Drug users 51 year old Marina and 55 year old Alexander both HIV+.

They inject mixture of Shirka stimulants and Opiates. Both of their former partners have died. Both been in prison for posession of drugs. Marina - "I would never inject someone for the first time it is an awful thing to do". "When I found out I was HIV+. I did not lose interest in life and lose hope. I have an agreement with God that I will live until all my grandchildren have children. We have a saying; As soon as you become a great grandmother that is a guarantee that you will go to paradise - so I am not going to die until then". 

Ukraine has the second highest HIV prevalence in Europe. Official figures state that in 2016 240,000 people in Ukraine were living with HIV – a figure that has doubled since 2010. Although the real figure is believed to be much higher.

Historically HIV has been mainly restricted to the drug injecting communities. Recently, however, there has been an alarming development; now hetrosexual sex has taken over as the main route for transmission of the virus. I visited Kyiv and Odessa for UNAIDS accompanying local N.G.Os including "Way Home" and "Faith, Hope Love" who are working with vulnerable communities exposed to HIV. Due to its position as a port on the Black Sea, Odessa is one of the epicentres of HIV in Ukraine.

This photo is of 46 year old Alexander an injecting drug user and exconvict. "I came from a criminal family – my father was a criminal, my mother was a pick pocket– as you can imagine, as my parents were always away from home, I grew up on the street – of course that’s where I find out about drugs and tried them for the first time". Mainly injects opiates. First went ot prison aged 14. Sent to prison 6 times for a total of 28 years three times for robbery and assault the other three times for posession of drugs. If he had life again would never get involved in drugs. "That person who offers you drugs for the first time - this person is not your friend, this person you should see as your enemy because if someone offers you drugs that person is responsible for your life - they are going to destroy your life". Odessa, Ukraine

Former convict and drug user 35 year old Sergei

35 year old Sergei an iinjecting drug user and ex convict. Was in prison for 15 years on five different occassions - three times for posession ofdrugs and twice for theft. He uses home made opiates. Odessa, Ukraine.

Homeless teenager crawling out of basement in apartment block housing heating pipes, where he was living

Homeless teenager with NGO donated bread. Odessa

A homeless teenager living underneath apartment block in basement housing heating pipes. He injects a home made drug made from Ephedrene called Boltushka. In the longterm the drug causes neurological damage. He has difficulty walking. Seen here with food given to him by local N.G.O, "Way Home" . Odessa, Ukraine.

Homeless teenagers living underneath apartment block in basement housing heating pipes. Odessa, Ukraine

The boy is crawling in through the only entrance. They inject a home made drug made from Ephedrene called Boltushka. In the longterm the drug causes neurological damage. Seen here with food given to them by "Way Home" . Odessa, Ukraine.

Homeless teenager living underneath apartment block in basement housing heating pipes.

Homeless teenager living underneath apartment block in basement housing heating pipes. He injects a home made drug made from Ephedrene called Boltushka. In the longterm the drug causes neurological damage. He has difficulty walking. Seen here in van of local N.G.O "Way Home" who are taking him to a drug treatment centre. He returned to the street a few days later to continue injecting Boltushka. 

An exhausted homeless teenager in van of outreach workers. Odessa

He lives underneath apartment block in basement housing heating pipes. He injects a home made drug made from Ephedrene called Boltushka. In the longterm the drug causes neurological damage. He has difficulty walking. One of the withdrawal symptons is exhaustion. Seen here in van of local N.G.O "Way Home" who were taking him to a drugs treatment centre. He returned to the street with his friends a few days later to continue injecting Boltushka. 

Former homeless drug user 17 year old Sasha at the Narcotics centre, Odessa

Former drug user "Roma", who now has difficulty speaking, at the narcotics centre, Odessa

Twenty two year old Roma from Moldova was taken to the centre by the N.G.O "Way Home". Roma had been living on on the street for 9 years. He was a long term injector of the home made stimulant drug Boltushka. This has caused neurological damage, he now has difficulty speaking and walking. 

Sasha - who has been injecting drugs for 22 years applying ointment to thrombosis caused by longterm intravenous drug use. Kviv

Ointment provided by outreacher worker (in background) from N.G.O Nikta. Kyiv, Ukraine.

Making home made "Shirka". Odessa

"Shirka" is a stimulant drug made from psuedoephedrine - found in many decongestion tablets. In Ukraine these medicines can no longer be bought over the counter due to the number of people who use it to make home made drugs. Some pharmacists however are prepared to sell the decongestants to drug users. Odessa

Making home made "Shirka". Odessa

Making home made "Shirka". Odessa

After injecting home made drug "shirka"

Ornament and syringe of home made drug "Shirka"

Vica - a Sex Worker, working on one of the roads that leads out of Odessa to Kyiv, many of her clients are truck drivers. Odessa,

Sex worker, 48 years old Natasha sitting in bar on outskirts of Odessa.

