Designup

Category: Project

  • Bio-Behavioral Surveillance Survey among People Who Inject Drugs in 7 cities of Georgia, 2015

    Curatio International Foundation continues implementation of Bio-Behavioral Surveillance Surveys (BBS) among Key Affected Populations (KAP’s) with the aim to measure HIV prevalence among KAP’s, monitor risk behaviors among these groups and generate evidence for advocacy and policy-making.

    The current study describes the most recent wave of BBS surveys among People Who Inject Drugs (PWIDs) in Georgia (Bio-BBS surveys among PWIDs have been implemented since 2002).  Study also was looking at HCV prevalence among PWIDs. CIF implemented this study together with partner organisations – Bemoni Public Union and Georgian AIDS and Clinical Immunology Research Center.

    The study used a cross-sectional study design. A sample of 2037 injecting drug users 18 years and older were recruited using respondent-driven sampling in seven major cities of Georgia: Tbilisi, Gori, Telavi, Zugdidi, Batumi, Kutaisi and Rustavi.

    The study was financially supported by the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM).

    Major findings:

    Socio-demographic characteristics
    • The vast majority of participants reported being unemployed, and 51% of PWIDs mentioned having a monthly income of less than 300 GEL;
    • The median age of initiating non-injection drug consumption and injection drug use has not changed since 2012 and equals 15-16 years and 18-20 years, respectively.
    Drug Scene and other contextual factors
    • Non-injecting drugs consumption has not changed  radically since 2012. About a quarter of young PWID who reported non-injection drug use mentioned use of new psychoactive drugs.
    • Injected drug scene has significantly changed during last years. Heroin is the most frequently used substance among drug users in Georgia followed by buprenorphine. Heroin use dropped in 2012 and then increased to the same level in 2015 (58.1%).  Buprenorphine use also dropped in 2012 and increased up to 26% in 2014-2015. Alternatively, lower proportion of PWID reported use of homemade opioid-type drugs like Desomorphine and Amphetamine type stimulants (so called “Vint”, “Jeff”) compared to 2012.
    HIV knowledge and HIV testing practice
    • Knowledge of HIV/AIDS among PWID remains relatively good. The majority is aware of primary transmission risks associated with injection and sexual behavior.
    • There is significant increase in proportion of PWID who were tested during last 12 months and know their status. Increase is observed across all cities. In general one in four injecting drug user has been recently tested on HIV.
    Sexual behavior
    • More drug injectors have safe sexual contacts with occasional partners than in previous years in some study locations, although protective behavior remains at alarmingly low levels and needs special attention.
    Access to and coverage of treatment and harm reduction interventions
    • The majority of PWIDs have never attended drug treatment facilities. Only 6% underwent or was still under any kind of treatment.
    • Coverage of preventive programs (minimal coverage) has increased from 24% to 32.4% since 2012.
    • While awareness about syringe exchange programs has improved in Telavi, Batumi, and Zugdidi, in general, knowledge about the program remains low and needs to be improved. Substitution therapy programs are much better known among PWIDs.
    HIV and HICV prevalence
    • The combined dataset analysis of all seven cities shows that HIV prevalence in 2015 was 2.2% (95% CI 1.53-2.99) and has not changed since 2012, when HIV prevalence was  3.0% (95% CI 2.20-4.04) because of overlapping confidence intervals. An estimate for PWID living with HIV varies from the lowest 0.9% (95%CI, 0%-4.3%) in Rustavi to the highest 4.8% in Zugdidi (95%CI, 0.2%-11%). Batumi and Zugdidi remain the cities with highest HIV prevalence rates.
    • The study revealed alarmingly high HCV prevalence (66.2% – in all seven cities).

    Full study report is available here.

  • TB Community Systems Strengthening in Georgia

    We are glad to announce that Curatio International Foundation has been selected to be Round 7 Challenge Facility for Civil Society (CFCS) grantee under the Stop TB partnership financial support.

    TB Community Systems Strengthening (TBCSS) project in Georgia aims – to build up integrated and comprehensive response to TB that is patient-centered and includes strong partnership with communities and civil society.

    The project will have 3 main objectives:

    1. Assess legal and social environment and civil society capacity, gaps and needs for engaging civil society in TB community response;
    2. Organizational strengthening for sustainable development of civil society in the TB field and
    3. Improve linkages, coordination and networking of TB constituencies, civil society organizations, state and other actors and those objectives will be achieved in two phases.

