Implementation of interactive methods of preventive work with vulnerable youngsters

SALUS Charitable Foundation, Lviv, UkraineForeword: Founded in 1996 SALUS Charitable Foundation is providing activities aimed on health promotion and improving of physical and psychological health of Ukrainians. Activities focused on STIs and AIDS prevention, health promotion and human rights protection are part of the of SALUS Foundation’s strategic tasks. Experienced trainers of SALUS during 20 years have developed and/or adjusted unique trainings together with helpful manuals and hand outs. The trainings are popular and of big demand within youth groups all over Ukraine. Aim: The aim of workshops is not simply conveying information about health and risks. The trainers should influence young people’s values towards healthy options in ways which have as much appeal and attraction as the allure of the risk taking alternatives. For example, in considering health educational messages to cut down the incidence of unprotected casual sex in young people, traditional approaches which centre on urging general sexual restraint, are unlikely to be successful. Such approaches fail to address the reality and motivation of risk-taking behaviour in young people. Activities: During the period from 2004 till our days hundreds of trainings have been performed. 1) The methodology of gender sensitive training games «The World of Girls and Women» and «The World of Men» created by SALUS trainers' team - to provide in playful way full, correct and comprehensive information on issues that are key for young people: sexual and reproductive health and rights, family planning, gender equality, violence, HIV and STIs, healthy life style, right choices in life, relations, some legal aspects of their lifes and other. The World of Men training has been adjusted in 2004 with support of Elton John Foundation. The World of Girls and Women has been created in 2006 with support of Ukrainian Women Foundation. 2) The methodology of training exercise «When And How To Say NO» designed by SALUS trainers' team - to teach young people (especially girls) in playful way the basic skills of assertiveness, dignity, self-respect and respect to others, the ways to escape and solve conflict situations. The main objective of the training – visualisation of the gender and violence issues for young women (15-22) with the help of innovative interactive training methodologies. The training was created in 2010 with support of Feminist Review Trust (Great Britain). 3) The innovative approach to problems of violence within adolescents has been introduced and approbated in Lviv region and Western Ukraine since 2005 within the EU project “Development of Network of Innovating Social Services in UKRAINE for Women Victims of Trafficking”. The project was developed in partnership with Secours Catholique Caritas France, ALC and Caritas Ukraine thanks to the support of the TACIS IBРP program. It was implemented in 2004-2005. Using the experience of ALC organization (France) “Grain de Sable” project was designed as a global programme for the prevention of violence to adolescent boys and girls. The project was of big success and of great demand in Ukraine. The recommendations and tutorial manual for educators have been developed. Besides above mentioned interactive methodologies, Salus Foundation has had extensive experience in providing health education concerning sexually transmitted infections (STIs) and HIV/AIDS prevention in Lviv and Lviv Region. As a result of this experience the organization has developed many professional and lay contacts. In spring 2009 SALUS participated in pilot project of International AIDS Alliance in developing of the «Living Libraries». The «Living Libraries» were first launched in Ukraine thus SALUS gained a unique experience. More than 1000 participants took part in over 15 «Living Libraries» held in Lviv region. The most popular alive «books» were: HIV-positive woman, gay, disabled person, social outreach worker. The informational materials have been distributed within the action. Over 600 persons passed the HIV-tests due to «Living Libraries» motivation. As the result of the activities the informational level and the rate of tolerance within youth has increesed by 9% and within adults – by 5%. In 2001-2003 several Ukrainian NGOs participated in EU-USA project on HIV prevention among youth. The methodology of cascade trainings was used. The good partnership relations have been established. The Community Centers for vulnerable groups (mostly women and girls) exist in 5 cities and were supported by different donors (UNICEF, International Alliance on HIV/AIDS in Ukraine, All-Ukrainian Network of PLWH). Conclusions: The methodology of interactive trainings has proved its efficiency and success. The main