Eurasian Harm Reduction Association (EHRA) just published the case study “The Challenges of Global Fund Transition in Albania: HIV Prevention Services for Key Populations on the Brink of Collapse” which looks at the challenges which could be faced by country in sustaining HIV prevention programmes among KAPs, implemented primarily by civil society organisations (CSO’s), as a result of the withdrawal of the Global Fund through the transition period.
The purpose of this report is to identify gaps and challenges faced by CSO’s in the transition from Global Fund assistance to government support of services for key populations (KP) under the 2017-2019 grant. Whilst the funding commitment by government institutions is to absorb all costs, the methodology to prepare for this transition, and also the strategy to transfer costs, is unclear.
We hope that the information and arguments presented in this case study as well as the recommendations could be used by the civil society and communities representatives to support their sustainability and transition related advocacy activities as well as to establish the communication with other potential donors to persuade them to establish a ‘safety net‘ through which bridging funds can be made available to address the sustainability related challenges faced by KPs services in country.
The burden of an HIV epidemic in Kosovo* lies among the key populations (KPs) of female sex workers (FSWs), men who have sex with men (MSM), and people who inject drugs (PWIDs). The aim of this study was to estimate the size and distribution of these populations to create evidence for developing action plans for HIV prevention.
Results of this Study:
Of the estimated 6814 men who have sex with men (range: 6445 to 7117), nearly 4940 operate through the internet owing to the large stigma and discrimination against same-sex relationships. Geo-based men who have sex with men (who operate through physical spots) congregate at a few spots with large spot sizes (13.3 men who have sex with men /spot). Three-fourths of the men who have sex with men are distributed in 5 major municipalities. Fridays and Saturdays are the peak days of operation; however, the number only increases by 5%. A significant number are involved in sex work, that is, provide sex to other men for money. People who inject drugs are largely geo-based; 4973 (range: 3932 to 6015) people who inject drugs of the total number of 5819 (range: 4777 to 6860) visit geographical spots, with an average spot size of 7.1. In smaller municipalities, they mostly inject in residential locations. The numbers stay stable during the entire week, and there are no peak days. Of the 5037 (range: 4213 to 5860) female sex workers, 20% use cell phones, whereas 10% use websites to connect with clients. The number increases by 25% on weekends, especially in larger municipalities where sex work is mostly concentrated. Other than a few street-based spots, most spots are establishments run by pimps, which is reflective of the highly institutionalized, structured, and organized female sex workers network.
This study provides valuable information about the population size estimates as well as dynamics of each KP, which is the key to developing effective HIV prevention strategies. The information should be utilized to develop microplans and effectively provide HIV prevention services to various KPs.