Russian Federation

The network of the Russian Federation’s more than 100 AIDS prevention and control centres, established in 1989 to respond to HIV, has been mobilized to support the country’s fight against COVID-19.

Each of the centres, which specialize in HIV surveillance, prevention, testing and treatment, has high-technology laboratory equipment, highly qualified health staff, including infectious disease specialists and epidemiologists, and expertise in epidemiological surveillance and contact tracing. Those centres are now using their technology and expertise on HIV testing and diagnosis to scale-up testing for COVID-19.

Public health experts at the AIDS centres are also supporting epidemiological surveillance and contact tracing, using the approaches developed for HIV. Many of their doctors and nurses have been seconded to medical teams dedicated to providing care for people with COVID-19.

“Many AIDS centres across the country have repurposed their laboratories to also diagnose coronavirus, but provision of quality medical care for people living with HIV continues,” said Natalia Ladnaia, Senior Researcher at the Central Research Institute of Epidemiology of Rospotrebnadzor, Russian Federal AIDS Centre.

In order to ensure the continuity of HIV services, many AIDS centres are working closely with community organizations to provide online counselling, deliver antiretroviral therapy to people living with HIV to their homes and address mental health challenges, which have grown since the COVID-19 pandemic began. Community activists from Novosibirsk representing the Ostrov and Humanitarian Project nongovernmental organizations, in collaboration with the regional AIDS centre, are delivering antiretroviral medicines to people living with HIV who are not able to collect their medicine from the AIDS centre.

Even some HIV testing services are moving online. Owing to quarantine restrictions, mobile laboratories cannot travel, so the Humanitarian Project organized remote testing for key populations in Siberia. “We are working with representatives of key populations and the regional Ministry of Health,” said Denis Kamaldinov, the head the Humanitarian Project. The initiative is providing online support and counselling for people who are at risk of HIV. Since March 2020, online and telephone-based counselling related to HIV and the health of people who use drugs and other key populations has intensified. “Our counsellors are communicating with clients by phone, social media and instant messaging,” he added. In order to receive an HIV self-test kit, a client only needs to complete an online application on the organization’s website.

The Deputy Prime Minister of the Russian Federation, Tatiana Golikova, has called for nongovernmental organizations working with key populations and people living with HIV to be supported during the COVID-19 pandemic. The regions that have introduced COVID-19 lockdowns have been advised to allow nongovernmental organizations working on social services, including the AIDS response, to continue their work, with their employees having freedom of movement and being supplied with personal protective equipment.

"The unique value of the AIDS centres is demonstrated by their quick and professional response to COVID-19. We are seeing this leadership coming from AIDS centres across the region. With the strategic involvement of AIDS centres and their partners, the COVID-19 response in our region will be more effective and the risk of progress in the AIDS response being rolled back will be mitigated,” said Alexander Goliusov, Director, a.i., of the UNAIDS Regional Support Team for Eastern Europe and Central Asia.

A new film about HIV in the Russian Federation by YouTuber and journalist Yuri Dud is stirring people’s interest about the epidemic in the country.

Since its release on 11 February, the video has been viewed by more than 14 million people, and the number of online searches about HIV and HIV testing has skyrocketed. According to Google Trends, the number of searches on where to buy an HIV test has increased by 4000% since the launch of the video—the highest level of interest in HIV and HIV testing in the past five years.

In the film, published on his YouTube channel, Mr Dud talks to people living with HIV, activists, experts and journalists. Through his interviews, the film voices some of the taboos surrounding HIV in Russian society, including condom use, and looks into the drug use epidemic in the country, the services available for people who use drugs and the lack of sex education, among other things.

It is clear in the film that younger people still lack basic information about HIV—things like the difference between HIV and AIDS, the effectiveness of treatment or even how the virus is transmitted are still mysteries for many in the country. “You can touch people living with HIV, exchange clothes, swim in the same pool, drink from the same mug, cuddle, kiss. It's stupid to be squeamish about people living with HIV. It is much better to be squeamish about unprotected sex and drugs. These are still the two main modes of HIV transmission,” said Mr Dud.

