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Category: HIV/AIDS and Desease Surveillance

  • Impact of global HIV/AIDS initiatives on health systems in Ukraine, Kyrgyzstan and Georgia

    During January-July 2010 Curatio International Foundation in collaboration with London School of Hygiene and Tropical Medicine and other partners started exploring the effects of Global Fund HIV programmes on the roles of civil society organisations (CSOs) in Georgia, Kyrgyzstan and Ukraine. The study attempt to assess CSO advocacy efforts to reform HIV/AIDS and drug related Policies in three former Soviet Union countries.

    In-depth semi-structured interviews were conducted in Georgia, Kyrgyzstan and Ukraine by national researchers with representatives from a sample of 49 civil society organizations (CSOs) and 22 national key informants.

    On July 4th findings of the study were published in Health Policy and Planning, titled as Has Global Fund support for civil society advocacy in the Former Soviet Union established meaningful engagement or ‘a lot of jabber about nothing’?

    As the results of the study prompt the Global Fund support resulted in the professionalization of CSOs, which increased confidence from government and increased CSO influence on policies relating to HIV/AIDS and illicit drugs. Interviewees also reported that the amount of funding for advocacy from the Global Fund was insufficient, indirect and often interrupted. CSOs were often in competition for Global Fund support, which caused resentment and limited collective action, further weakening capacity for effective advocacy.

    The study was funded by the Open Society Foundations.

    Read the full version of the paper online.

    Download the paper.

  • Poster Presentation at Copenhagen 2012 Conference on HIV

    Curatio International Foundation presented two posters at Copenhagen 2012 Conference- HIV in Europe.

    One of the posters presented results of Bio-Behavioural surveys among Injecting Drug Users in five cities of Georgia in 2008-2009 and specifically explored Low testing uptake and their determinants among this high risk group in Georgia. Authors: Ivdity Chikovani, Ketevan Goguadze, Natia Rukhadze, George Gotsadze

    The poster was presented in the session – Lessons learned in the implementation of HIV testing strategies for IDUs.

    Another poster addressed issues around late diagnoses for HIV care. The National HIV/AIDS database for 2000-2010 was analysed and characteristics of high risk groups for late diagnosis in Georgia were identified. Authors: Ketevan Goguadze, Ivdity Chikovani, Natia Rukhadze, George Gotsadze

    The posters can be seen at the HIV in Europe web site:

    Low testing uptake and their determinants among IDUs in Georgia

    High risk groups for late HIV diagnosis in Georgia

  • Contributing to publishing the paper: Circus monkeys or change agents? Civil society advocacy for HIV/AIDS in adverse policy environments

    Curatio International Foundation has contributed to publishing the paper that explores the factors enabling and undermining civil society efforts to advocate for policy reforms relating to HIV/AIDS and illicit drugs in three countries in Eastern Europe and Central Asia: Georgia, Kyrgyzstan and Ukraine. The paper was published on the world’s leading scientific papers’ source Sciencedirect.com in the rubrics: Social Science and Medicine.

    The paper looks at political contexts and explores how the civil society actors’ strengths and weaknesses inhibit or enable advocacy for policy change – issues that are not well understood in relation to specific policy areas such as HIV/AIDS, or particular regions of the world where national policies are believed to be major drivers of the HIV/AIDS epidemic. The study is based on in-depth interviews with representatives of civil society organizations (CSOs) (n = 49) and national level informants including government and development partners (n = 22).

    Development partners and government tend to construct CSOs as service providers rather than advocates. While some advocacy was tolerated by governments, CSO participation in the policy process was, ultimately, perceived to be tokenistic. This was because there are financial interests in maintaining prohibitionist legislation: efforts to change punitive laws directed at the behaviors of minority groups such as injecting drug users have had limited impact.

    Read the full paper online or download PDF.

  • Paper on Prevalence of HIV among injection drug users in Georgia published on Journal of International Aids Society, 2011

    In February 15, 2011 the Journal of International Aids Society Published the paper by CIF on Prevalence of HIV among injection drug users in Georgia.