Sex worker, 48 years old Natasha sitting in bar on outskirts of Odessa.

Zena 35 year old sex worker "There were some good times in my life, but very few"

Zena 35 year old sex worker. Was married at 16 to a drug user. Started injecting drugs. Some of the women she injected with were sex workers for her "it seemed like an easy way to make money". Was arrested for possession. "I spent most of my 20s and 30s in prison and that is the time when most people are starting a family- I don't have any children and now I am over 30 so I think that the best period of my life is gone now - its too late now to have children and make a family - life is very difficult and I can see no future. There were some good times in my life - but there were very few". "It is strange I took the HIV test twice. Once it was positive, the second time negative. After that I did not want to take it again because I don’t want to know whether I am positive or not. I would never agree to the test again - because I think if a person knows they have HIV they can die knowing. They can die much sooner than if they do not know". She always uses clean needles and condoms. "I would choose a different life if I had the chance again. I think it is possible to change but for this you need someone who can support you and who you can rely on not necessarily a special man just someone not connected to prison and drugs and prostution – just a normal life" 

Marina 38 year old sex worker from Tashkent, Uzbekistan: "My family wasn't very good"

Marina 38 years old sex worker. Brought up in Tashkent, Uzbeckistan. "My family wasn't very good" - she lived with her mum and step Dad when she was a teenager her step father wanted to have sex with her - her mother "didn't object" so she had to run away from home, put into a childrens home - which was "like a prison". Fell in love at the age of 16 with man who turned out to be a pimp who found rich clients for her - mafia bosses, criminals and government officials. To escape her life in Tashkent she managed to get the youth Komsomol of Tashkent to find her a job in Odessa at a car plant as well as free accommodation and the cost of transport to Ukraine. Left job in Odessa after having to work two shifts whilst only getting paid for one shift - also had to leave free accommodation, ended up working on street a s sex worker. In 2000 went to prison for selling drugs - homemade shirka. Released early after four years but had nowhere to live. Within two weeks she was back in prison for posession. When left prisonfor the last time, she stopped using drugs as needed to have wits about her to work as sex worker on the street, as it had become much more dangerous to work on her own. "I think it is a matter of time before I stop being a sex worker - I know some women who find a good man and get married and their life changes". Her sister works as a sex worker in the Arab Emirates. Odessa, Ukraine.

Natasha 48 years old sex worker: "I love the night", Odessa

Sex worker standing in Tamozhennaya Square, Odessa

A square near the port that is the main centre for sex workers in the city. Here there are around 150 sex workers working on any given night. The clients are a mixture of sailors and wealthy Odessa residents. Here the sex workers can charge some of the highest rates in the city but have to give half of their earnings to the pimps who control the area. Around 20% of the sex workers are HIV+.

Sex workers standing in front of car, for the occupants of the car to decide who they want to hire in Tamozhennaya Square.

A square near the port which is the main area for sex workers in the city. Here some 150 sex workers are working on any one night - there are roughly 300 in all who work here. Their clients a mixture of sailors and the more wealthy of Odessa's residents - these sex workers are able to charge some of the highest rates in the city but have to give half or more of their earnings to the pimps who control this area. Around 20% of the sex workers here are HIV+. The local NGO "Faith, Hope, Love" operates a mobile van which offers free tests, advice and condoms to the sex workers in the square. The Sex workers are given cards to say that they are regularly checked for STD's and HIV. 

Sex workers standing in front of car, for the occupants of the car to decide who they want to hire in Tamozhennaya Square.

 A square near the port which is the main area for sex workers in the city. Here some 150 sex workers are working on any one night - there are roughly 300 in all who work here. Their clients a mixture of sailors and the more wealthy of Odessa's residents - these sex workers are able to charge some of the highest rates in the city but have to give half or more of their earnings to the pimps who control this area. Around 20% of the sex workers here are HIV+. The local NGO "Faith, Hope, Love" operates a mobile van which offers free tests, advice and condoms to the sex workers in the square. The Sex workers are given cards to say that they are regularly checked for STD's and HIV. 

Two customers at a gay nightclub. Odessa.

Odessa, has always had a reputation of being a tolerant holiday destination and attracts heterosexual and gay tourists from across Ukraine and Russia.