The popularity of the film has prompted government officials to take a closer look at the HIV epidemic and response.

“Yuri Dud’s film about HIV is undoubtedly useful. It provides a lot of important information and motivates people to get tested for HIV,” said Oleg Salagai, Deputy Health Minister, in his Telegram channel. Mr Salagai emphasized how the film draws attention to the issue of the stigma endured by people living with HIV. “HIV is not a death sentence anymore. It is very important that people living with HIV have access to HIV treatment to live a healthy and fulfilling life,” he wrote.

Mr Salagai was not the only government official reacting to the video.

Alexei Kudrin, the Head of the Accounts Chamber of the Russian Federation, promised to carry out a review of the effectiveness of HIV prevention and care programmes in the country. “This year, the Accounts Chamber will analyse the effectiveness of government resources allocated to people living with HIV in the Russian Federation,” he said.

And the first Deputy Head of the State Duma Health Committee, Fedot Tumusov, invited members of parliament to watch the film and discuss to the HIV situation in the Russian Federation. He is also planning a round-table meeting in the State Duma to explore ways to improve access to HIV prevention and treatment.

“The public response to Mr Dud’s film is incredible. However, even such a successful action is not enough. We need consistent and long-term activities to raise HIV awareness coupled with programmatic actions to ensure access to HIV testing and treatment for all,” said Alexander Goliusov, Director, a.i., of the UNAIDS Regional Support Team for Eastern Europe and Central Asia.

Eastern Europe and central Asia, of which the Russian Federation is a part, has the fastest growing HIV epidemic in the world. Most new HIV infections in the Russian Federation are among key populations, including people who inject drugs, despite the well-documented power of harm reduction programmes, where available, to reduce new HIV infections—insufficient access to sterile injecting equipment and the unavailability of opioid substitution therapy are stymying efforts in the country to prevent HIV infections among people who inject drugs.

#InSpiteOf, a social media campaign featuring the right of women living with HIV in eastern Europe and central Asia to live with dignity and respect, has reached more than a million people.

Each of the #InSpiteOf Instagram stories showed a different aspect of women living with HIV and challenged the stereotypes and myths that surround the virus. The stories focused on testing and treatment, motherhood and the adoption of children by people living with HIV, disclosing one’s HIV status to partners and children, enjoying the right to work, living with HIV in custody, being a migrant living with HIV, violence and drug abuse, and contributing to HIV education and prevention.

A common feature of all the women featured in the campaign is that they were supported at a critical time in their lives by their loved ones, women’s organizations or communities and are now not only living with HIV and challenging society’s stereotypes, but helping others.

“Mutual support, women’s leadership in preventing violence, protecting rights and dignity, and combating stigma and discrimination have always been and remain one of the most important aspects in countering the HIV epidemic,” said Svetlana Moroz, Chair of the Eurasian Women's Network on AIDS.

On the eve of World AIDS Day 2019, Odnoklassniki, one of the Russian Federation’s most popular social networks, hosted a live event in support of the #InSpiteOf campaign. Celebrities such as the singer Zara, Irina Starshenbaum, Lyubov Aksyonova and others voiced their support for the campaign and read poems, accompanied by music played by Anton Sevidov of the band Tesla Boy. Vera Brezhneva, the UNAIDS Goodwill Ambassador for Eastern Europe and Central Asia, also attended the event, at which she stressed the importance of speaking honestly and openly about HIV and ensuring that people get the treatment and support they need.

“Be sure to listen and share #InSpiteOf stories! They are not only about one’s right to live with dignity, to love and to be happy. They are also about these women’s amazing power, spirit and will to live despite all odds. Each one of us has her own #InSpiteOf challenge, so let us support those who made it and let us inspire those who still doubt their power,” said Ms Brezhneva.

