The survey was undertaken to identify HIV infection risk factors. Data on the HIV spread among working population were presented at a meeting of the Interagency Coordinating Council under the Governors of the Irkutsk Oblast by Boris Tsvetkov, Chief Specialist, HIV Expert of the Irkutsk Oblast Health Department.

Following an Ordinance of the Irkutsk Oblast Administration as adopted on November 16, 2007, the survey covered 11 major enterprises in the cities of Irkutsk, Angarsk, Shelekhov, Usolye-Sibirskoye, Ust-Ilimsk, Sayansk and Bratsk. It permitted to collect 2,500 questionnaires and submit them to the Social Survey Division of the Oblast Administration. Once the data are processed, they will be used for purposes of developing HIV prevention programs for working people in the Oblast. It is also intended to launch an information campaign against HIV.

Information note: In 2007, 2,343 HIV infection cases were registered in the Irkutsk Oblast, including 46 cases among foreigners and 24 cases among people from other Russian regions. In the prisons under the Department of the Federal Prison Service for the Irkutsk Oblast, 370 HIV-infected persons were identified. In 2007, the newly identified HIV-infected people included 16.2 % of prisoners and 24.3% of non-working population. The HIV incidence among working population remains high, but recently the share of working people among HIV-infected people decreased from 19.8% in 2006 to 14.9 % in 2007. In 2007, the share of students decreased from 4.3 % to 1.5 %.


Today, a meeting was opened to discuss steps towards universal access to HIV and hepatites B and C prevention, diagnosis, and treatment. The meeting is organised by the Directorate of Epidemiological Surveillance, Sanitary Protection and Oversight in Transport and the Federal AIDS Centre. It takes place near Moscow.

Its agenda includes such issues as HIV-provoked secondary disease diagnosis and review, viral hepatites and TB treatment in HIV-infected patients, criteria for selecting antiretroviral treatment regimens for drug resistant patients, needs assessment and evaluation of regional applications for antiretroviral drugs.

The meeting is attended by the heads of clinical departments of territorial AIDS Centres, representatives from the Russian Health Care Foundation (which supplies antiretroviral drugs to 22 Russian regions), and foreign manufacturers of antiretroviral drugs.


Yesterday, the HIV/AIDS Interagency Coordinating Council had its regular meeting which took place in the Regional Administration Office and was chaired by S.V. Krut, Deputy Governor of the Irkutsk Oblast.

Apart from its permanent members, the meeting brought together representatives from major international donor organisations operating in the Irkutsk Oblast, including I. Krasheninnikova, Regional Advisor, AIDS Foundation EAST-WEST (a Dutch NGO), Ramine Bahrambegi, Representative of the US Red Cross in Russia, A. Pankratov, Program Coordinator, Russian Health Care Foundation. The guests told the audience about their programs implemented in the region and prospects for future cooperation. The Russian Health Care Foundation alone is supporting 10 on-going projects in the Irkutsk Oblast.

The report of M. Akulova, Chairperson of the Irkutsk Department of the Russian Red Cross, appeared of particular interest for the meeting. She described the RHCF-supported projects providing psychological and social care to HIV-infected children with a focus on orphans and operating the Reference Centre for those who work with children born of HIV-infected mothers (HIV/AIDS prevention, treatment and social support).

According to M. Akulova, a number of drawbacks were identified in the system of medical and social patronage for HIV-positive pregnant women, mothers, and children. These drawbacks include: (i) lack of a well-established system of social and psychological care provision to HIV-affected households; (ii) poorly coordinated care; and (iii) no centres providing integrated care to HIV-positive people, and no HIV/AIDS hotlines.

It is proposed to prepare and implement a project to design an interagency model of medical, social and psychological care for HIV/AIDS-affected pregnant women, mothers and children. Such a project would help improve the quality of life of HIV-affected people through providing continuous social support to the households and develop sustainable interagency coordination arrangements for regional social and health services. It is intended to include in the project such activities as training for specialists, provision of health and social care, efforts to put in operation an HIV hotline, and other activities. In addition, in five cities (Sayansk, Cheremkhovo, Usolye-Sibirskoye, Angarsk, and Irkutsk), it is planned to train trainers in integrating HIV-positive children into the education system, to hold meetings of school principals, and to conduct a public information campaign under the motto Every child is precious!

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The Russian Health Care Foundation jointly with the WHO Moscow Office and the Federal AIDS Centre offers a course of training in how to plan and conduct operational studies. The training is delivered in the period of March 31 - April 4, 2008.

The training is delivered by: George Schmidt from the WHO (Switzerland); Jim Forate from the Population Council (USA); and I. Mogilevkina from the National Medical University (Ukraine).