    Updated information about activities and achievements will be provided and share through social media during the project lifecycle.

  • BioBehavior Surveillance Survey results were represented to the members of Parliament of Georgia

    Curatio International Foundation together with BEMONI PUBLIC UNION (BPU) represented BioBehavior Surveillance Survey results to the Members of Parliament of Georgia.

     

    The study was conducted in seven major cities of Georgia (Tbilisi, Gori, Telavi, Zugdidi, Batumi, Kutaisi and Rustavi) with a sample of 2037 injecting drug users 18 years and older. The current study describes the most recent wave of Bio-BBS surveys among PWIDs in Georgia (Bio-BBS surveys among PWIDs have been undertaken since 2002).  The study was funded by the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM).

    Study Findings

    Socio-demographic characteristics

    • The median age of initiating non-injection drug consumption and injection drug use has not changed since 2012 and equals 15-16 years and 18-20 years, respectively.

    Drug Scene and other contextual factors

    • Non-injecting drugs consumption did not demonstrate major changes since 2012. CNS depressants and hallucinogens were reported as the most popular drugs for consumption with a slight decrease observed since 2012. About a quarter of young PWID who reported non-injection drug use mentioned use of new psychoactive drugs.
    • Injected drug scene has significantly changed during last years. Heroin is the most misused substance among drug users in Georgia followed by buprenorphine. Alternatively, lower proportion of PWID reported use of homemade opioid-type drugs like Desomorphine and Amphetamine type stimulants (so cold “Vint” and “Jeff”) compared to 2012. Thirty-five percent of the survey participants are active opioid-dependent.
    • Injection in other countries has dramatically grown across all survey locations and this trend is notable since 2009. HIV risk behaviors increase while abroad, as exhibited by the four-fold increase in rates of sharing injection equipment in other countries compared to Georgia.

    HIV knowledge and HIV testing practice

    • Knowledge of HIV/AIDS among PWID remains relatively good. The majority is aware of primary transmission risks associated with injection and sexual behavior.
    • There is significant increase in proportion of PWID who were tested during last 12 months and know their results. Increase is observed across all cities. In general one in four injecting drug user has been recently tested on HIV.

    Sexual behavior

    • High risk sexual behavior remains one of the major problems among PWIDs.
    • Although, more drug injectors have safe sexual contacts with occasional partners than in previous years, but in Kutaisi, Batumi and Rustavi, however, protective behavior remains at alarmingly low levels and needs special attention.

    Access to and coverage of treatment and harm reduction interventions

    • The majority of PWIDs have never accessed drug treatment facilities. Only 6% underwent or was still under any kind of treatment.
    • Coverage of preventive programs (minimal coverage) defined as knowing where to get an HIV test and receiving at least one of the following program commodities: sterile injecting equipment, condom, brochure/leaflet/booklet on HIV/AIDS, and qualified information on HIV has increased from 24% to 32.4% since 2012.
    • While awareness about syringe exchange programs has improved in Telavi, Batumi, and Zugdidi, in general, knowledge about the program remains low and needs to be improved. Substitution therapy programs are much more well-known among PWID.

     HIV and HICV prevalence

    • The combined dataset analysis of all seven cities shows that HIV prevalence is 2.2% (95% CI 1.53-2.99) with no change since 2012 when HIV prevalence was 3.0 (95% CI 2.20-4.04). An estimate for PWID living with HIV varies from the lowest 0.9% (95%CI, 0%-4.3%) in Rustavi to the highest 4.8% in Zugdidi (95%CI, 0.2%-11%). Batumi and Zugdidi remain the cities with highest HIV prevalence rates.
    • The study revealed alarmingly high HCV prevalence (66.2% – in all seven cities).

    Presentation is avalable in Georgian. 

  • Strengthening Capacity of Civil Society for Promoting Research Evidence into Policy Development in Georgia

    Strengthening Capacity of Civil Society for Promoting Research Evidence into Policy Development in Georgia
    The idea of initiating the project was prompted by aggressive health and insurance market oriented reforms focusing on hospital sector privatization and financing of health care services through the private insurance companies. Implicit risks posing this campaign and fast pace of implementation needed to be mitigated through effective and evidence informed policies and regulations.

    The project aims to achieve development of policies that are: a) evidence informed; b) tailored to Georgia’s social, economic and cultural context, and c) responsive to public interest. Curatio International Foundation intends to contribute to achieving this goal by allying two distinct networks of NGOs and strengthening their capacity in delivering evidence into policy process. The alliance gathers experts in their own operations field, been active as watchdogs for health sector reforms on one hand and focusing on mental health issues on another hand.

