Extreme Vulnerabilities: Qualitative Evaluation of the Programs Targeting Most-at Risk Adolescents (MARA) for HIV Infection
Extreme Vulnerabilities: Qualitative Evaluation of the Programs Targeting Most-at Risk Adolescents (MARA) for HIV Infection

Summary/Abstract: In Romania social work/outreach programs addressing hard-to-reach groups whose behaviours are criminalised such as female sex workers (FSW) and injecting drug users (IDU) or blamed by the public such as men having sex with men (MSM) are implemented only by NGOs and financed by international donors (UNICEF, UNODC, GFATM). Between 2007-2010 a program financed by Irish Aid Fund through UNICEF targeting most-at risk adolescents (MARA) for HIV was carried out. The program started with a baseline research to explore the access to harm reduction services and risk behaviours of female sex workers and injecting drug users aged less than 25 years. Based on these results seven NGO’s in four cities (Bucharest, Timisoara, Iasi and Constanta) providing outreach services for marginalised groups have been financed by UNICEF to specifically target MARA. As a final stage of the overall program an evaluation of the projects implemented was carried out (July – September 2010) against 6 indicators: relevance, efficacy, efficiency, impact, sustainability and replicability. The research used a qualitative approach and included in-depth interviews with 45 MARA clients (15 FSW, 20 IDU, 10 MSM) and 11 interviews with programme managers from each NGO in each location. Outreach programs were considered by their users as relevant, useful for them, helping them stay healthy and to find support when needed. The major challenge for organisations is long-term sustainability due to lack of public funding of such programs. The way forward to ensure sustainability is within a public-private partnership.

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