

d) Available resources;<br />

e) Service quality and levels <strong>of</strong> coordination and cooperation.<br />

2. To provide recommendations and to guide the design, implementation<br />

and evaluation <strong>of</strong> an extended, comprehensive<br />

and multisectoral national response to prevention, treatment,<br />

care and support for this target group.<br />

Methods: A comprehensive situation and comparative analysis<br />

and a quantitative and qualitative survey among 650 children<br />

and young people living or working on the streets in<br />

Kiev and Odessa.<br />

Results:<br />

1. The phenomenon <strong>of</strong> children and young people living or<br />

working on the streets has been steadily increasing over the<br />

past 16 years in Ukraine.<br />

2. Most children run away from home, because <strong>of</strong> a dysfunctional<br />

family, abuse and the fact that there is no adequate social<br />

support system in place to address the problems at home<br />

and to prevent them from running away.<br />

3. But once the children and young people are living or working<br />

on the streets, their needs are also not being adequately<br />

met.<br />

Key research findings:<br />

a) This is a group most likely to be exposed to violence,<br />

abuse, discrimination, exploitation, HIV and many other diseases.<br />

b) They have a poor health status, very low education levels<br />

and their rights are being seriously violated.<br />

c) The majority are engaging in risk behaviour.<br />

d) They lack protection, as well as the means, skills, knowledge<br />

etc. to protect themselves.<br />

e) The services provided to them are <strong>of</strong> low quality.<br />

f) There is a lack <strong>of</strong> <strong>of</strong>ficial, standardized and reliable data.<br />

Conclusions: The target group represents only the ´tip <strong>of</strong> the<br />

iceberg´. ´Below the water´ is a large and growing number <strong>of</strong><br />

vulnerable children and young people in Ukraine, who are<br />

also most-at-risk and most affected by the HIV epidemic, and<br />

should therefore be at the centre <strong>of</strong> policy-making. The research<br />

report provides detailed recommendations to the<br />

Ukrainian government in key strategic areas on how to extend<br />

and improve the national response based on the experience<br />

gained in addressing the HIV epidemic over the past years in<br />

the country.<br />

A.56 (Poster)<br />

Knowledge, attitudes and behaviour in regard to<br />

HIV and STI among MSM in Austria, Slovak<br />

Republic, Italy and Slovenia – a BORDERNET<br />

cross border survey<br />

Amort F. 1 , Steffan E. 2 , Sokolowski S. 2 , Schnitzer S. 2<br />

1 <strong>AIDS</strong>-Hilfe Wien, Prävention, Wien, Austria, 2 SPI Forschung<br />

gGmbH, Berlin, Germany<br />

Objectives: BORDERNET (EU funded) aims to enhance<br />

HIV/<strong>AIDS</strong> and STI-prevention, diagnostic and therapy in regions<br />

across the old and the current EC-outer borders. In<br />

Western Europe in general over one third (35%) <strong>of</strong> the HIV<br />

infection diagnosed in 2005 occurred through sex between<br />

men. The epidemics range in Central Europe remains still<br />

small in comparison, but also here sexual contacts between<br />

MSM are an important source <strong>of</strong> infection.<br />

Methods: Two BORDERNET model regions (MR 3 – Austria/Slovakia,<br />

MR 4 – Italy/Slovenia) decided to make MSM<br />

to one <strong>of</strong> their target groups for a BORDERNET KAB survey<br />

with additional questions on mobility. Based on preliminary<br />

defined selection criteria <strong>of</strong> gay friendly venues, a total number<br />

<strong>of</strong> 371 MSM was questionned with a self-administration<br />

questionnaire.<br />

Results: In regard to cross border mobility, the MSM respondents<br />

from Slovenia and Slovakia are the most frequent travellers<br />

to the neighbouring countries, whereas the Austrian<br />

men are moderate travellers and the Italian travel even more<br />

seldom. Leisure time is the most important reason for travelling<br />

across the borders.<br />

Even though the respondents showed a very high basic<br />

knowledge <strong>of</strong> HIV/<strong>AIDS</strong>, there are also many insecurities as<br />

well as fears to get infected with HIV. A high percentage <strong>of</strong><br />

MSM have been tested for HIV (Austria: more than 90%),<br />

and a high proportion <strong>of</strong> them stated to have received pre- and<br />

post test counselling.<br />

Concerning condom use, different patterns <strong>of</strong> risk management,<br />

such as consequent safe sex, being faithful, decrease <strong>of</strong><br />

number <strong>of</strong> partners, serosorting, seropositioning and avoidance<br />

<strong>of</strong> risky venues could be identified in all countries. More<br />

risky behaviour was stated with steady partners than with casual<br />

ones. Over 20% <strong>of</strong> the men reported an STI diagnosis in<br />

the last two years, Italian MSM showed the highest incidence<br />

here.<br />

Discussion: A main challenge <strong>of</strong> the combined HIV and STI<br />

prevention among MSM is to handle the consequences <strong>of</strong> the<br />

“normalisation” process <strong>of</strong> HIV. Cross border prevention<br />

strategies for MSM might be a possibility to reach synergetic<br />

effects and should particularly focus on irrational fears and<br />

risk management strategies and help to overcome still existing<br />

prejudices and misconceptions.<br />

A.57 (Poster)<br />

Ansatz der Bewertung einer HIV-Infektion bzw.<br />

<strong>AIDS</strong>-Erkrankung in Österreich, 2006<br />

Schröck T. 1<br />

1 Donauuniversität Krems, Wien, Austria<br />

Fragestellung: Behandlungskosten von HIV bzw. <strong>AIDS</strong><br />

waren in Österreich bislang unbekannt. Daher wurde im Vorfeld<br />

der Studie beschlossen, den Ansatz einer Bewertung<br />

vorzunehmen.

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