aids2022.

org #AIDS2022 29 July – 2 August · Montreal & virtual

Dr. Maria GEORGESCU, ARAS, Romania | Coalition PLUS

Symposium “COVID-19, community and HIV: Importance of
community involvement in pandemic response”
(Room 517a/Channel 3)

Maintaining the HIV response and

harm reduction activities in the
context of massive return of
population from other European
countries

PHOTO: LIBERTATEA.RO
Conflict of interest
disclosure
I have no relevant financial
relationships with ineligible
companies to disclose.
Romanian immigrants in the
Covid-19 epidemic context
• East European Country
• Massive emigration since 2000
• COVID-19 epidemic affected immigrants with no job
contract
• About a million Romanians have returned to the
country due to the pandemic (Ministry of Labor)
• Local epidemics with many deaths in the first and
second wave.
• Anxiety and stigmatization
• Rapid growth of number of people with COVID-19
in the country led to the blockage of health and
military systems

29 July – 2 August · Montreal & virtual aids2022.org #AIDS2022

 HIV infection challenges among
Romanian immigrants during
epidemic
 Romania has more than 17.000 % of new HIV+ tests among Romanian
persons living today with HIV [PLHIV] immigrants between 2015-2021 (source:
CNLAS)
 Among Romanian immigrants, a
25.00%
different HIV incidence was noticed
between workers and non-workers
between 2015-2021
 Back home, migrants living with HIV
faced a hostile medical system focused 7.50%
6.33%
on COVID-19 epidemic
 Admissions, hospitalisation and
physical consultations for people living
with HIV decreased dramatically 2015 2016 2017 2018 2019 2020 2021

29 July – 2 August · Montreal & virtual aids2022.org #AIDS2022

Harm reduction challenges for
Romanian immigrants during
pandemic

 There is no national harm reduction program in Romania

 Our NGO (ARAS) is the only one that constantly managed
to offer this service (with reduced funding)
 Small number of places available in the public Substitution
Treatment Centers and a longtime waiting lists within
ARAS’s OST centers, who already cover 50% of the total
OST places available in the country.
 A lack of places in OST centers for drug addicted
immigrants having referrals from the country of
emigration.
 Drug addicted persons previously in OST treatment abroad
were forced to restart injectable drug consumption.
 Structural challenges during the
epidemic

«I had some stings in my

Infectious
chest,disease
it hurthospitals => into
very badly… COVID-19
And phase I
I left the
hospitals
emergency room at 5 a.m. because they didn't want to put their hands
on me. But absolutely not,
Othernot
hospitals
at all,=> into COVID-19
saying support
that “It's COVID, hospitals
what do
you want now, to put the
A reduction
nurses in (-90%) in the number
protective of hospitalizations
suits for you?”»
between March and August 2020 (PLHIV, M, 32 years)
 Overcrowded hospitals and acute lack of medical staff
 A low level of community involvement by local health
authorities
 Lack of trust, misinformation and manipulation – especially
among key populations
 Chronic healthcare seekers, including PLHIV, were in
extreme situations as all infectious disease services
postponed until their reopening in March 2021.
 ARAS’s response during the COVID-19 epidemic
ARAS is a dynamic and flexible NGO with 30 years of experience in
HIV/AIDS field and about 10 years membership in the International
“A young man returning from England in poor health was diagnosed with advanced
Coalition PLUS.
HIV infection and could not be hospitalized as the local Infectious Diseases Hospital
to which hewas assigned
Since was fullyof
the beginning dedicated to COVID-19.
the epidemic As short-term
ARAS participated solution and
in informing
he was admitted to a gastroenterology
mobilizing the community section, but in absence
to understand of HIV
restrictive specificat first,
measures
treatment and care the patient risked dying within several days. At family request,
and then the importance of testing and vaccinations.
ARAS sent letters and informative notes to all responsible institutions and succeeded
to convince authorities
With the to emergency
open one support
room withfromtwoCoalition
beds forPLUS
PLHIV and
in other
criticaldonors,
situation. Similar
ARAS situations
was ableoccurred
to meetinthe
Bucharest,
needs ofthe capital, where
vulnerable people only fewthe
during
emergency beds were available
COVID-19 at the
crisis and Military
to offer Hospital.”
secured harm reduction and OST services
(Monica Dan, ARAS’s psychologist)
that were open throughout the pandemic
 Facing an unexpected big demand of psychological support from PLHIV
during the COVID-19 pandemic, ARAS formed a network of volunteers
of support to respond to these needs.
 Multilevel support and linkage to care was offered to PLHIV and drug
addicted Romanian immigrants who were unable to access the needed
services.
 Lessons learned during COVID-19 pandemic
 Inadequate medical system unable to meet the needs
neither in normal situations nor in crisis
 No programs to address immigrants despite the acute
immigrant crisis we are facing today in Romania

We hope
 The crisis to change for the better
 It will increase the interest for everything that means
health system, state of public health, quality of public
administration, etc.
 The reduction of politicization in public decisions
 New challenges

 Rapid mobilisation of civil society

 Positive impact on government’s decision
to change the legislation
 Ukrainian immigrants
 Different drug consumption patterns
 Different methadone procedures
 Different HIV care approach and treatment
 Women with children
 Psychological support
 Language barrier

29 July – 2 August · Montreal & virtual aids2022.org #AIDS2022

Thank you!

Contact email:
maria.georgescu@arasnet.ro