    Curatio International Foundation embarked on a strategy of using evidence-informed advocacy as an essential ingredient in the policy development process. The Evidence to Policy is viewed through institutional lens rather than individual, therefore it focuses on interventions on institutions and on strengthening the links between institutions within and outside of the NGO networks through trainings of NGO staff and establishing Information Exchange Platforms. Training topics were informed from the assessment of capacity needs undertaken prior to project launch.

    As a result of this project it is expected that:

    * The capacity of NGOs involved in the network will be increased in accessing, acquiring and communicating available evidence to policy makers;
    * NGOs will develop better capacity to identify policy relevant research evidence and use the means of communication to effectively influence the policymakers;
    * NGO and stakeholder understanding about how they could engage with each other will improve “bonding” and “bridging” ties that link researchers, policy makers and NGOs involved in evidence informed policy making.

    NGO networks involved in alliance are:
    1. Network of NGOs already active as watchdogs and advocacy groups for health sector reforms:
    a. Georgian Young Lawyer’s Association (GYLA)
    b. Transparency International Georgia
    c. Open Society Georgia Foundation (Soros Foundation national chapter)
    d. Association of Young Economists of Georgia (AYEG)
    e. Economic Policy Research Centre

    2. Network of NGOs focusing on mental health issues:
    a. Georgian Association for Mental Health (GAMH)
    b. Mental Health Coalition
    c. Association of People in Need of Special Care (APNSC)
    d. The Georgian Association for Psychosocial Aid “Ndoba”

  • HIV risk and prevention behaviors among Prison Inmates in Georgia, 2012

    By 2012 there were 23 000 prisoners in the Georgian penitentiary system. Georgia had one of the highest in the world prison population rate per 100,000.

    The main reason for imprisonment in Georgia is drug-related crime. The majority of prisoners are arrested for repeated use of drugs or for
    keeping them in small amounts. Despite the fact that conditions in the prisons have improved over the last years, still the situation remains very hard. Prisons areconsidered as endemic areas for diseases such as tuberculosis, HIV infection, and hepatitis B and C. According to various data, risk behaviors such as sharing syringes, needles and other injecting equipment are widespread in prisons. Testing for blood-borne infections in prisons started in 2005 with wide expansion since 2008. By 2012, there were about 6000 prisoners tested annually.

    This study represents the subsequent wave of Bio-BSS undertaken among prisoner population. The first Bio-BSS was conducted in 2008
    using the SRS technique and managed to recruit 211 prisoners in total. The objective of the 2012 Bio-BSS was to measure the prevalence of HIV and Syphilis among prisoners, to provide measurements of key HIV risk behaviours and to generate evidence for advocacy and policy
    -making.

    The study was implemented within the GFATM-funded project “Generate evidence base on progress in behavior modification among MARPs and effectiveness of preventive interventions, to inform policies and practice” by Curatio International Foundation (CIF), Center for Information and Counseling on Reproductive Health-Tanadgoma and the National Center for Disease Control and Public Health.

    Read the full version of the study.

  • Awaiting the results of Prisoners’ Behavior Surveillance Survey (BSS)

    Curatio International Foundation together with Infectious Diseases, AIDS and Clinical Immunology Research Center and Association Tanadgoma has conducted the Behavior Surveillance Survey with biomarker component.

    The study report of Behavior Surveillance Survey with biomarker component among 210 prisoners will be available in early fall.

    The study was carried out in the framework of the Global Fund project “Establishment of evidence-base for national HIV/AIDS program by strengthening the HIV/AIDS surveillance system in the country” by the Curatio international Foundation in collaboration with Infectious Diseases, AIDS and Clinical Immunology Research Center and Association Tanadgoma. The study covered Tbilisi and regional city Kutaisi.

    In the framework of the same project the sentinel surveillance among STI patients and Behavior Surveillance Surveys with biomarker component among Intravenous Drug Users (IDUs), and Commercial Sex Workers (CSWs) have been carried out.

  • Analyses of Costs and Financing of the Routine Immunization Program and New Vaccine Introduction in the Republic of Moldova

    In 2012-2014 Curatio International Foundation implemented the costing study that aimed to evaluate routine immunization program costs and financing as well as incremental costs and financing of a new vaccine introduction in the Republic of Moldova.

