A healthy life after addiction

Marginalised, living in precarious conditions and exposed to the use of psychoactive substances, sex workers are also vulnerable to HIV and other sexually transmitted infections, with an HIV seroprevalence rate of 30.9% and 27.1% for syphilis according to the IBBS 2021 survey, unsafe abortions, unwanted pregnancies, sexual violence and repressive laws. The same survey reveals a seroprevalence rate of 15.3% among injecting drug users.

Risk factors: poverty, bad family circumstances, war, experience of gender-based violence, etc.

This harm reduction initiative focuses on marginalised women and includes medical, psychological and social support, advocacy, health education, social reintegration and post-support follow-up.

1. Involve our peer educators and community mobilisers in the three urban communes of Bujumbura to gather strategic information on the link between drug use and sex work.

2. Analyse and validate the information gathered

3. Advocacy with healthcare providers to improve reception and mobilise our identified beneficiaries to raise awareness and encourage testing for HIV and other sexually transmitted infections.

4. Advocacy and psycho-social support for those in need, and social reintegration preceded by empowerment training, with equipment and materials already available and in use.

5. Supporting beneficiaries who have tested positive for HIV and following up their children.

6.Creation of groups of 15 to 20 beneficiaries to initiate credit-savings to strengthen mutual support and social cohesion

Technology used: whatsAPP chat group and SMS messages

- Our intervention is aimed at sex workers who, according to the IBBS 2021 survey, have an HIV prevalence rate of 30.9% and most of them use psychoactive substances.

- They have limited access to health care services as a result of discrimination and self-stigmatisation.

- Consequences: high vulnerability to sexually transmitted infections, sexual violence, unwanted pregnancies and unsafe abortions, and their children are the victims.

- In addition to empowerment training, our intervention would focus on increasing their knowledge of HIV prevention and other sexually transmitted infections, sexual and reproductive health, and the risks of drug use for themselves and their children.

- Impact: reduced stigma and discrimination, improved access to health services, greater capacity for self-care, greater social reintegration and social cohesion. 

• The majority of our team is made up of representatives of our beneficiaries, who have developed positively and earned the status of managers of our "Bright Future Generation" support centre, peer educators and community mobilisers, in order to strengthen local support based on an inclusive and significantly participative approach.
• Our beneficiaries themselves expressed their priority needs in terms of empowerment through Savings and credit initiative to strengthen mutual support,sewing, bread and soap making.
• What's more, our former reinsertion beneficiaries provide post-support follow-up in collaboration with the local communities.
• As an approach to leadership and governance, we favour teamwork, empathy, good collaborative communication, transparency, confidentiality and the meaningful involvement of beneficiaries.

-Since 2019, we have set up two support centres for marginalised men and women separately.

-Facilities are available for training, accommodation for those in need, sports coaching (basketball court, pool table) and self-empowerment training (bakery equipment, soap-making unit, sewing machines, small cattle breeding).  

-Every year, at least 85 people receive vocational training to help them take charge of their own lives, and the same people know their HIV status and have benefited from capacity-building in sexual and reproductive health. -75% of these people are successfully reintegrated into society and serve as role models for others who still engage in risky behaviour. 

-Self-stigmatisation has been reduced to a minimum and around 70% attend health care facilities without fear of discrimination, but adherence to antiretroviral treatment is still low among drug users living with HIV.  

We urgently need to exchange best practice with stakeholders in other countries.

Our organisation is not in a position to respond favourably to all the requests for support it receives, due to limited financial, human and material resources. The needs are multi-faceted: for example, a woman cannot be cared for without taking into account her children, who in turn need health care, nutritional support, schooling, self-fulfilment and so on.

-We are applying for SOLVE to help us connect with other partners in order to benefit from innovative practices elsewhere that will help us improve our services.

-SOLVE could support us with technical assistance to clearly define the causal link between drug use and sex work, which has become a major challenge in supporting our beneficiaries, not to mention their children, most of whom are of unknown parentage.
-Financial support could help us achieve our set objectives.

Ce qui rend notre solution innovante repose sur :

-Créer des centres communautaires où les groupes marginalisés peuvent se sentir à l'aise et s'exprimer librement sur leurs propres problèmes.
-Une implication significative des bénéficiaires stimule leur motivation à prendre part aux initiatives de prévention et de traitement du VIH et d'autres infections, sans crainte de discrimination.
-La formation à l'autonomisation renforce l'estime de soi et stimule le maintien d'un bon comportement.
-La création de groupes d'entraide renforce la solidarité communautaire et la cohésion sociale

Nous visons une transformation en termes de comportement et de bien-être 

-Une travailleuse du sexe est sensibilisée à sa vulnérabilité et à sa totale dépendance à l'égard de ses clients. Ce faisant, notre organisation l'aide à renforcer sa décision d'adopter un comportement sécuritaire pour éviter de tomber malade et d'exposer ses enfants, sachant que la consommation de drogues exacerbe sa situation déjà destructrice.
-Cette transformation lui confère une perception positive dans son environnement, et l'auto-stigmatisation et la discrimination cèdent progressivement la place à l'intégration sociale.

OBJECTIFS D'IMPACT :

-Promouvoir l'accès annuel aux services de santé pour au moins 85 femmes marginalisées et leurs enfants afin d'améliorer leur bien-être 

-Garantir les soins personnels d'au moins 85 femmes marginalisées par an afin d'assurer leur insertion sociale et d'adopter des comportements à faible risque.
-Faire pression sur les décideurs pour qu'ils mettent en place des lignes directrices pour la prise en charge des victimes d'addiction aux drogues et autres substances psychoactives.

INDICATEURS :

-95% des femmes marginalisées ciblées et leurs enfants ont un accès facile aux soins de santé : prévention, traitement et soutien

-Les femmes marginalisées accompagnées sont réinsérées dans la communauté et sont autonomes.
-Des lignes directrices pour la prévention et le traitement de la toxicomanie sont disponibles.

-Pour les bénéficiaires, les technologies utilisées se limitent aux pratiques ancestrales que nous combinons avec les messages WhatsApp et SMS. Cela nous permet de partager des informations et des communications au sein des groupes et entre les groupes eux-mêmes.
-Pour le personnel et les partenaires, nous utilisons Internet et WhatsApp.

• 12 people work at our headquarters, which houses the « Bright Future Generation »support centre.
• Field team: 8 community mobilisers and 12 peer educators

Our organisation has been working with vulnerable populations since September 2019.

Our head office and field staff are recruited regardless of their diversity in terms of social status, gender, identity or sexual orientation or their serologyIt is this diversity that is the strength of our organisation.

-Pour garantir la pérennité de nos interventions, nous privilégions le renforcement de l'autonomisation de nos bénéficiaires à travers des initiatives génératrices de revenus et la mise en place d'un système d'épargne et de crédit pour renforcer le soutien mutuel. Cela leur permet de s'auto-prendre en charge et de se réintégrer au sein de leurs communautés avec des comportements à moindre risque.

-Nous leur inculquons l'esprit de se transformer en agents actifs pour le changement au lieu de rester comme des bénéficiaires passifs

Cette approche a connu des succès chez les travailleuses du sexe qui, pour le moment font un petit commerce et subviennent à leurs besoins quotidiens sans utiliser au travail du sexe