objective of the trainings have been reached. They were as following: • Increasing informational and educational level of participants, • Popularization and teaching educators of innovative methods working with youth • Forming tolerant attitude towards people living with HIV/AIDS and other vulnerable groups, fight with stigma and discrimination in the society • Promotion of the healthy life style, informed decision making, responsibility towards own health and the health of others, decrease risk behavior • Respect for moral and human values While designing the programme of workshops and developing information materials for the project team and trainers will apply the main key points: - Clear, realistic and measurable objectives - Start with what young people already know and think - Convey clear and accurate information - Challenge and correct misinformation and prejudice - Avoidance of over-reliance on mass media methods - Use the language and imagery of youth - Education sensitive to individual background and culture - Personalise the risks - Use fear appeals with caution - Encourage appropriate use of legislation and political measures The successes and outcomes of the projects are used and further developed: reintegration assistant and medical services, crisis Centre for persons in crisis situation, training seminars against domestic violence, introduction of sexual education for children, HIV and STIs preventive education for youth, fight stigma and discrimination of vulnerable towards HIV/AIDS groups in technical schools, “ART Against AIDS” program, “Living Library”, “Mobile Ambulance” – motivation of youth to pass tests on HIV. Aim: The aim of workshops is not simply conveying information about health and risks. The trainers should influence young people’s values towards healthy options in ways which have as much appeal and attraction as the allure of the risk taking alternatives. For example, in considering health educational messages to cut down the incidence of unprotected casual sex in young people, traditional approaches which centre on urging general sexual restraint, are unlikely to be successful. Such approaches fail to address the reality and motivation of risk-taking behaviour in young people. Activities: During the period from 2004 till our days hundreds of trainings have been performed. 1) The methodology of gender sensitive training games «The World of Girls and Women» and «The World of Men» created by SALUS trainers' team - to provide in playful way full, correct and comprehensive information on issues that are key for young people: sexual and reproductive health and rights, family planning, gender equality, violence, HIV and STIs, healthy life style, right choices in life, relations, some legal aspects of their lifes and other. The World of Men training has been adjusted in 2004 with support of Elton John Foundation. The World of Girls and Women has been created in 2006 with support of Ukrainian Women Foundation. 2) The methodology of training exercise «When And How To Say NO» designed by SALUS trainers' team - to teach young people (especially girls) in playful way the basic skills of assertiveness, dignity, self-respect and respect to others, the ways to escape and solve conflict situations. The main objective of the training – visualisation of the gender and violence issues for young women (15-22) with the help of innovative interactive training methodologies. The training was created in 2010 with support of Feminist Review Trust (Great Britain). 3) The innovative approach to problems of violence within adolescents has been introduced and approbated in Lviv region and Western Ukraine since 2005 within the EU project “Development of Network of Innovating Social Services in UKRAINE for Women Victims of Trafficking”. The project was developed in partnership with Secours Catholique Caritas France, ALC and Caritas Ukraine thanks to the support of the TACIS IBРP program. It was implemented in 2004-2005. Using the experience of ALC organization (France) “Grain de Sable” project was designed as a global programme for the prevention of violence to adolescent boys and girls. The project was of big success and of great demand in Ukraine. The recommendations and tutorial manual for educators have been developed. Besides above mentioned interactive methodologies, Salus Foundation has had extensive experience in providing health education concerning sexually transmitted infections (STIs) and HIV/AIDS prevention in Lviv and Lviv Region. As a result of this experience the organization has developed many professional and lay contacts. In spring 2009 SALUS participated in pilot project of International AIDS Alliance in developing of the «Living Libraries». The «Living Libraries» were first launched in Ukraine thus SALUS gained a unique experience. More