“Gender norms and taboos regarding sexual and reproductive life, as well as gender-based violence, increase women’s risk of HIV infection. Then, after being diagnosed with HIV, women face stigma and discrimination, hide their status and do not seek help. This vicious circle can only be broken with the women themselves, their mutual support and leadership, as well as a change in society’s attitude to HIV and the people it affects,” said Elena Kiryushina, Gender Focal Point at the UNAIDS Regional Support Team for Eastern Europe and Central Asia. 

The campaign was developed by the UNAIDS Regional Support Team for Eastern Europe and Сentral Asia jointly with the Eurasian Women’s Network on AIDS.

Originally published by UNESCO on 16 October 2019

On 9 October, Po Pravde Govorya, an educational show by UNESCO, UNAIDS and OK.RU, went live on air to discuss how to talk with teenagers about health and sexual relations. The Russian social network Odnoklassniki hosted Po Pravde Govorya, [Telling the Truth], a live talk show co-organized by the UNESCO Institute for Information Technologies in Education (UNESCO IITE) and the UNAIDS Regional Office for Eastern Europe and Central Asia (UNAIDS EECA). Experts and celebrity parents discussed ways of talking with kids and teens about complex issues such as puberty, sexual relationships, personal boundaries, HIV and AIDS, and much more. The two-hour show hosted by TV presenter and journalist Lika Dlugach, received some 1.3 million views and 1,320 likes from OK.RU users.

The talk show guests included film and theater actress Elena Borshcheva, journalist Tatiana Nikonova, family therapist Marina Travkova, obstetrician-gynecologist Tatiana Rumyantseva, Alfiya Maksutova, editor-in-chief of DVOR, a social media page for youth, Vinay Saldanha, UNAIDS Regional Director for Eastern Europe & Central Asia, and Tigran Yepoyan, UNESCO Regional Health Education Advisor.

They used examples from their personal life and professional practice to illustrate how to discuss sensitive issues with kids and teens in an atmosphere of trust and without embarrassment, how to help young people make sense of what happens to their minds and bodies as they reach the challenging period of puberty, and how to educate them, honestly and non-judgmentally, about the basics of health and relationships.

Should we talk with kids and teens about sex and if so, how to do it right?

Marina Travkova, family therapist

We should tell them the truth in a way that is adapted to their age. But I would like really like all parents to understand that they do not need their child to be a certain age or to pick a special time and place for this conversation. Like it or not, you have been communicating with your kids about sex all the time since the moment they were born, because understanding sexuality is not only about technical knowledge of where babies come from. There is a lot more to it, including how your children feel about themselves, their personal boundaries, whether or not they tolerate uncomfortable clothes, how they feel about being hungry, whether they can refuse to kiss a granny who loves them. All of these are integral parts of our sexuality. The hands of the father and mother who hold and caress the baby build the first layer of what will later become his or her sexuality. How they feel about themselves, their body, the world around, their personal boundaries. We’ve been having this conversation with our kids all the time by sending them messages about the way to live their lives, to make choices, to fall in love, and to treat their bodies. When your child approaches you with a concrete question, this is a moment not to be missed – a moment of trust. Parents who feel at a loss or afraid to say the wrong thing should remember that it’s always possible to say, “I don’t really know, to be honest,” and perhaps find and offer your child a good book on the topic. You also need to understand that today, teens live in an incredibly open world, and the average age they are introduced to pornography is 9 to 11. Indeed, many teens today say or write, “How can I explain to my mom that she needs to read something about sex?” This is the way teens take care of their parents.

What questions do teens want answered?

Tatiana Nikonova, journalist

Most of the time, teens seek answers to questions which have little to do with what adults want them to ask about. What are most parents concerned about? Pregnancy, bad company, sexually transmitted diseases. But teenagers are interested in relationships. What to do and say, how to tell a person you love them, how to survive rejection, how to say no, and how to deal with the fact that everyone knows something about you that you’d rather keep private. Very often, teens struggle with the issues of bullying and aggression. What happens on a date and what can happen besides being offered sex – this is also something they’d like to know.