The course is designed to train managers from regional health administrations and chief physicians of AIDS Centres in research technologies to help them choose among available options of resource use to achieve specific goals of health programs. Foreign specialists recommend appraising each project/program to be implemented in Russia to meet concrete objectives. E.g., prior to implementation of a harm reduction project, it is advisable to undertake a needs assessment for printed products, and condoms for the target group; to estimate the costs of needle exchange; to project the number of clients to visit the AIDS Centre; etc.. If it is a treatment adherence project, a study is to give answers to the following questions: how to motivate patients to take prescribed drugs; whether the AIDS Centres visiting schedule is convenient for patients; whether there is a need to provide counselling services on week-ends, etc.

The audience includes not only managers from regional health administrations and chief physicians of AIDS Centres but also specialists from the Federal AIDS Centre.


On March 26, 2008, the Ulyanovsk Oblast Administration hosted a press-conference to discuss how to improve interagency cooperation to combat HIV/AIDS in the Ulyanovsk Oblast. It was attended by A.I. Nabegayev, Director, Human Resource and Legal Department, Ministry of Health of the Ulyanovsk Oblast, D.A. Khakimova, Head, Epidemiological Surveillance Unit, Department of the Federal Oversight Service for Consumer Rights Protection and Human Welfare for the Ulyanovsk Oblast, S.F. Ibragimova, Chief Physician of the AIDS Centre, A.V. Pankratov, Program Coordinator, Russian Health Care Foundation, A.N. Lysenkov, TV Team Leader, AIDS-Ambulance TV Project, and Yu.A. Nepomnyashchikh, Producer, AIDS-Ambulance TV Project.

The press-conference was associated with the arrival of the AIDS-Ambulance TV Team to shoot the Program in Ulyanovsk. This TV project is funded by the Russian health Care Foundation.

The TV program will be centred on HIV-infected residents of Ulyanovsk, but none of them agreed to participate in it personally and speak up with an open face. Since 1987, over 8,000 HIV-infected people have been identified in this region, and nobody of them has ever dared to appear before the camera. And no wonder because according to Yuri Nepomnyashchikh, the AIDS-Ambulance project producer, very few people would make it publicly known that they are infected with HIV. People do not want to open their faces, they fear to be recognized. By the way, there is one HIV-positive young man from Ulyanovsk who is actively working in a volunteer team, delivering lectures, providing peer consultations in Moscow, but he is not willing to do the same in his native city.

During the first two months in 2008, 138 new HIV infection cases were registered which is fewer than during the same period in 2007 (by 15%). Among the HIV-infected people who were newly identified during the two months in 2008 and know their risk factors, the share of heterosexually transmitted infections is 61.3%, and that of parenteral infections is 32.5%. During the whole period since the emergence of the epidemic, the most prevalent way of transmission has been and remains parenteral transmission (intravenous drug use), accounting for 64.6%, with the heterosexual transmission accounting for 34.3%. During this period, HIV diagnosis was confirmed in 69 children, 3 of whom died (2 of them died from AIDS, and 1 child died with HIV). The highest HIV prevalence is found among people aged 20 - 40 (106 persons or 76.8% of the newly identified people). This age group is prevailing in the general population as well (80.6% of the adult population). As regards the gender distribution of newly registered HIV cases (over the 2 months in 2008), women account for 57.9%. In the age group from 20 to 30, the number of women is 1.8 times greater than that of men.


In Russia, the HIV epidemic poses a grave threat to its national security and demographic development. This was stated by participants of a press-conference in Vladikavkaz today. The press-conference was held at the initiative of the Russian Health Care Foundation to discuss interagency cooperation to respond the AIDS/HIV epidemic in the Republic of North Osetia - Alania. Since the autumn 2007, the Russian Health Care Foundation has been implementing the Program: Promoting a Strategic Response to HIV/AIDS Treatment and Care for Vulnerable Populations in the Republic of North Osetia - Alania.

The press-conference was attended by representatives from the Government of the Republic of North Osetia - Alania, as well as Zmira Yusupova, Coordinator from the Russian Health Care Foundation, Zinaida Tsarakhova, Chief Physician of the AIDS and Communicable Disease Control Centre of the Republic of North Osetia, and Alexey Lysenkov, a popular TV journalist, TV Team Leader, AIDS-Ambulance TV Program (the TNT TV Channel).

The press-conference gave rise to an open discussion of how to join efforts of executive authorities, health administrations, various agencies and civil society organisations involved in HIV/AIDS control in the Republic of North Osetia - Alania.

It was noted that the number of HIV-infected people has noticeably increased.

