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Sustainability of community-based social services for key populations in Russia: problems and prospects of national investment programs

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BACKGROUND: According to the Governmental Analytical Center of the Russian Federation, a small share of spending on HIV prevention in total spending on HIV prevention activities is one of the key characteristics of contemporary HIV funding in Russia. According to the data of the last decade, the largest number of new HIV cases in Russia is among key populations. NGOs play a crucial role in HIV prevention among key populations.It is important to support the sustainable work of NGOs, which is driven by well-developed funding mechanisms at different government levels. One such mechanism is the government procurement system. The aim of the study was to assess the structure of public spending on HIV prevention programs among key populations by community-based NGOs.
METHODS: In 2019 and 2020 monitoring of government procurements for HIV prevention programs was conducted in the most affected HIV-infection regions of the Russian Federation
(N = 24). Key populations were the main focus of monitoring. To interpret quantitative data and obtain information about other sources of funding, interviews were conducted with the heads (N = 5) and focus groups were conducted with specialists (N = 16) of community-based NGOs in 5 regions of the Russian Federation.
RESULTS: Information on 403 procurements in the amount of 641,143,397 rubles (approximately $8,699,367) for HIV prevention programs was analyzed. NGOs from 14 regions of Russia received 79,975,459 rubles for the preventive programs implementation. Only 21.1% of these funds were spent on HIV prevention among key populations. These funds were used to implement 18 prevention projects among key populations. In the volume of prevention goods and services for key populations, more funds are invested in people who use drugs. Also some NGOs are not always ready to use this funding mechanism because of the bureaucratic system of state organizations that announce auctions for the procurement of goods and services.
CONCLUSIONS: It is necessary to develop national funding mechanisms that will contribute to the sustainability of NGOs providing preventive services to key populations. NGOs and the scientific community need to continue working with opinion leaders to develop the most effective methods of HIV prevention among key populations.