How to be more confident talking with your children?

Marina Travkova, family therapist

I can share two lifehacks with parents of teenagers. The first is to speak honestly about yourself, e.g. about the first time you fell in love, the first time you said no to a boy who was in love with you and how it made you feel – all of this has great value for your child. The second lifehack is to be honest with them about your fears.

Tatiana Nikonova, journalist

Discuss TV serials with them – something is always happening there! Like, unplanned pregnancies, complex diseases, breakups, misunderstandings – these are the most common stories in TV shows and a virtually endless source of topics for discussion.

Is it true that sex education can encourage young people to have sex earlier in life?

Vinay Saldanha, UNAIDS Regional Director for EECA

Numerous studies in different countries have found that not only sexuality education programs do not lead to an earlier or more active onset of sexual life, but have the opposite effect: adolescents tend to have a later sexual debut, fewer partners, a lower incidence of risky behaviors, and they are more responsible about the use of condoms and contraception. Together, this reduces the risks of contracting HIV and other sexually transmitted infections. Of course, such programs must be age-appropriate, evidence-based and, most importantly, they must be timely, i.e. before children become adults, otherwise it will be too late. This is what is said in the International Technical Guidance on Sexuality Education developed by several UN organization led by UNESCO.

Why do we need to talk with children about HIV if most people who get infected are adults?

Vinay Saldanha, UNAIDS Regional Director for EECA

In EECA countries alone, dozens of thousands of children and adolescents live with HIV. Therefore, we cannot say that this disease does not concern children. But it is essential to have a high-quality sexuality education program to make sure that a discussion of these complex issues brings positive outcomes.

What can we do if a kid does not believe that HIV exists, because they have read on the internet that “HIV is a hoax”?

Tatiana Rumyantseva, obstetrician-gynecologist

Give this kid a link to the website of the World Health Organization, to other sites which discuss infections. There are many organizations of people living with HIV who work to help others. You can take the kid to such an organization and let him or her meet people there. This approach might work well with someone who responds to emotions more than to words.

How to talk about HIV and not scare people?

Tatiana Rumyantseva, obstetrician-gynecologist

This information serves as a warning. Speaking about infections, I would say that some of them cannot be cured but require lifelong treatment. It makes good sense to plant a grain of concern for their future in young people’s minds. We usually spell out the dangers which we want to protect children from, and the same should apply to sex.

What source of information would a teenager trust the most?

Elena Borshcheva, actress

Bloggers. All teens are watching bloggers. Good educational programs for teens on TV are lacking, so young people learn a lot from bloggers. It makes sense to share essential information through their idols.

Recently, I came across a book and read it before giving it to my daughter. The author is American, and some realities are different from ours, but the concept of personal boundaries in relationships not only between a boy and a girl but also between friends is very well explained. And I thought, “Where was this book when I was a child?” It explains, plain and simple, how to act in certain situations, how to check what’s right, and what to say.

We all want relationships in the first place, warm relationships in which we need and love each other, and sex is part of such relationships. But many people – especially young people — do not quite understand why sex is special and whether a girl can refuse a guy, although it is her right. They need to learn how to tell real love from being taken advantage of in a relationship.

Can websites help parents in educating their children, and how can we teach children to safely navigate the diverse resources?

Tigran Yepoyan, UNESCO Regional Health Education Advisor

Absolutely yes. There is an increasing number of such resources available for parents and for teenagers. As far as teenagers are concerned, media literacy is the key, and UNESCO has been working to help countries educate teachers about media literacy, so that they may teach their students. Here are some basic lifehacks: it is essential to help children develop an ability to critically assess and analyze information, never take it for granted but double-check and look at the source of information: who created the website, who are the authors of posted materials, whether they provide links to primary sources and refer to relevant experts and research findings; ask yourself whether the main purpose of the website is to provide objective information or to impose a particular behavior pattern or lifestyle, manipulate the reader, or sell a product or service.