As a reminder, North Osetia will adopt its AIDS Prevention Program for 2008 2012. The Program was developed at the initiative of the regional government and is very relevant and important for the Republic. Alexander Reutov, Chairman of the Parliaments Committee for Social Policies, Health, and Veterans Affairs clarified: Unfortunately, the HIV incidence is growing. The Program is primarily aimed at strengthening preventive activities, including those through mass media. The Program will be fully funded from the regional budget. The executive authorities are to identify sources of funding for the Program. Our Committee is actively participating in the work to address all issues related to this important document. The Program will be approved at a session of the Parliament of the Republic.


Last year, the Sverdlovsk Oblast AIDS Centre started to provide comprehensive health care to its patients, including services of physicians of the following specialties: communicable disease, skin and venereal disease, obstetrics/gynaecology, dentistry, therapy (to treat hepatites), TB care, and also services of feldshers to address drug addiction.

The Sverdlovsk Oblast AIDS Centre pays special attention to the development of non-medical services, social and psychological support to HIV-infected people and their relatives. It has 6 psychologists to provide consultations, a newly established social service staffed with 5 social work specialists. It also put in place such patient education programs as a School of Life with HIV, a School of Pregnant Women, a mutual support group, and an HIV/AIDS hotline.

The overall goal of non-medical services is to complement and reinforce provided medical care. In other words, treatment is more effective if patients have good adherence to it which is stimulated by specialists delivering non-medical services, including psychological support, assistance with documents restoration, temporary housing, care to gravely ill patients, social and legal support, etc.

One of the projects funded by the Russian Health Care Foundation is designed to support multi-professional teams for counselling, and antiretroviral therapy adherence stimulation and maintenance with a focus on the need to coordinate services of infectionists, nurses of the AIDS Centre and such non-medical service providers as psychologists, social workers and peer consultants. Therefore, the new approach and establishment of multi-professional teams would improve the process ARV treatment adherence stimulation and maintenance.


Another AIDS-Ambulance TV program was filmed in Ivanovo.

On March 6, 2008, the AIDS-Ambulance TV program filming crew lead by A. Lysenkov, arrived in Ivanovo, and upon arrival, a press-conference was held in the conference hall of the Regional Governments Press Service to discuss ways to develop interagency cooperation to contain the spread of HIV/AIDS in the Ivanovo Oblast. Apart from the TV program host from Moscow, the following participants of the event answered journalists questions: E. Ryabova, Director of the Oblast Health Department, A. Pankratov, Program Coordinator from the Russian Health Care Foundation, A. Shchurenkov, Chief Physician of the Regional AIDS and Infectious Disease Control Centre, and representatives from other various entities directly or even indirectly involved into the response to the HIV/AIDS epidemic in the Ivanovo Oblast. Prior to the press-conference, the Program Coordinator from the Russian Health Care Foundation had a meeting with Olga Khasbulatova, Deputy Governor of the Ivanovo Oblast.

The HIV/AIDS problem is so far not as critical for the Ivanovo Oblast (with its 3,081 registered HIV-infection cases) as it is, e.g., for the Irkutsk Oblast (with its 24,000 HIV-infected people) or for the Moscow Oblast (32,000 HIV-infected people). However, the situation may drastically worsen unless concerted and integrated actions are taken to improve it. Now, these efforts benefit not only from active involvement of the regional leaders and executive authorities, but also from inputs of the Russian Health Care Foundation implementing the Global Fund Program Promoting a Strategic Response to HIV/AIDS Treatment and Care for Vulnerable Populations in the Ivanovo Oblast. The representative from the Russian Health Care Foundation emphasized that it would have been impossible to implement the Program of the Global Fund in the region without political will and commitment of the regional leaders.

A. Lysenkov noted that in the Ivanovo Oblast, in contrast with other regions, none of HIV-infected people consented to participate in the TV program with an open face. We had to film them with their backs turned to the camera, and to modify their voices. Such stylistics of criminal chronicles create a negative image of the HIV-infected person, said A. Lysenkov.


On February 29, 2008, the Irkutsk Press Centre of the Interfax-Siberia News Agency hosted a press-conference on the eve of the Siberian AIDS Day (March 1 of each year). The press-conference participants included: O. Burdukovsky, Chief Physician of the AIDS Centre, E. Ryadnova, Head of the HIV Prevention Department, Irkutsk Oblast AIDS Centre, and P. Tsikolin, HIV Control Advisor to the Governor of the Irkutsk Region, Director of the Step Forward to Help You NGO (an Irkutsk Regional Civil Society Organisation). The Step Forward to Help You NGO is implementing three projects financed by the Russian Health Care Foundation.

