Scale-up of the national response to HIV/AIDS among most-at-risk populations in Montenegro

Overview


Photo: UNDP in Montenegro

The programme seeks to scale up and strengthen the Montenegrin national response to the HIV epidemic among the most-at risk populations, building on the experience, successes achieved and challenges faced during the implementation of the Montenegrin National AIDS Strategy 2005–2009. It was developed in broad consultations with all key stakeholders contributing to the Montenegrin AIDS programme and is aligned with relevant WHO and UNAIDS policy guidelines and the National AIDS Strategy 2010 to 2014. The goal of the programme is to maintain low HIV prevalence in Montenegro. This programme is financed within the Round 9 GFATM funding.

What is the project about?

Overall, project activities are aimed towards fulfilling five goals:

1. To prevent HIV transmission among most-at-risk populations. Recent surveys among men having sex with men (MSM), injecting drug users (IDU), and sex workers (SW) indicate a very strong need to intensify preventive interventions. Activities planned include outreach work (needle exchange programme, condom and lubricant distribution, counselling, distribution of information, education and communication materials, etc.), drop-in and counselling centres and peer education programmes. Functioning of the 8 existing Montenegrin voluntary counselling and testing (VCT) centres is planned to be improved through additional training, strengthened supervision and improved coordination. Work of three existing methadone maintenance treatment (MMT) centres has been supported and another three will be opened by the end of the programme. 

2. To improve quality of care and support to people living with HIV. To this end, the programme aims to improve care and support to people living with HIV (PLHIV) through several activities: training in antiretroviral therapy prescribing, procurement of modest equipment for the Montenegrin Clinic for Infectious Diseases, training in provision of psychosocial support for staff of the Montenegrin infectious disease clinic who are in closest and most regular contact with PLHIV, provision of psychosocial and legal assistance to PLHIV, and through sensitization trainings implemented with the aim of creating a network of physicians, nurses and dentists willing and able to provide PLHIV with necessary medical services.

3. To create a supportive environment for HIV prevention and care. Already implemented awareness campaigns had focused on de-stigmatizing both PLHIV and equally important populations at risk such as MSMs, IDUs and SWs who remain strongly stigmatized in Montenegro. At the moment, activities related to stigma have been reduced only to activities incorporated in the other service delivery areas (SDA) dedicated to most at risk groups due to budget reduction. Activities implemented under a separate SDA will introduce the gender sensitive approaches to the HIV response, in particular through targeting governmental organisations’ and NGOs’ staff contributing to the national response to the HIV epidemic, but also through training of journalists and other media representatives.

4. To strengthen the HIV surveillance system among most-at-risk populations. Activities are aimed at further enhancing the second generation HIV surveillance system with the aim of better understanding the epidemic in the country. To this end, a comprehensive information system at the national level will be implemented, which will serve as a basis for a quality recording and reporting on HIV/AIDS as well as trends in the most relevant indicators established and tracked through regular bio-behavioural surveys among most at risk groups.

5. To increase capacity and coordination of a focused response to HIV among most-at-risk populations. A key feature of the Round 5 grant has been developing partnerships between governmental and nongovernmental organizations and raising the capacity of all implementing organization. The Round 9 programme builds on these achievements and further proposes activities with the aim of empowering Montenegrin GOs and NGOs primarily to ensure sustainability of programs upon the completion of the grant period.

What have we accomplished so far?



