ST. PETERSBURG, RUSSIA - At the age of fourteen, Tanya had already spent many years living on the street. She had left an abusive home and now spent her nights in the basements of housing blocks and her days trying to survive. When she first visited a Drop-in Center (DIC) run by the health and human rights organization Doctors of the World-USA, Tanya was not attending school, was sexually active, and regularly used drugs and alcohol.

Although a test at the time revealed that she was HIV-negative, Tanya was still at risk for contracting the virus. In fact, street youth in Russia have one of the highest HIV infection rates in the world. A study conducted by DOW and Centers for Disease Control and Prevention in 2006 revealed that as many as 37.4% of street youth in St. Petersburg are HIV-positive.

Recognizing the urgent need for programs specifically designed to prevent new infections among street youth and assist those living with HIV to access treatment, DOW has established partnerships with local non-profit and government organizations. With support from DOW, these organizations now deliver a range of interventions, including rapid testing and medical care, crisis intervention, overnight shelters, and supportive (halfway) housing to youth with no place to go.

CHANGING ATTITUDES AND SAVING LIVES THROUGH INFORMATION AND EDUCATION

In partnership with public and private donors, DOW has designed and implemented a series of HIV prevention workshops that aim to give clients like Tanya the knowledge and skills they need to stay HIV-negative, and to promote tolerance and fight the stigma and discrimination experienced by those living with HIV/AIDS. The workshops have been developed with input from street youth to create a program that engages them and addresses the specific needs and concerns they deal with on a daily basis.

Street youth engaged both at DICs and through mobile outreach teams are encouraged to participate in the workshops, and incentives - including food, clothes, and an MP-3 player - are offered to youth who attend the sessions. During the workshops, facilitators use lively dialogue and group activities to overcome the barriers that have often prevented social service providers from reaching street and at risk youth in the past.

In addition to raising awareness of HIV/AIDS, its transmission, and the risks associated with drug use, the workshops help youth develop refusal skills and understand the importance of avoiding activities that may place them at risk for infection. The workshops also improve their knowledge of reproductive health and gender issues. The final session is devoted to tolerance, teaching participants to recognize stereotypes and adopt non-discriminatory attitudes towards others, particularly people living with HIV/AIDS.

A recent independent evaluation of the workshops showed that participants significantly improved their knowledge of HIV and its transmission while gaining the skills and assertiveness they need to preserve their health. Youth who completed the program reported an increased readiness to refuse to engage in risk behaviors, while reporting a greater confidence in their ability to protect themselves from becoming infected - a fate many thought was inescapable previously. DOW will continue to develop and expand the workshop series and hopes to reach more youth with life-saving information.