    The study was a part of a larger effort to evaluate costs and financing of routine immunization in six countries (Moldova, Benin, Uganda, Zambia, Ghana, Honduras) supported by the Bill & Melinda Gates Foundation.

    The study generated new information that will help a) improve the planning of resource requirements and financing needs at the country level; b) improve the understanding of the total immunization program costs and unit costs, as well as delivery costs of Routine Immunization services and delivery costs associated with the introduction of a new vaccine and c) contribute to updating GAVI Alliance policies on new vaccine introduction support.

    The findings of our study provide critical information for discussing issues related to the affordability of new vaccine introduction in Moldova, and the financial sustainability of the national immunization program after it graduates from GAVI support.

    Please follow the links to read the final presentation, project report and policy brief.

       

  • Final Evaluation of GAVI Alliance's Support to Bosnia and Herzogovina

    In 2014 Curatio International Foundation conducted a final evaluation of GAVI’s support to Bosnia & Herzegovina (BiH), commissioned by the Global Alliance for Vaccines and Immunization (GAVI) Alliance Secretariat.

    The evaluation assessed both financial and programmatic sustainability through an in-depth analysis of BiH’s experiences and immunization program performance before, during and after the conclusion of GAVI’s period of support for the country. The evaluation also identified factors contributing to the sustainability of these programs and their achievements.

    GAVI’s support to BiH was evaluated along three-evaluation focus areas: planning (pre-GAVI support), implementation (support received during GAVI period) and outcomes (post-GAVI support). Additionally, evidence related to each of the focus areas was assessed against five OECD/DAC evaluation criteria: relevance, efficiency, effectiveness, impact/results, and sustainability, with greatest emphasis on sustainability.

    The recommendations derived after the evaluation are planned to help further define M&E and potential programmatic activities to be conducted in graduating countries in the future.

    To read the final evaluation report, please follow the link.

  • Policy Information Platform (PIP) Expert Consultation Meeting

    Policy Information Platform (PIP) expert consultation was held in Istanbul on 29-30 January, 2015. At the meeting methodological issues, roadmap for the PIP implementation and evaluation approaches were discussed.

    CIF director George Gotsadze and Research Unit director Ivdity Chikovani participated in the expert consultation.
    PIP is a repository of peer-reviewed publications and grey literature that should generate knowledge for health policy decision-making. PIP should respond to the priority topics emerging in the policy-making process.

    The project is an initiative of Alliance for Health Policy and Systems Research (AHPSR) aiming at alleviating access barriers to policy-relevant information at national level in low-middle income countries. The piloting countries are: Georgia, Argentina, Pakistan and Nigeria.

    In the pilot countries PIP implementing partners are: CIF, Argentina MoH, Pakistan King Edward Medical University and Nigeria Ebonyi State University.

    CIF contributes to the whole PIP initiative by developing methodological approaches for grey literature evaluation.

    The PIP project will be implemented during 2015-2016.

  • HIV risk and prevention behavior among Female Sex Workers in two cities of Georgia – Bio-Behavioral Surveillance Survey with Population Size Estimation in Tbilisi and Batumi, 2014

    Curatio International Foundation together with Center for Information and Counseling on Reproductive Health TANADGOMA is implementing the research project which aims to generate reliable information to plan preventive interventions targeting key populations at riks of HIV/AIDS.

    Currently Georgia belongs to the groups of countries with concentrated HIV epidemics. According to the National Center for Disease Control and Public Health 4,131 People living with HIV (PLWH) were officially registered by the end of 2013. The number of newly registered cases is about 500 per year. According to the national HIV surveillance system among newly registered HIV cases heterosexual transmission is the main mode of transmission (49%), followed by injecting drug use (35%) and homosexual intercourse (13%). The findings of the last Bio-BSS conducted in 2012 among female sex workers (FSWs) in Tbilisi and Batumi showed that, HIV prevalence among FSWs is 1.3% in Tbilisi and 0.8% in Batumi. The current study represents a further round of Bio-BSS in Tbilisi and Batumi, with the additional survey of population size estimation, which is important for the planning and implementation of adequate preventive interventions.

    The current study is supported by Global Fund to fight HIV/AIDS, tuberculosis, and malaria. International experts are invited to participate in the survey design development and results analysis.

    To view full reports please follow the links below:

    1. HIV risk and prevention behaviours among Female Sex Workers in two cities of Georgia, 2014
    2. Population Size Estimation of Female Sex Workers In Tbilisi and Batumi, Georgia 2014