  • Established 3 drop-in centres for injecting drug users (IDUs) - 2 in Podgorica and 1 in Bar, drop-in centres for sex workers (SWs) and men having sex with men (MSMs) in Podgorica;
  • More than 1000 IDUs, 250 MSM, 220 SWs and their 60 clients were provided with the basic HIV prevention package, as well as councelling services and referrals to relevant health and social services each year;
  • More than 1600 young Roma, Ashkalie and Egyptians were covered with HIV prevention services through outreach work each year;
  • Group and individual counselling sessions on HIV and other sexually transmitted infections continuously provided to more than 200 prisoners;
  • More than 700 health and non-health professionals trained in different aspects of HIV response including public relations, harm reduction programmes, HIV related stigma and discrimination, HIV related gender response, human rights, HIV/AIDS treatment;
  • More than 1700 merchant mariners covered with HIV prevention services in 2013, through outreach work and within counselling centre for merchant mariners within the Primary Health Care Center at Kotor;
  • Strengthened voluntary counselling and testing (VCT) network, consisting of eight VCT centres evenly distributed geographically has ensured access to the VCT services at the entire Montenegrin territory and contributed to higher HIV testing rate resulting in more than 1000 tested a year, with a steady increase of percentage of clients from the most at risk population;
  • Apart from the existing methadone maintenance treatment (MMT) centre within the Primary Health Care Centre in Podgorica, two additional MMT centres have been opened in June 2010 in Berane and Kotor, with constantly increasing number of clients. Additional three centres will be opened 2014, making the network of six MMT centres a part of the public health system. Staff of all MMT centres and 21 key health professionals were additionally trained in regard to harm reduction programs and provision of MMT services. More than 250 clients provided with MMT services in 2013;
  • A national HIV/AIDS Information System is developed and introduced with the aim of improving the reporting system and evidence-based decision making and will rely on the Unique Identification Code which has been used for reporting of all clients and services;
  • Healthy Lifestyles introduced as an optional course in high schools. The course textbook and teachers’ guide prepared, adopted and printed; 3230 primary school students and 1468 hisgh school students in academic 2013/2014 covered with HLS course. 
  • So far, more than 350 000 condoms procured and distributed to most-at-risk populations and additional 200 000 will be procured and distributed by the end of the programme;
  • In terms of communication and advocacy, UNDP has initiated and published four issues of the GFATM Programmes in Montenegro Newsletter, which contains information on the implementation of the above programmes. The Newsletter is issued on a quarterly basis.
  • In 2013, Guidelines for Journalists on proper HIV-related reporting was developed;
  • Strengthened the second generation of the HIV surveillance system. Regular Bio-behavioural surveillance surveys (BBS) among most at risk population were conducted;

Within Round 9 of the programme the following surveys were conducted:

  • In 2011, BBS survey among 350 IDUs revealed 0.3% HIV prevalence and 55% HCV prevalence, while the BBS survey among 111 MSM revealed 4.5% prevalence. 
  • In 2012, 4 surveys were completed: 1. Knowledge, Attitudes and Practices (KAP) survey among 1171 young people aged 15-24, which revealed that significant percentage of youth are practicing risky behaviours related to HIV; 2. BBS survey among 200 sex workers revealed 0% HIV and 15% HCV prevalence; 3. BBS survey among 309 prisoners revealed 0% HIV prevalence; 4. KAP survey covering 813 health professionals revealed high presence of stigma towards people living with HIV, as well as towards most at risk population;
  • In 2013, two BBS surveys were conducted: for the first time in Montenegro, a BBS survey was conducted among RAE aged 15-24 with 400 respondents and no HIV case was found. Second BBS survey was conducted among merchant mariners, with 1131 respondents and the HIV prevalence among them was 0.6%;  
  • Continuous provision of rapid HIV tests for VCT centres and survey purposes, in addition - tests for hepatitis C virus procured for the survey purposes;
  • Completed review and analysis of existing laws, strategies and policies in Montenegro related to gender issues and their impact on HIV vulnerability.

Who finances it?

2012 - 2015

Donor name

Amount contributed

The Global Fund to fight  AIDS, Tuberculosis and Malaria

€ 1,638,118

2010 - 2012

Donor name

Amount contributed

The Global Fund to fight  AIDS, Tuberculosis and Malaria

€ 2,332,012

Delivery in previous fiscal years

December 2013 USD    832,806

December 2012

USD    581,258

December 2011

USD  1,469,291

December 2010

USD    810,673

Project Overview
Status:
Active
Project Start Date:
July 2010
Estimated End Date:
July 2015
Geographic Coverage:
Nationwide
Focus Area:
Social Inclusion
Project Officer:
Ms. Itana Labović
itana.labovic@undp.org
Tel. +382 20 244 676
Fax +382 20 244 130
Partners:
Institute for Public Health (IPH), Bureau for Education, State Textbook Publishing Agency, Clinical Centre of Montenegro/Clinic for Infectious Disease, Primary Health Care Centre Podgorica, Primary Health Care Centre Kotor, NGO CAZAS, NGO Juventas, NGO Montevita, NGO Montenegrin HIV Foundation, NGO Zastita, NGO SOS Podgorica, NGO Association of Private Dentists of Montenegro, NGO Otvori srce, NGO Zdravlje i mladi.
Related Documents
Project document
Additional Documents
  • National AIDS Strategy 2010-2014 English
  • Action Plan National HIV AIDS Strategy 2010-2014 Montenegrin
  • National strategic response to HIVAIDS in Montenegro 2010-2014 Montenegrin
  • National HIV-AIDS Legislation Analysis Montenegrin