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Interview with Vantala, Ukraine

Aliya Rakhmetova, SWAN Coordinator: I met Vantala (her nickname) at the International AIDS Conference. She came there with the drug users' community from Ukraine and was mostly participating in discussions around harm reduction and drug use in the region. She is a human rights activists, who supports rights of drug users and sex workers. So I thought it might make sense to look into the reality in which sex workers who use drugs live in Ukraine. The interview was held in Russian and I took short notes, so I hope I didn't miss anything.

AR: Tell me about yourself.
V: When there was nothing to sell or steal from home to support my drug habit, I had to think about other ways to find money. By the looks men gave me it was obvious that I was attractive. So I started to provide sexual services… It wasn't difficult. I knew about sex from movies. After getting paid I would go to the other end of the city to my dealer to buy drugs. The next evening everything started again.
Surprisingly, in 3 years of my sex work experience I never was harassed by the police. Maybe my expensive outfit looked more like a young girl going to a party?

AR: What can you say about other sex workers who use drugs in Ukraine?
V: As far as I know, today ¾ of sex workers in Ukraine are «chemically dependent», but there are more sex workers who use alcohol. And there are less of opiate users nowadays, a lot of them died. The young ones are afraid of injections and prefer other methods, that leave less visible traces on the body.
Since now I work together with self-help groups in one NGO I know that the number of drug using sex workers ranges from 40 to 80% depending on the size of the city and it's proximity to the regional center. In smaller towns sex workers use alcohol more than drugs.

AR: What is the situation with substitution therapy in Ukraine?
V: The organizations try to reach out to people who might need substitution therapy. They even made a film about it to show to women and to promote their programs among women.
Unfortunately, sex workers are not invited to share their experience and opinion on the effectiveness of the introduced health treatments in our country and as a result we have laws and policies that do not work. For example, the substitution treatment system, which was introduced in Ukraine, does not address the needs of sex workers. Many of whom work during the day, while the clinics are open from morning until afternoon and the therapy requires a strict schedule for taking the necessary medication.
In past, they gave out Canadian methadol, which was supposed to be given twice a day, but in reality the clients got it only once a day. So by the end of the day the participants of such program felt bad. Originally this medication was produced in tablets, while local experts had to grind it to powder for fear that program participants would steal tablets and sell to somebody else. So, they gave it in the form of powder, which did no good to digestion system and health.
Later they bought Metaddict (German product) which was in liquid form. So no worries about drug user selling them to third parties. But the doctors gave it in smaller portions than it was suggested in the original instructions.

My organization provides necessary information about such medications. It is not often that doctors provide all details, including the dosage suggested by the producers and side effects of medication used in treatment.
Not all sex workers are interested in such medications, because most of them make you sweat more than usual or make you gain weight, etc…

AR: What is your impression about the conference?
V: So far I have been following only drug use-related sessions and discussions and have not had any chance to attend sex work-related meetings. It is great that people voice the need to provide different types of services in one place as opposed to having general therapy in one end of the city and a substitution treatment clinic in another. Unfortunately, in Ukraine this is the case. Problems of access and accessibility to treatment are solved sporadically: in individual regions and for individual people. No systematic approach taken.

Other speakers [at the sessions] look at us as if we came from pre-historic period. They gape, when we tell that sometimes outdated medication is used which leads to terrible side-effects, that sometimes doctors have no idea what they are doing… That the police set ambush at the entrances to the clinics, storm into hospital wards, arrest doctors and so on. Sex workers don't want to have anything to do with such things.

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