Community health workers in Krasnoyarsk, Russia, deliver rapid HIV tests and condoms to female sex workers at 11 p.m. on a secluded, frozen roadside, meeting them in the cold rather than waiting for them to come to a clinic, AIDS Healthcare Foundation reported.
The account comes from Denys Nazarov, who has worked with the organization for more than 17 years. About a decade ago, while traveling through Russia on a work trip for the foundation, he joined a local organization serving female sex workers on one of its nighttime outreach runs.
Outreach Van Rolls Up at 11 p.m. Outside Krasnoyarsk
Under a lone streetlight casting a dim amber circle, four or five women stood along the secluded road outside Krasnoyarsk, their bare, slender legs braced against the cold while the rest of their bodies disappeared into puffy jackets. Steam from steady breathing rose into the night air. A couple of men in black leather jackets sat in a car tucked beneath some trees, acting as a security detail that did not interfere with the HIV-prevention work.
When the van pulled up, everyone seemed to understand the arrangement. Community health workers were regular visitors, and the security presence relaxed when they recognized the vehicle.
Svetlana and the Women on the Roadside
Svetlana, perhaps 30 years old, was in the middle of her shift when the visitors arrived. After hearing they were from AIDS Healthcare Foundation, she leaned toward Nazarov cheerfully and said, “Well then, go ahead and undress!” He politely declined. Their conversation was easy and jovial.
As they talked, one of the health workers invited another woman into the van for a rapid HIV test. Minutes later, the woman returned to the freezing night air, slipping a few condom strips into her fur coat’s pocket. Svetlana said the women appreciated the service.
From Condoms to Clinic Referrals
The group also partnered with a nearby clinic for sexually transmitted infections, whose staff were prepared to receive referrals for treatment and follow-up care. Even the customers seemed familiar with the routine.
A gray Lada, a boxy sedan from the Soviet era, drove past the scene three or four times, the driver seemingly unsettled by the strangers talking with women trying to work. In the end he pulled over, a passenger door swung open, there was a short exchange, one of the women climbed in, and the vehicle vanished into the Siberian night.
Why Meeting People Where They Are Works
The exchange seemed ordinary: no preaching, no shaming, and no insistence that anyone justify the decisions that led them to that roadside. All it involved was a test, some condoms, a link to medical care when necessary, and individuals ready to come out late at night in the freezing temperatures because that was simply where the people they served were. Public health, Nazarov wrote, can become buried under strategies, targets and technical language, but at its best the principle is simpler: meet people where they are rather than waiting for them to come to you.
Questions Readers Ask About Roadside HIV Outreach
Who conducts the outreach in Krasnoyarsk? A local organization serving female sex workers runs the nighttime outreach, with community health workers making regular visits to the roadside.
What services are provided on site? Workers offer rapid HIV tests conducted inside the van, distribute condoms, and refer women to a nearby sexually transmitted infections clinic for treatment and follow-up.
How is safety handled during these visits? Men acting as a security detail sit in a nearby car and do not interfere with the HIV-prevention work once they recognize the health workers’ vehicle.
A mobile health clinic in Krasnoyarsk shows how public health is moving toward delivering services where people live and work instead of relying on people visiting fixed facilities.
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