Olga Blinova Voronezh Autonomous Non-Profit Organisation AntiAIDS Centre

1. Olga Blinova Voronezh Autonomous Non-Profit Organisation AntiAIDS Centre Experience of Cooperation between Law Enforcement Institutions and Civic Organisations Pilot Scheme of Referrals for Drug Users in Voronezh City, Russia

2. Prerequisites Links between drug use and drug-related crime: both crime and drug use are related to other social economic problems Difficulty in getting access to efficient treatment and prevention services

3. Pilot Scheme of Referrals for Drug Users in Voronezh City This a partner initiative between the police and local services working with drug users. Target group: drug users detained at Levoberezhny PD

4. Schemes of Referral for Treatment Goal: stemming the spread of HIV-infection, other socially significant illnesses and drug-related crime Enhancing access to available treatment and prevention services and rehabilitation programmes

5. Functioning Principles of the Scheme of Referral for Treatment are realised by police-independent services using the fact of detentionby the police as akey opportunityto offer help and access to treatment with a view to stemming drug-related crime No alternative to criminal persecution or law enforcement but a direct way from the jail to treatment and prevention services.

6. Methods: Work to involve people at the place of detention for an administrative offence: all detainees are offered an opportunity to meet a counsellor to obtain referral for treatment A police officer invites a counsellor to work with the detainee The counsellor establishes a trust-based relationship with the client and interviews him or her

7. Methods: Finding out the detainee's needs Compiling a social assistance plan referral of detainees for treatment to state medical services and available programmes The counsellor’s task: interview, issue of referral, escort Follow-up report

8. Partner organisations UNODC – financial and methodological assistance Voronezh County Central Authority of the Interior (GUVD) Voronezh County Administration Central Authority of Health and AIDS medical services Voronezh County Public Chamber ROA

9. Preparation for the Project Launch Meetings with the Governor of Voronezh County, heads of the GUVD and the FSKN, health care chiefs Levoberezhny District of Voronezh was chosen the programme site as one of the most difficult districts from the viewpoint of drug use. The management of the GUVD and the RUVD of Levoberezhny District of Voronezh supported the initiative to become a pilot project site

10. Project Card of Schemes of Referral for Treatment all drug users detained for administrative offences or crimes are issued a project card with the counsellor's telephone number

11. Counsellors' Work Counsellors for referral for treatment: these are specialists for working with detained drug users at police units - the staff of the AntiAIDS Centre Their key task is to identify problem drug users among the detainees and refer them to relevant services. Counsellors often continue supporting the detainees throughout the entire period of awaiting treatment or other help.

12. Counsellors' Knowledge, Capabilities and Skills Addiction issues Information on services available: medical, social, psychological, legal Legal issues Ability to listen – basic skills of psychological counselling Ability to evaluate Ability to communicate and establish relations with the police, social services, NGOs, etc.

13. Counsellors' Functions To explain the scheme to detainees To evaluate To issue referrals for treatment To develop work with the police, partner organisations providing medical and social services Collection of information and interviews

14. Drug User Treatment Constituents Treatment can be defined as a kind of interference aimed at correction of a certain problem or disease having impact on behaviour or psychological conditions. Treatment starts from full assessment followed by compilation of the assistance plan; further treatment is based on agreed social assistance procedures. Psychological assistance is included in the concept of treatment.

15. Obstacles for IDUs to Treatment Obstacles to treatment Financial limitations Fear of registration as a drug user Opinion that treatment services available are little efficient

16. What Services Needed by Detained Drug Users Over 3 months (January to March 2007) of work the project was contacted by 54 IDUs • 94% of them needed HIV testing • 67% – addiction-related assistance • 60% – needle and syringe exchange programmes • 57% – counselling by a psychologist and specialist in skin and sexually transmitted infections • 205% – rehabilitation programmes • 22% asked for referrals for hepatitis tests • 15% needed infection treatment and 9% – tuberculosis tests • 4% declared their HIV+ status

17. Project Impact Increase in activity of the police in the area of HIV/AIDS prevention Enhancing access to medical and social services Carrying out project-based research to analyse the situation Access to another, more closed group of IDUs (80% of clients of the pilot scheme were not involved in HR programmes)

18. Peculiarities of the Pilot Scheme Functioning Account of priorities of the current law enforcement system: the role of the police is to prevent recurrence of crimes and to curb crime Selection and training of counsellors: to know where and what to say, communicative abilities, legal knowledge Aiming at practical results: treatment, withdrawal from drug use as a long-term outcome

19. Sustainable Results:What Are We to Achieve? Curbing high-risk behavioural practices (no use of non-sterile injection paraphernalia)‏ Reduction of drug use Retention in the treatment programme Drug-free life Stemming drug-related crime Reducing the pace of spread of HIV, virus hepatitis, sexually transmitted diseases

20. antiaids@comch.ru AntiAIDS Centre Voronezh, Russia Thank you!