HIV/AIDS IN ARMENIA: A SOCIO-CULTURALAPPROACH UNESCO 2005 CONTENTS FOREWORDS .......................................................................................................................... 5 PREFACE .................................................................................................................................. 8 ACKNOWLEDGEMENTS .................................................................................................... 10 The views and opinions expressed in this publication are those of the authors, and do not nec- LIST OF ACRONYMS ........................................................................................................... 11 essarily represent the views and official positions of UNESCO or of the Flemish government. MAP OF ARMENIA ............................................................................................................... 13 The designations employed and the presentation of material throughout this review do not imply INTRODUCTION .................................................................................................................... 15 the expression of any opinion whatsoever on the part of UNESCO or the Flemish government PART I. EPIDEMIOLOGICAL AND SOCIO-CCULTURAL REVIEW concerning the legal status of any country, territory, city or area or its authorities, or concerning I.1. Existing information on prevalence and trends of the disease ....................................... 16 its frontiers or boundaries. I.2. Demographics of registered PLHIV ............................................................................... 20 I.3. Socio-Cultural context of HIV risk-related behaviour ................................................... 21 This project has been supported by the Flemish government. I.3.1. Overview ................................................................................................................. 21 I.3.2. Gender issues, HIV and AIDS ................................................................................ 23 I.3.3. Key populations ...................................................................................................... 26 This publication is also available in Russian and Armenian (translated from the original in I.3.3.1. Injecting drug users ........................................................................................ 26 English). All versions can also be found in electronic format at I.3.3.2. Sex workers .................................................................................................... 28 I.3.3.3. Men who have sex with men .......................................................................... 29 http://www.unesco.org/culture/aids. I.3.3.4. Prisoners ......................................................................................................... 30 I.3.3.5. Youth ............................................................................................................... 30 Published by: I.3.4. Sexual education ..................................................................................................... 34 Culture and Development Section I.3.5. Migration ................................................................................................................ 35 Division of Cultural Policies and Intercultural Dialogue I.3.6. Poverty, HIV and AIDS .......................................................................................... 36 UNESCO I.3.7. HIV, AIDS and religion .......................................................................................... 38 1, rue Miollis, 75015 Paris, FRANCE I.4. Public perception of HIV and AIDS ............................................................................... 39 e-mail: [email protected] I.4.1. Knowledge on HIV and AIDS ................................................................................ 39 web site: www.unesco.org/culture/aids I.4.2. HIV and discrimination .......................................................................................... 41 I.4.3. Review of materials in mass media for HIV and AIDS awareness ....................... 44 Project Coordination, UNESCO: Helena Drobna and Christoforos Mallouris I.5. What has been done and what is being done? ................................................................ 47 I.5.1. Activities carried out by the National Center for AIDS Prevention ...................... 47 I.5.2. HIV prevention among IDUs on Kapan city .......................................................... 49 Cover design: Stanislav Hakobyan I.5.3. HIV prevention among street CSWs of Yerevan city ............................................ 49 Typesetting: Alvina Nazaryan I.5.4. HIV prevention among migrants and their family members of Gavar city ........... 50 I.5.5. Support to the activities carried out within the framework of the National Printed in printshop Programme on HIV/AIDS Prevention ................................................................... 50 UNESCO Number: CLT/CPD/CAD-05/4 I.5.6. Training of specialists ............................................................................................. 51 © UNESCO 2005 3 PART II. INSTITUTIONAL ASSESSMENT FOREWORD II.1. Health ............................................................................................................................. 52 The Flemish Government and the global fight against HIV/AIDS II.2. HIV and AIDS Legal Field and National Response to HIV Epidemic at the Level of Legislative Power ........................................................................................... 54 On the occasion of the latest World AIDS Day, UNAIDS and WHO released a report stating that the II.2.1. HIV and AIDS legal field ...................................................................................... 54 HIV epidemic is spreading fastest in Eastern Europe, Central Asia, Sub-Saharan Africa, and East Asia. II.2.2. Main principles determined by the RA Constitution ............................................ 55 Since 2000, the fight against HIV and AIDS has been one of the top priorities of the international com- munity in general, and of the United Nations in particular. A rough global estimate at the end of 2003 was II.2.3. The RA law on 'Prevention of disease caused by Human that 40 million people were living with HIV, with 25 million in Sub-Sahara Africa alone. Immunodefficiency Virus' ..................................................................................... 55 Children and young adults represent a crucial target group in the fight against HIV and AIDS. II.2.4. National response to HIV epidemic at the legislatorial level ............................... 56 Effective prevention of HIV infection requires, among other things, the sensitisation of adolescents. The II.3. National Response to HIV and AIDS at the Level of Governement ............................ 57 Flemish Parliament and Flemish government have repeatedly proven their dedication to targeting these II.3.1. National response to HIV and AIDS at the level of executive power .................. 57 groups, and Flemish policy in the fight against HIV and AIDS emphasizes prevention and targets chil- II.3.2. 'National Programme on HIV/AIDS Prevention' .................................................. 58 dren, adolescents, and women. In 2002, the Flemish government decided to make the fight against HIV and AIDS a horizontal pri- II.4. Non-Governmental Organizations ................................................................................. 63 ority of its development co-operation policy, which is implemented through bilateral and multilateral II.4.1. National response to HIV and AIDS at NGO and international channels. Flanders finances international programmes, provides indirect support through NGOs, and has organizations' level ................................................................................................ 63 signed an agreement with Mozambique to support its health sector. II.4.2. UN system support to the 'National Programme on HIV/AIDS Prevention' ....... 63 The Flemish government has included the battle against HIV and AIDS in its list of projects that are eligible for funding under the UNESCO/Flanders Fund in Trust. Within the framework of the Fund, spe- II.5. Non-Governmental Organizations working directly on HIV/AIDS .............................. 64 cial attention is given to educational and cultural HIV-prevention approaches, as well as to the care of PART III. CASE STUDY those infected and affected by HIV. In 2001 the Flemish government decided to support the project, ‘Culturally appropriate HIV preven- Peer education among youth ............................................................................ 70 tion in the Caucasus.’ This ambitious pilot project aims to develop and implement culturally-adapted PART IV. CONCLUSIONS AND RECOMMENDATIONS ........................................... 76 research, capacity-building, and training in order to achieve sustainable change in the behaviour of the people in this deeply affected region. REFERENCES .......................................................................................................................... 80 We wish the UNESCO team much success in their endeavours and look forward to the results of the project and their potential use in other settings and countries. ANNEX I. List of national experts interviewed by the research group ................................ 82 ANNEX II. Biography of Authors