About DVOR, an online community for teens

The Mayor of Yekaterinburg, Alexander Vysokinsky, has announced that Yekaterinburg will become the first city in the Russian Federation to sign the Paris Declaration to end the AIDS epidemic.

In signing the Paris Declaration, Yekaterinburg will commit to putting the city on the Fast-Track to ending the AIDS epidemic through reaching the 90–90–90 targets, whereby, by 2020, 90% of people living with HIV will know their HIV status, 90% of people who know their HIV-positive status will be accessing treatment and 90% of people on treatment will have suppressed viral loads.

According to government statistics, more than 22 000 people are living with HIV in Yekaterinburg.

In announcing the decision to sign the Paris Declaration, Mr Vysokinsky noted that the initiative will encourage innovations and cutting-edge treatment programmes to address HIV and other health challenges and will contribute to a better life for future generations.

Since the launch of the Fast-Track cities initiative on 1 December 2014, about 300 cities and municipalities around the world have signed the Paris Declaration. Leaders in those cities have recognized that their strategies for responding to the AIDS epidemic also offer them a platform to address the need for social inclusion, public services, primary health care and community mobilization.

Stigma and discrimination among health-care workers is among the most severe barriers that people living with HIV experience in accessing life-saving health services. In order to encourage a new generation of health-care workers in the Russian Federation to provide medical services in a non-stigmatizing and discrimination-free setting, 20 medical students from across the country are participating in a new week-long course at the Vera HIV Medical School.

“Medical students often only hear second-hand stories about how to treat or care for people living with HIV. But if they receive the right training and practical support, they can be a bridge between people at risk of HIV and access to life-saving services,” said Anton Yeremin, the course’s coordinator, who is also an infectious diseases doctor who specializes in HIV treatment and care. “If doctors unknowingly promote stigma or explicitly discriminate against people living with HIV, or people at risk of HIV, it can result in patients being denied access to treatment, or even avoiding contact with medical services," he added.

The course is designed to complement what students learn at university. “We encourage future doctors to develop skills specific to the HIV context, such as relating to patients and understanding some of the social and legal aspects of their diagnosis,” said Mr Yeremin. The course consists of lectures and workshops on non-discriminatory approaches to people living with HIV and meeting people living with HIV, doctors, lawyers, psychologists, HIV activists and representatives of nongovernmental organizations to hear their stories.

According to Dmitry Petrov, a peer counsellor at the Svetlana Izambayeva Charitable Foundation, his clients are often denied admission to hospital. “An ambulance will arrive and the ambulance crew will say we can drive him to a hospital, but they won't admit him,” he said. Not long ago, he was helping a client to be admitted to a hospital; two official referrals from the local AIDS centre made no difference, and the woman was denied admission. Only after formal complaints filed by the patient’s family to the local government did the client get admitted. When asked about the most recent time a client was refused hospital admission, Mr Petrov answered “Yesterday,” without hesitation.

The stories shared by the Svetlana Izambayeva Charitable Foundation’s staff are consistent with the findings published in a recent Human Rights Watch report, which notes that people living with HIV regularly face stigma and discrimination from health-care workers. The situation is said to be worse outside of the major cities.

The course was initiated and organized by the National Union of Medical Students and was featured on a crowdfunding platform called No One Left Behind, a joint project of the Russian AIDS Center Foundation and UNAIDS.

Vera Brezhnevа, UNAIDS Goodwill Ambassador for Eastern Europe and Central Asia, has sponsored the course. “Every doctor must expect to see a person living with HIV at some point. We want medical students to understand that people living with HIV are a large and diverse group of people and their diagnosis is not a reason to hold negative attitudes towards them,” said Ms Brezhnevа. "I hope these first graduates of the Vera HIV Medical School will be the beginning of the end of HIV-related discrimination in health-care settings,” she added.

The Russian Minister of Health, Veronika Skvortsova, has reiterated the commitment to reach the targets agreed at the 2016 United Nations General Assembly High-Level Meeting on Ending AIDS.