According to the Regional AIDS Centre, the Irkutsk Oblast has thrice as higher HIV incidence as in Russia on the average, the region is among the ten Russian regions with the greatest numbers of HIV-infected people. And within the Siberian Federal District, it ranks the first in this respect. In 2004 and 2007, respectively, over 1,700 and 2,300 persons were diagnosed as HIV-infection cases. As of January 1, 2008, the total number of HIV-infected residents of the Irkutsk Oblast reached 21,372 people, which is 1% of the total population in the region. A most alarming situation is found in Usolye-Sibirskoye where 2% of its total population is infected with HIV, with women accounting for 60 % of them.

In the Irkutsk Oblast, the HIV incidence is steadily growing. Though the number of HIV-infection cases went down among adolescents and drug users, there is an upward trend in the number of HIV-infected women of fertile age and children born of them. Dr. O. Burdukovsky explains that women are more susceptible to HIV compared with men, and now, the number of HIV-infected pregnant women is growing.

At the same time, the Chief Physician notes that to date, health services are stocked with all modern pharmaceuticals needed to combat AIDS. The National Priority Health Project and the Program Promoting a Strategic Response to HIV/AIDS Treatment and Care for Vulnerable Populations in the Russian Federation are supplying such pharmaceuticals. Under the Program referred to above which is implemented by the Russian Health Care Foundation, the region is implementing projects in such areas as HIV/AIDS prevention, development of social services for HIV-infected patients and their relatives, palliative care, operation of reference centres for those who work with children born of HIV-infected mothers.

Dr. O. Burdukovsky informed the audience that it was intended to start construction of two new buildings for the Regional AIDS Centre in 2008. These new premises would enable the Centre to treat its patients in better settings. It is also planned to establish up-to-date laboratory centres in big cities of the region.


On February 28, 2008, the Government of the Ryazan Oblast hosted a press-conference to discuss ways to develop interagency cooperation to combat the HIV/AIDS in the region.

The press-conference gave the floor to A. Smirnov, Director of the Regional Health Department, A. Pankratov, Program Coordinator from the Russian Health Care Foundation, health managers from the City of Ryazan and the Oblast, and A. Lysenkov, Director of the AIDS-Ambulance TV Project (broadcast through the federal TNT TV Channel). The press-conference gave rise to an open discussion of such issues as cooperation among the executive authorities, health administration, various agencies and organisations and civil society engaged in the response to the HIV/AIDS epidemic in Ryazan Oblast.

According to A. Smirnov, as of December 31, 2007, the number of newly identified HIV-infection cases reached 2,123 in the Ryazan Oblast. In terms of the HIV rate, the region ranks the eighth in the Central Federal District. Over 80% of HIV-infected people are people under 30. Regular HIV patient monitoring covers 95% of those in need of it versus 76 % in Russia on the average.

Since 2006, AIDS prevention, identification and treatment activities have been implemented under the National Priority Health Project. In particular, the Project has met the needs for diagnostic test-systems and antiretroviral drugs, procured all needed reagents for testing to establish immune status and viral load which is critically important for HIV treatment prescription and quality control.

However, most of HIV/AIDS prevention programs and activities targeting the high-risk groups (injecting drug users, commercial sex workers, men having sex with men, and prisoners) are funded out of proceeds made available by international organisations, agencies and foundations, including the Global Fund to Fight AIDS, TB and Malaria. As identified at the meeting of the HIV/AIDS Coordinating Committee under the Ministry of Health and Social Development of the Russian Federation on January 21, 2008, a key gaol of the response to the HIV/AIDS epidemic is to develop coordination of actions of all stakeholder (governmental and non-governmental) organisations under HIV prevention and treatment projects.

A. Pankratov, Global Fund Program Coordinator, Russian Health Care Foundation, reported that the Ryazan Oblast became one of the 22 Russian regions which had joined the Program Promoting a Strategic Response to HIV/AIDS Treatment and Care for Vulnerable Populations implemented by the Russian Health Care Foundation. Funding to implement the Program is extended by the Global Fund established in 2002 by decision of the UNGASS. The Program is to: cover with ARV treatment 100 % of those in need of it; provide AIDS Centres with laboratory equipment and test-systems; train specialists; improve access to palliative and psychosocial care; establish social bureaus for former prisoners, and support production of HIV publications and operation of a hotline.

As pointed out by A. Lysenkov, mass media are to play a key role in the fight against HIV/AIDS, as they are called to raise public awareness of HIV and to change the attitude to HIV-infected people. He also emphasized the need for a broader coverage of HIV prevention and health promotion issues in mass media.

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