September 2016—Hanna*, a former injection drug user and person living with HIV in Ukraine, was diagnosed with tuberculosis (TB) in 2008. When she was arrested in 2009, she had already undergone three months of TB treatment. She initially served her time at a specialized TB penal colony in Ternopil and then moved to a regular female penal colony in Kharkiv oblast.

The Kachanivka Female Penal Colony is one of many Kharkiv penitentiary facilities providing interactive training sessions on TB/HIV co-infection prevention and treatment with support from USAID’s Strengthening Tuberculosis Control in Ukraine project. After participating in the sessions, Hanna joined a project-supported volunteers’ school. She completed her courses, received certification, and became a peer-to-peer counselor on TB and HIV.

After completing her sentence, Hanna, 43, remained in Kharkiv and soon joined the USAID-supported NGO, Parus, which offers a range of services to support HIV-positive people in Kharkiv penitentiary facilities.

“In our experience, HIV-related stigma in female penal colonies is much higher than at male penitentiary facilities,” said Tatiana Vasheva, a Parus representative. “Women are afraid to talk about their status, so our work is much harder. Hanna went through it and never faltered. She is very persistent.” 

As part of her work, Hanna meets with people she knows from her time in the penal colony. She talks to them about undergoing TB and HIV diagnosis to begin rebuilding their lives by maintaining healthy bodies and having positive goals. In two short months, she convinced three people to start drug treatment.

“I think that, even if your past was not perfect, it makes sense to fight for your future,” says Hanna. “My sobriety, and seminars organized by USAID in the penal colony, helped me to reflect on my life and understand the importance of taking care of my health. I managed to overcome tuberculosis, I still undergo antiretroviral therapy, and I know what I want from my tomorrow.”

As for her counseling technique, Hanna explains: “I do not hide anything. I do not soften the truth. I talk honestly about my own life, and say that the future is worth taking your health seriously. Thanks to the USAID-organized volunteers’ school, I gained experience in consulting in a penal colony, as well as the knowledge and desire to help others and make my life purposeful.”

USAID’s Strengthening Tuberculosis Control in Ukraine project has expanded access to effective TB prevention, diagnosis and treatment to nearly half of Ukraine’s population and has upgraded multidrug-resistant TB and TB/HIV co-infection treatments to meet international standards. In eight oblasts, 95 percent of newly diagnosed HIV patients have been screened for TB, and 97 percent of newly diagnosed TB patients have been screened for HIV. The project, which runs from April 2012 to April 2017, has also helped develop and pilot ambulatory TB care in the country.

* Full name withheld for privacy reasons.

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