“We have to provide every person living with HIV with quick access to the correct treatment. The Ministry of Health plans to increase the coverage of people living with HIV who know their status on antiretroviral therapy to 75% by 2019, and by 2020 the figure should reach 90%,” said Ms Skvortsova at the 28th meeting of the Health Council of the Commonwealth of Independent States, held in Saransk, Russian Federation, on 4 September 2018.

In 2018, the Russian Federation reported for the first time on national progress towards the 90–90–90 targets—in 2017, 81% of people living with HIV in the Russian Federation knew their status, 45% who knew their status were on treatment and 75% who were on treatment were virally suppressed.

In order to improve strategic information and build evidence for decision-making at the local level, the Russian Ministry of Health recently conducted a workshop on HIV estimates for representatives of 10 Russian regions. Regional experts were trained on modelling HIV estimates, which will help to ensure a more complete picture of the number of people living with HIV and of the 90–90–90 targets at the subnational level.

Eastern Europe and central Asia is the only region in which the numbers of new HIV infections and AIDS-related death are still on the rise. At the end of 2017, the number of new HIV infections in the region reached 130 000. At the end of 2017, it was estimated that the 90–90–90 cascade in the region was 73%, 50% and 72%.

“The Russian Minister of Health’s statement is another important step in a series of consistent actions undertaken by the Government of the Russian Federation to accelerate the country’s Fast-Track approach to reach 90–90–90 by 2020,” said Vinay P. Saldanha, Director of the Regional Support Team for Eastern Europe and Central Asia.

A record 3000 delegates from more than 60 countries, including representatives of civil society, scientific institutions, the private sector and governments, gathered in Moscow from 18 to 20 April 2018 to participate in the Sixth Eastern Europe and Central Asia Conference on HIV/AIDS. The conference focused on four major tracks: prevention, science and treatment, civil society, and international cooperation.

Eastern Europe and central Asia is the only region where the number of new HIV infections and AIDS-related death are still on the rise. The conference provides a unique opportunity to take stock of progress and discuss the challenges and transformation needed to get the eastern Europe and central Asia region on track to end AIDS.

The keynote speakers at the opening ceremony included Michel Sidibé, UNAIDS Executive Director, Olga Golodets, Vice Prime Minster of the Russian Federation, Anna Popova, Head of Russia’s Federal Service for Consumer Protection and Human Wellbeing, Alexsey Tsoy, Deputy Minister of Health of Kazakhstan, Alexander Pankin, Deputy Minister of Foreign Affairs of Russia, Lyudmila Rastokina, a representative of the Kazakhstan’s Union of People Living with HIV, and representatives of the private sector and others.

Despite the overall increase in HIV-related deaths and infections, in the past two years the eastern Europe and central Asia region has made progress in a few areas. For example, Armenia and Belarus were validated by the World Health Organization as having eliminated mother-to-child transmission of HIV. Most countries of the region adopted the test and treat approach and the average cost of first-line antiretroviral treatment has dropped from almost US$ 2000 per person, per year to less than US$ 200 per person, per year.

A number of key challenges were highlighted at the conference, including the fact that only 3% of total HIV expenditures in the region go for programmes focused on key populations, including people who inject drugs, migrants, sex workers, transgender people, prisoners and men who have sex with men. The region also faces the triple epidemics of HIV, tuberculosis and hepatitis C virus which require an integrated approach to prevention, diagnosis and treatment.

The conference was organized by the Russian Federation’s Federal Service for Consumer Protection and Human Wellbeing and UNAIDS.

Russian and international football legends and Russian players living with HIV joined forces on 17 April to play the first football match of the UNAIDS World Cup for Ending AIDS and Discrimination. International and national football stars draw attention to the stigma faced by people living with HIV and demonstrated the value of goodwill, solidarity, and human values towards ending stigma and discrimination.

