UNODC, Country Office, Pakistan is implementing a Regional project entitled ‘Prevention of Transmission of HIV among drug users in SAARC Countries’ that is being implemented in partnership with the governments and civil society organizations of the member countries of the SAARC region. This is a 9-year project that is divided into three phases - Fast Track (3 years including evaluation), the extended Phase I (1 year) and Phase II (5 years). Phase II of the project is being implemented jointly with UNAIDS and WHO.Phase II of the project was initiated in June 2007 and activities will be scaled-up in the 7 SAARC countries. Phase II will draw upon Phase I of Project H 13 and will foster national responses of the scale required to achieve 100% coverage of IDUs with comprehensive prevention and care services. The project will establish regional and national learning centres to train the government and civil society workforce.
The project in partnership with the mentor and partner agencies in the seven SAARC countries is implementing the ‘Comprehensive package’ of services for drug users, injecting drug users and their sex partners. The three pillars of the project are capacity building, ensuring gender sensitivity and sustainability beyond project life.
Pakistan , is currently classified as a concentrated HIV/AIDS epidemic country. To date, 46,000-210,000 adult HIV positive cases have been estimated for Pakistan. Recent surveillance reports suggest the epidemic is most prevalent among Injecting Drug Users (IDUs), bringing them to the forefront of High Risk Groups ( HRGs). The epidemic is further accelerated, with IDUs interlinking with other HRGs as well as multiple sexual partners. However, the spread of HIV does not stop here in fact has also alternatively effected the spouses/regular sex partners (RSPs) of DUs and IDUs.In 2008, ‘The Hidden Truth’ revealed that approximately 50% of the street based IDUs in Pakistan are shown to be married and report having unprotected sex with their wives. There is also significant evidence of the interaction of DUs/IDUs with female sex workers. In a recent assessment carried out by UNODC (2008), condom use among DUs/IDUs with their RSPs was found to be as low as 20%. Both studies display low levels of awareness regarding HIV/AIDs. Limited access is seen to be the primary reason behind low levels of awareness among the spouses of DUs/IDUs. A combination of these factors alternatively enhances the vulnerability of the spouses as well as the forthcoming generations, towards sexually transmitted infections (STIs), HIV/AIDs and the associated stigma. Furthermore, spouses of drug using males also fall victim to economic hardship, ill health, verbal and physical abuse and poverty.
At present, there exists very little data on the widespread effect of drug use on the spouses and partners of drug users/injecting drug users (DUs/IDUs). Given the combination of high risk behaviours related to oral opioid as well as injecting drug use, the likelihood of the HIV/AIDS epidemic to impact vulnerable groups such as the spouses of DUs/IDUs has increased. Given that the partners/spouses of DUs/IDUs are a target group under the overall objective of the project, a planned intervention is required in order to address their vulnerability to the twin epidemic of drug use and HIV. The project would like to use the services of a short-term consultant to carry out a qualitative assessment of the social and economic impact of drug use on the spouses of DUs/IDUs in the cities of Quetta, Karachi, Larkana and Gujranwala. The consultant will coordinate closely with the Project Officer who will ensure support in the deliverance of all assigned responsibilities.
The primary objectives of this consultancy are to:
· Examine the socio-economic impact of drug use on the spouses of DUs and IDUs;
· Understand the gender issues related to drug use;
Scope of Service and Tasks
· Carry out a qualitative assessment of the spouses of DUs/IDUs at the project sites
· To establish and train on-site teams to facilitate data collection
· To consolidate findings in the form of a report with a set of key recommendations or future action
The consultancy is designated approximately 17-20 days and it is distributed as follows:
- The consultant will be required to carry out a desk review of any existing literature on the subject, prior to the field work;
- The consultant will facilitate research protocol development in conjunction with UNODC;
- The consultant will be the designated team leader for this assignment. He/she will lead a team at each project site comprising of 3 Outreach workers- one male, two female;
· The consultant will be responsible for providing a basic one-day ‘Research skills’ training to each team at the respective project site. For this purpose he/she will collate all the necessary material required for the training. The scheme of the training will be based on:
o Power point presentations;
o Visuals aids;
o Case studies and or Exercises/group work to involve participants.
- The consultant will be responsible for carrying out focus group discussions (FGDs) at each site;
- The consultant will be responsible for developing questionnaires for one-on-one /key informant interviews-with facilitation by the project team;
- Data analysis will be the carried out by the consultant upon return of the completed questionnaires.
- Deliverables and Outputs The consultant will be required to gather a qualitative insight given the sensitive nature of the topic. The study is divided into the following sub-sections: Personal characteristics and family situation of the spouses of DUs/ IDUs.
- History of DU/IDU of the husband
- Community attitudes towards the spouses as well as DU/IDU husbands
- The impact of Drug-related HIV: Case Studies highlighting incidents of domestic violence, women being forced into Commercial Sex work (CSW), women as drug peddlers and traffickers, spouses of DUs/IDUs in prisons due to involvement in illegal activities.
- Trained teams to negotiate with vulnerable populations and able to gather necessary information
- A practical set of recommendations in order to devise appropriate interventions for spouses/families of DUs/IDUs