than 1000 participants took part in over 15 «Living Libraries» held in Lviv region. The most popular alive «books» were: HIV-positive woman, gay, disabled person, social outreach worker. The informational materials have been distributed within the action. Over 600 persons passed the HIV-tests due to «Living Libraries» motivation. As the result of the activities the informational level and the rate of tolerance within youth has increesed by 9% and within adults – by 5%. In 2001-2003 several Ukrainian NGOs participated in EU-USA project on HIV prevention among youth. The methodology of cascade trainings was used. The good partnership relations have been established. The Community Centers for vulnerable groups (mostly women and girls) exist in 5 cities and were supported by different donors (UNICEF, International Alliance on HIV/AIDS in Ukraine, All-Ukrainian Network of PLWH). Conclusions: The methodology of interactive trainings has proved its efficiency and success. The main objective of the trainings have been reached. They were as following: • Increasing informational and educational level of participants, • Popularization and teaching educators of innovative methods working with youth • Forming tolerant attitude towards people living with HIV/AIDS and other vulnerable groups, fight with stigma and discrimination in the society • Promotion of the healthy life style, informed decision making, responsibility towards own health and the health of others, decrease risk behavior • Respect for moral and human values While designing the programme of workshops and developing information materials for the project team and trainers will apply the main key points: - Clear, realistic and measurable objectives - Start with what young people already know and think - Convey clear and accurate information - Challenge and correct misinformation and prejudice - Avoidance of over-reliance on mass media methods - Use the language and imagery of youth - Education sensitive to individual background and culture - Personalise the risks - Use fear appeals with caution - Encourage appropriate use of legislation and political measures The successes and outcomes of the projects are used and further developed: reintegration assistant and medical services, crisis Centre for persons in crisis situation, training seminars against domestic violence, introduction of sexual education for children, HIV and STIs preventive education for youth, fight stigma and discrimination of vulnerable towards HIV/AIDS groups in technical schools, “ART Against AIDS” program, “Living Library”, “Mobile Ambulance” – motivation of youth to pass tests on HIV

COVID-19 epidemiology and performance of the WHO clinical algorithm to diagnose COVID-19 in people with HIV from Ukraine

Background: The two main objectives were to evaluate the COVID-19 point prevalence and the test performance of the WHO case definition to diagnose COVID-19 clinically in people with HIV in West Ukraine.Methods: Multicenter cross-sectional study in Lviv, Ukraine, from October 2020-November 2021. COVID-19 unvaccinated people with HIV were included regardless of COVID-19 symptoms at routine clinical visits and had standardized medical, quality of life (EQ(5D)) and SARS-CoV-2 serology assessments. Reported symptoms indicating potential COVID-19 events at inclusion or between March 2020 and inclusion were classified by the WHO case definition as suspected, probable or confirmed. A clinical COVID-19 case was defined as being SARS-CoV-2 seropositive with at least a suspected COVID-19 according to the WHO case definition. The primary endpoints were the clinical COVID-19 prevalence and the test characteristics of the WHO case definition with SARS-CoV-2 serology as reference. (Clinicaltrials.gov:NCT04711954).Results: The 971 included people with HIV were median 40 years, 38.8% women, 44.8% had prior AIDS, and 55.6% had comorbidities. SARS-CoV-2 seroprevalence was 40.1% (95%CI:37.0–43.1) and 20.5% (95%CI:18.0–23.1) had clinical COVID-19 median 4 months (IQR:2–7) before inclusion. Clinical COVID-19 occurred less frequently in people with HIV with tuberculosis history, injecting drug use, CD4+ T-cells &lt;200/mL and unemployment. The quality of life was not impacted after COVID-19. An at least probable COVID-19 classification by the WHO case definition had 44.1% sensitivity (95%CI:38.7–49.7), 85.2% specificity (95%CI:81.5–88.4), 66.6% positive predictive value (95%CI:59.8–73.0) and 69.5% negative predictive value (95%CI:65.5–73.3) to diagnose COVID-19.Conclusions: COVID-19 unvaccinated people with HIV from Ukraine had a significant COVID-19 rate and using the WHO case definition had insufficient diagnostic accuracy to diagnose these cases. The lower burden in vulnerable people with HIV was unexpected but might reflect a shielding effect.</p