The match took place in Moscow on the eve of the opening of the Sixth Eastern Europe and Central Asia AIDS Conference. This was the first of a series of matches to be held with support from FIFA in several different countries in the lead up to the 2018 World Cup which will be held in the Russian Federation from 14 June to 15 July 2018. The initiative highlights the need for zero discrimination on the basis of race, nationality or HIV status, both on and off the pitch.  

The Russian FC “Rosich” team was led by its captain, Deputy Prime Minister and Chairman of the Organizing Committee for the FIFA World Cup 2018, Arkady Dvorkovich. Team members included the Minister of Energy, Alexander Novak, the former Russian international and FIFA Anti-Discrimination Officer for the 2018 World Cup, Alexey Smertin, as well as former Russian internationals Dmitry Bulykin, Roman Shirokov, Evgeny Aldonin, Dmitry Sennikov, Oleg Kornaukhov, Marat Makhmutov, Vladimir Leonchenko and Roman Berezovsky.

Michel Sidibe, UNAIDS Executive Director, coached the UNAIDS “Red Ribbon” team, which was captained by former Cameroon international Samuel Eto’o. The Red Ribbon team featured former Senegal international, Abdoulaye Diagne-Faye, former French and Martinique international, Julien Faubert, former French under-21 international, Florent Sinama-Pongolle, former Nigerian international, Peter Odemwingie, former Moroccan international, Jaouad Zairi, Brazilian-born former Bulgarian international, Marcelo da Costa, former Palestinian women international and FIFA official, Hone Thalidjieh, and former Madagascar international, Alister Veerasamy.

According to the Centre for AIDS Prevention and Control in Saint Petersburg in the Russian Federation, fewer people are becoming infected with HIV in the city. “Ten years ago, Saint Petersburg was among the top five most affected cities in the Russian Federation. Now it is only the 14th most affected,” said Denis Gusev, Head Physician of the AIDS centre. “Saint Petersburg is the first urban metropolis in the Russian Federation where a steady decline in new HIV infections has been recorded,” added Vinay P. Saldana, Director, UNAIDS Regional Support Team for Eastern Europe and Central Asia.

In 2017, there around 1750 people newly diagnosed with HIV in the city, compared to nearly 2200 in 2015. In total, about 42 000 people have been diagnosed as living with HIV in Saint Petersburg, 80% of whom access services at the Centre for AIDS Prevention and Control. The AIDS centre provides not only antiretroviral therapy, but also a full range of specialized medical care and HIV prevention services.

Artem Vereshchagin, who answers calls at the AIDS centre’s hotline, has been a client of the centre for more than 18 years and more recently an employee. He notes that more and more people who call the hotline now ask practical questions, such as “How do I get HIV treatment” and “How much time is needed to get an undetectable viral load”.

Saint Petersburg is one of the few cities in the Russian Federation that provides patients with virtually the entire range of HIV prevention and treatment services, including harm reduction. Prevention services are available at the city AIDS centre, where people can exchange syringes and get sterile equipment and condoms.

Quick testing for HIV is important, according to Mr Gusev, who says that the majority of people who are diagnosed with HIV in Saint Petersburg get immediate access to HIV treatment. “The main thing is for a person living with HIV to see a doctor and start antiretroviral therapy. Then we save a person’s life and help prevent new infections,” he said.

Saint Petersburg provides services for key populations, both in mobile clinics, in partnership with community-based organizations, and at the AIDS centre. “Women can get tested for HIV, receive condoms free of charge and talk to peer consultants,” said Irina Maslova, of the Astra Foundation, which works with female sex workers.

The Centre for AIDS Prevention and Control’s Department of Motherhood and Childhood provides services for women and children affected by HIV. The current level of mother-to-child transmission of HIV at the centre is 1%, but the staff want to reduce that to zero.

Saint Petersburg’s residents have been learning about HIV prevention services from a large outdoor advertising campaign and public service announcements across the city, supported by the city government. The advertising has three key messages—on HIV testing, the availability of HIV treatment and the elimination of all forms of stigma and discrimination against people living with HIV.

Credit for all photos above: UNAIDS/Olga Rodionova