Community-Level Intervention for HIV Testing and Prevention in the Republic of Georgia
Tsagareli, T., Sirbiladze, T., McLellan, I., Kasrashvili, T., & Djibuti, M. (2012, July). Community-Level Intervention for HIV Testing and Prevention in the Republic of Georgia. Presented at AIDS 2012, Washington, DC.
Injection drug use is the primary driver of Georgia’s HIV epidemic: injecting drug users (IDUs) represent about 55% of the country’s HIV infections with a known transmission route (1). Strict enforcement of laws criminalizing drug use deters IDUs from accessing HIV testing and prevention services. The Georgia HIV Prevention Project piloted a model of community-level intervention (CLI) to increase IDUs uptake of services and to promote behavior change based on the realities of IDUs’ micro-social environments, which are characterized by fear and stigma.
In addition to peer educators influence, reinforcing messages on HIV testing and prevention from new channels (including healthcare providers and law enforcement probation services) increased IDUs’ HIV services coverage (HIV Counseling and Testing (HCT), condoms, IEC materials) by 21.7% (from 7.4% to 29.1%). CLI strategies to engage parents and partners of IDUs to influence IDUs behaviors were less successful, which was mainly due to high levels of stigma related to drug use. Based on the pilot results, the project developed a community rapid assessment tool for identification of potential partners/channels for IDUs community-level interventions.
In Georgia, the criminal context for IDUs limits both the availability of and access to evidence-based HIV testing and prevention services. This CLI pilot showed that (1) outreach to IDUs by trained peer educators and healthcare providers can effectively increase uptake of HIV services and (2) outreach conducted in collaboration with probation services provided access to IDUs who were not likely to be reached otherwise. By using a rapid assessment tool, the project has expanded the CLI model to other areas of the country that face similar IDU-related challenges.