    Georgia is categorized as a low-HIV-prevalence country. According to the national HIV registry data, there has been a sharp increase in newly diagnosed cases since 2004, with a steady increase since 2008. Annually, almost half of the newly diagnosed cases are revealed at the AIDS stage of disease. There is regional heterogeneity in HIV prevalence with higher rates in the capital (Tbilisi), regions bordering Turkey, and in the conflict zone of Abkhazia. Injection drug use remains a major risk factor for HIV transmission. In 2009, more than 70% of new HIV infections were attributed to injection drug use or sexual contact with an injection drug user.

    Drug abuse and its related health and social consequences are critical challenges facing Georgia. As a bridge between Europe and Asia, Georgia and other south Caucasian countries serve as a drug trafficking route into Russia and Europe. The conflict regions may also have conditions that support drug trafficking. No reliable estimates on the extent of drug use in Georgia currently exist

    Since the Injection drug use remains a major risk factor for HIV transmission in Georgia authors of the study aimed to characterize the prevalence of HIV among injection drug users locally.

    To assess the knowledge and behavior in injection drug users a cross-sectional, anonymous bio-behavioral survey in combination with laboratory testing on HIV status was conducted in five Georgian cities in 2009. A snowball sample of 1127 eligible injection drug user participants was investigated.

    Read the full paper at Journal of International Aids Society web site.

  • Bio Behavioral Surveillance Survey with biomarker component among HIV/AIDS risk groups, identifying the number of injective drug users (IDU), operations survey, 2012

    The project was implemented with financial support from Global Projects Implementation Center.

    The project “Behavioral Surveillance Survey with biomarker component on HIV/AIDS in high risk groups, identifying the number of injective drug users, operations survey” aimed at creating credible/valuable source of information which will serve as the evidence for planning national programs on HIV/AIDS and assessing national response.

    In terms of targeting HIV/AIDS risk groups the objectives of the project was as following: a) Conducting bio-behavioral surveillance surveys among high risk groups, b) defining the number of injective drug users and c) conducting operations survey. All these objectives served the goal of identifying barriers that impede injective drug users to receive counselling and testing services.
    Behavioral surveys with bio-marker component among high risk groups took place within the time frame set by the HIV/AIDS National Plan among IDUs, prisoners, commercial sex workers and men who have sex with men (MSM).

    The following serways were implemented:

    The project was implemented by the Curatio International Foundation, National Center for Desease Control and Public Heatlh, public union “Bemoni” and Medical-Psychological Association “Tanadgoma”.

  • Releasing results of Bio-behavioral surveillance survey among men having sex with men

    Georgia is among the countries with low HIV/AIDS prevalence but with a high potential for the development of a widespread epidemic. However, over the past several years while transmission through injecting drug use is still the prevailing route for HIV spread, the role of heterosexual transmission is increasing. According to the national HIV surveillance system, infections acquired through homosexual contact account for a small proportion of all HIV cases.

    Curatio International Foundation and Association Tanadgoma release a study report on Bio-behavioral surveillance survey (BSS) among men who have sex with men (MSM) in Tbilisi, Georgia.

    This study evaluated prevalence of HIV and other STIs (Hepatitis B and C, Syphilis, Chlamydia, Herpes type-2 virus) and sexual risk behaviors among MSM in Tbilisi. Overall 278 respondents aged ≥18 years and having homosexual contact during last year were recruited using Respondent Driven Sampling (RDS) technique. The study findings has changed the country HIV epidemiological picture, moving from a low level to a concentrated epidemic among MSM in Tbilisi. The study provides recommendations for advocacy and policy level.

    The study was implemented in 2010 within the GFATM funded HIV/AIDS surveillance system strengthening project.

    Read the full version of the report to learn more on study methodology and findings.

