Expansion and modification of HIV prevention services in Montenegro

Montenegro’s public health system is successfully controlling the development of the COVID-19 pandemic, however, we are most proud that even during the epidemic and in such extraordinary circumstances, HIV prevention services continued to be provided in full, and, moreover, they met even the increased needs of clients. The entire SoS project team in Montenegro carried out advocacy activities daily to ensure the prioritization of HIV-related services by partner organizations, as well as to respond appropriately to the needs of key groups and to resolve difficulties that arose. During the COVID-19 pandemic in Montenegro, a call for proposals was announced to fund HIV-related services in 2020, and this indicates the importance of sustainability of HIV prevention programs.
Sanja Sisovic SOS_project Manager in Montenegro, Director of Programs, CAZAS NGO
The most important thing is that during the COVID-19 pandemic in Montenegro, the provision of services to people who inject drugs and other vulnerable groups wasn't interrupted. Of course, the services were adapted to existing needs, but the most important thing was to sustain the organization and ensure its stability so that groups of people who are already vulnerable did not put their health at even greater risk. Although COVID-19 is a global challenge for health systems, we must not forget the importance of harm reduction programs and the huge health challenge that can arise if these services are not provided!
Boban Sekulic Head of drop-in center, coordinator of harm reduction programs, NGO CAZAS

Problem and task

COVID-19 has influenced harm reduction programs at so many levels and has led to a new design of these programs in line with the new challenges, needs and barriers that key populations vulnerable to HIV have begun to face. Despite the fact that key populations have higher health risks, COVID-19 preventive measures have pushed them even closer to the brink, their economic circumstances have become more complex, and a large number of PWIDs have lost their homes and jobs. In addition, access to OST was limited for some patients who lived in remote areas or were isolated. Access to testing was also limited, since in Montenegro testing is provided only in health facilities.

Solution 

CAZAS has expanded the range of services provided – to address issues related to access to treatment, care and support (in particular, with regard to OST), work has begun to protect the rights of patients. 

  • Collaboration was established with the clinical center to deliver buprenorphine to clients from remote areas and/or in isolation (Roma clients)
  • A fund was created to distribute consumables to customers, which also included hygiene products and supplies; kits are distributed among clients in need
  • Mental health services launched
  • Newsletters on the needs and challenges faced by key groups related to COVID-19 have been sent to all facilites involved in HIV services and authorities.
  • Collaboration with the media was organized to advocate for the protection of patients’ rights, to draw attention to the need to ensure access to treatment, as well as to maintain confidentiality and prevent stigma

Result 

Despite the COVID-19 pandemic, harm reduction services in Montenegro continue to be provided to all clients who need them. The standard package of services has been expanded with activities to protect the rights of patients, the distribution of food packages and hygiene products. Since the introduction of preventive measures in connection with COVID-19 in Montenegro, more than 250 clients have been provided with such services. Buprenorphine daily delivery continues to be provided to six clients who are in isolation or quarantined.