UNICEF Armenia / Onnik Krikorian

In a report released last year, the United Nations warned that the Commonwealth of Independent States (CIS) faced one of the fastest rates of HIV infection in the World. In fact, it is believed that 1.8 million people are carriers of the disease in the region. Yet, even though countries such as Armenia are considered to have a low prevalence of HIV/AIDS, there are concerns that this might not remain the case for much longer.

Naira Sargsyan, UNICEF’s Young Person’s Health and Development Officer, says that the situation is already beginning to change, but not necessarily for the better.

“We have all the factors necessary for HIV to spread,” she says. “We are already in the second, concentrated state of the epidemic, and high risk groups are particularly in danger of infection. Already we have a high prevalence of infection among high risk groups such as intravenous drug users, and there are no programmes that specifically target Most at Risk Adolescents aged between 10 and 18 years of age.”

As a result, in May 2005, UNICEF with UNAIDS support funded a Rapid Assessment on the Vulnerability and Risky Behaviour of Especially Vulnerable Young People in Armenia, focusing on the following six high-risk groups: drug users, injecting drug users, female sex workers, men who have sex with men, children in conflict with the law, and children deprived of parental care such as street children, and those attending boarding schools or residing in children’s homes.

The National Center for AIDS Prevention of the MoH of RA conducted the Rapid Assessment and Arshak Papoyan was appointed to coordinate efforts.

“After the preparation phase was finalized in June, we conducted the field work among these specific high risk groups. At the same time, the information we collected was entered into a database and a qualitative analysis was completed in the middle of October. We conducted interviews with respondents from these six groups, as well as from those who provide services to them, policy makers and the heads of their communities.”

For example, explains Papoyan, 50 questionnaires were filled out by 50 drug users aged 10-18, and there were also three focus groups comprising of an additional 18 young people from this high risk category. In total, 78 drug users aged 10-18 were involved in the assessment, as well as 8 service providers and 4 policy makers. Papoyan says the results of the assessment were disturbing.

“The Rapid Assessment revealed that the level of knowledge on HIV/AIDS prevention was low,” he says. “Even so, knowledge among young drug users was considerably higher than among other high-risk groups. The same was true for female sex workers, but our survey showed that only 12 percent of street children, for example, had a sufficient understanding of how to prevent HIV infection or practice safe sex.”

But, continues Papoyan, even among those with a comparatively better understanding of how to prevent the infection and transmission , only 70 percent practiced safe sex such as using condoms. “There is a huge gap between knowledge and practice,” he admits, “and no specifically targeted programmes aimed directly at these high risk groups.”

The Rapid Assessment also revealed that part of the problem also relates to the lack of appropriate health services, especially in the regions.

“In the southern town of Sisian, for example, it’s impossible to buy a condom after 6 p.m.,” he provides as an example, “and for injecting drug users, the situation is even worse. Firstly, there’s a stigma attached to injecting drug users in Armenia, and although it’s now possible for them to seek medical services anonymously without being registered with the police, they don’t believe it.”

Nevertheless, a full Country Specific Strategic Plan based on the findings from the Rapid Assessment is now underway and will eventually be submitted to the Country Coordination Mechanism for HIV/AIDS Prevention for inclusion into the National Programme on HIV/AIDS Prevention for 2007-2011. Recommendations might also include using the media more effectively in warning of the dangers of HIV infection among socially vulnerable groups of young people.

“There is an increase in drug use among vulnerable children,” says Emil Sahakyan, UNICEF’s Media & Communications Officer. “However, the media has so far not covered this problem sufficiently or issued adequate warnings, and this definitely needs to be tackled — and most probably will be – in the new national strategy. It’s also important that training for journalists on how to report issues as sensitive as this be continued.”

“Peer education will also be continued,” adds UNICEF’s Naira Sargsyan. “Although it’s mainly targeted at young people in general at the moment, it also needs to be extended to include socially vulnerable and high risk groups of adolescents aged 10-19. We also need to promote the development of integrated youth friendly health services that include counseling and testing for HIV and sexually transmitted infections (STIs), as well as dealing with other related issues such as unwanted pregnancies and reproductive health.

Basically, we need to address everything that affects young people in Armenia.”