  • Prices, Availability and Affordability of Medicines

    The present report   “Price, availability and affordability of medicines in Georgia” attempted to obtain reliable data on these aspects and documents tendencies of change over the course of 6 month in 2010. The survey looked at availability and price of Innovative Brands and their equivalent low price generics, analyzed collected data by type of medicine, regional differences as well as by type of pharmacy. The survey also looks at medicine mark-ups and compares with mark-ups in European countries, measures affordability of standard treatments as percent of average subsistence monthly allowance and provides comparison of the standard treatments by innovative brands and equivalent low price generics.  Though the study has not covered all therapeutic categories, these do not detract from the importance of the above results as basis for action and as baseline for future studies. Authors: Tamar Gotsadze, Natia Rukhadze, Tinatin Turdzeladze; 2010. The full version of the report in available in Georgian.

  • Regulation of Health Professionals-Comparative Analysis of Georgia and Western Countries

    The report presents the Comparative Analysis of Georgia and Western Countries. This publication was produced for review by the United States Agency for International Development in the framework of the CoReform. The publication highlights factors deremining approaches to the regulation of health professionals, instruments used for regulating professional resources, factors influencing rules of licensing and authorization at national and international levels. Published in April 2008, Author: Vakhtang Megrelishvili. Read the full version.

  • Tracking global HIV/AIDs initiatives and their impact on health systems: effects on the roles of civil society organisations in Ukraine, Kyrgyzstan and Georgia

    The aim of the study is to explore the effects of Global Fund HIV programmes on the roles of civil society organisations (CSOs) in Georgia, Kyrgyzstan and Ukraine. The study represents a follow-up to the Global HIV/AIDS Initiatives Network (GHIN) studies that examined the effects of Global HIV/AIDS initiatives on country health systems. Specifically the study will assess the effects of Global Fund programmes on the focus, aims and roles of CSOs; seek to understand how Global Fund HIV programmes have influenced the relationships between CSOs and government; and build an understanding of the effects of Global Fund HIV programmes on relationships between CSOs. The study will primarily be based on semi-structured interviews with country stakeholders and CSOs. Duration: January-July 2010.

    Country studies are supported by the Open Society Institute. Network Funders are DFID, Irish Aid and Danida.

    In Georgia the study with be implemented by Ketevan Chkhatarashvili and Natia Rukhadze from Curatio International Foundation.

    The country researchers will provide inputs into the development of the Research Protocol (methodology) at other appropriate stages in the study including: design of interview tools, sampling strategy, identification of appropriate secondary data sources and relevant literature plus conducting the fieldwork.

    As a result of the study articles in peer reviewed publications will be posted.

  • Effects of GFATM on Georgia’s Health System Development, 2008

    Global health initiatives like Global Fund to fight HIV/AIDS, TB and Malaria (GFATM), Global Alliance for Vaccines Initiative (GAVI), Roll Back Malaria and Stop TB etc. are intended to support developing countries to effectively deal with specific diseases/conditions. In practice, the vertical nature of such financing is likely to have a variety of direct and indirect effects upon health care systems, both positive and negative. The size and the components of the grant, makes Global Fund the most significant player, at least for now. But evidence shows that experience with disbursement of GFATM grants has caused considerable frustration in recipient countries. In some countries, these new financing sources are providing larger sources of funding than the entire annual public health budget. Depending on how these resources are used, they have the potential to overstretch already weakened systems, or they may serve to support to the broader health care system with potentially positive effects on other health priorities as well. In Georgia, our study looked at the possible system wide impact of Global Fund on Georgia’s health care system. Therefore, the aim of the study was to look at the actual effects of GFATM on the policy environment, public-private interaction, human resources and access to specific services by clients. The findings are based on a base-line survey implemented in 2004 with financial support received from EU and an end-line survey financially supported by Alliance for Health Policy and Systems Research (AHPSR), within the frames of research network for Global HIV/AIDS Initiative. Authors: Ketevan Chkhatarashvili; George Gotsadze, Natia Rukhadze. View the document.