Russian Federation

UNAIDS Deputy Executive Director (Programme) Luiz Loures (left) and Ksenia Yudaeva, G20 Sherpa, Office of the President of the Russian Federation.

In her first visit to Geneva as Russian G20 Sherpa, Ksenia Yudaeva visited UNAIDS Headquarters for a broad ranging discussion on global issues that are priorities for the Russian Presidency of the G20, including civil society participation, youth empowerment and development for all.

“Russia is using its Presidency of the G20 to strategically connect the dots on issues critical to the future of global governance,” said Ms Yudaeva, Chief of the Presidential Experts Directorate and the Russian G20 Sherpa. “UNAIDS’ experience is of special interest to Russia in how to promote civil society participation, transparency and accountability.”

Ms Yudaeva and her delegation from the Russian Sherpa’s Office were welcomed to UNAIDS by Dr. Luiz Loures, UNAIDS Deputy Executive Director (Programme). “UNAIDS welcomes Russia’s unprecedented leadership on global governance. As President of the G20 in 2013 and of the G8 in 2014, Russia has an unprecedented opportunity to leverage support of civil society and young people to advance its priorities of sustainable, inclusive and balanced growth and development for all.”

Julia Lasker participated in a panel discussion entitled Achieving MDG6 in Eastern Europe and Central Asia: Focus on Women and Girls.
Credit: UNAIDS/Stan Honda

The glamorous world of pop music and the grim realities of the HIV epidemic in Eastern Europe and Central Asia may seem like strange bedfellows. However, Russian singer and AIDS activist, Julia Lasker, engages in both with full commitment.

Ms Lasker became interested in AIDS in 2009 as she had friends living with HIV. She realised how limited the understanding of AIDS was among young women and, since then, has used her public profile and popularity with young audiences to raise awareness of HIV. “I feel personally responsible for many young girls whom I may prevent from being infected just by providing them with knowledge about the virus and how to prevent it,” she said.

Last week, Ms Lasker returned from New York, where she participated in a panel discussion entitled Achieving MDG6 in Eastern Europe and Central Asia: Focus on Women and Girls organized as part of the UN Commission on the Status of Women. During the discussion she called for a new approach to HIV.  “There is a huge need to openly discuss the issue in the society, encourage people to test for HIV, encourage young people to protect themselves and their loved ones, call for tolerance.”

Hosted by the Government of Russia together with the Governments of Finland and Sweden and UNAIDS, the panel discussion brought together government, civil society and UN representatives to find ways to effectively respond to the growing HIV epidemic in Eastern Europe and Central. The event was a follow up to the International Forum on MDG 6—to combat HIV/AIDS, malaria and other diseases—convened in October 2011 under the leadership of the Government of Russia.

“It is clear that countries in Eastern Europe and Central Asia need to act quickly to stop the growing HIV epidemic among women and girls,” said Dimitry Maksimychev, Deputy Permanent Representative of the Russian Federation to the United Nations. “With less than 1,000 days now until 2015, we need to work together—governments, donors, international organizations and civil society—to maximize our impact. Russia stands ready to put its leadership into action assisting countries in the region to achieve MDG6,” added Mr Maksimychev.

Julia Lasker, like many other women and men engaged in the HIV response in the region, remains determined. “If I can get this message to at least a few people, it's a step in achieving the goal of zero new HIV infections, zero AIDS-related deaths and zero discrimination.”

Women and HIV in Eastern Europe and Central Asia

“Women are especially at risk of HIV due to multiple factors such as economic vulnerability, fearing or experiencing violence, and difficulties in negotiating for safe sex,” said UNAIDS Regional Director for Eastern Europe and Central Asia a.i., Dr Jean-Elie Malkin. “In extreme cases women combine all vulnerabilities associated with drug use, sex work, social marginalisation and stigma and discrimination which prevent them from accessing HIV services,” he added.

Julia Lasker meeting with Deputy Secretary-General of the United Nations, Dr Asha-Rose Migiro
Credit: UNAIDS/Stan Honda

The number of people living with HIV in Eastern Europe and Central Asia almost tripled between 2000 and 2009. In 2010 there were an estimated 1.5 million people living with HIV in the region. The number of new HIV infections acquired through heterosexual contact has increased by 150% in the last decade. HIV represents a growing threat for women in the region. Women make up a rising proportion of people living with HIV—up to 50% in some countries in Eastern Europe and Central Asia. In Russia, for example, the number of young women with HIV aged 15-24 is two times higher than among men of the same age.

While significant progress has been made in some areas—in 2010, 88% of pregnant women living with HIV in Eastern Europe and Central Asia received treatment to prevent HIV transmission to their child—challenges remain. Recognising that not all women are reached by HIV services and programmes, the Government of Russia together with UNAIDS and partners are collaborating to develop guidance on how to increase access to HIV treatment, care and support services for all women—including people who use drugs, their sexual partners, sex workers, prisoners and other key populations at higher risk of infection.

“There is opportunity and space for addressing the HIV needs of women, using their sexual and reproductive health concerns as an entry point,” said Evgenia Maron, of the Astra Foundation, an AIDS service organization in Russia. “There is a need to meaningfully involve women living with and affected by HIV in all aspects of the AIDS response. We know what our realities are, we know what we need and we know what the solutions are,” she added.

Panellists in the session included (from left to right): Nina Ferencic of UNICEF; Paige Alexander of USAID; James Chau, a UNAIDS Goodwill Ambassador; Mikhail Grishankov, a member of Russia’s State Duma; Dr Luiz Loures, Director of the UNAIDS Executive Office

Women, girls and HIV were the focus of a panel discussion on the final day of the International Forum on MDG-6 in Eastern Europe and Central Asia. Moderated by UNAIDS Goodwill Ambassador James Chau, the session included representatives from government, civil society and international development organizations.

Across Eastern Europe and Central Asia, the number of women infected with HIV is growing every year. In Russia, HIV prevalence among young women aged 15-24 is two times higher than among men of the same age, according to government figures.

Alexandra Volgina, an advocate for the Russian women’s network EVA, opened the session describing the key challenges faced by women and girls affected by HIV in the region. Stigma and discrimination, she said, continue to hamper access to HIV services and sustained availability of HIV treatment remains a major concern. Harm reduction programmes for women who inject drugs are insufficient, she added.

Ms Volgina was joined in the audience by women affected by HIV from across the region. Svetlana, a former drug user and mother of two, called for programmes that address the specific needs of women, including special treatment and care centres for women with children. “The birth of a child is a huge incentive for women using drugs to quit—but when these women seek help, we have nothing to offer,” she said.

Members of the regional networks highlighted the issue of violence faced by women within their own homes and communities. They also spoke of the pressure that many pregnant women living with HIV face to end their pregnancies. Several participants indicated that legal frameworks hinder access to much-needed care, including services that prevent new HIV infections in newborns.

Women affected by HIV launched a campaign at the MDG-6 Forum with the slogan, “Children’s health starts from mom! Invest in women!” This theme was echoed in the remarks of UNICEF’s Nina Ferencic, who drew attention to the inextricable link between mother and child. “If you ask HIV-positive children what they want, they’ll tell you that—more than anything—it’s for their mothers to be alive and well. For a child to be healthy and happy, we need to first take care of the mother,” she said.

Panelist Paige Alexander of the U.S. Agency for International Development (USAID) said that putting a human face to HIV is what will drive change in the region.  “We need to raise the face of women through all channels—by, for example, supporting women’s networks and women’s leadership,” she said.

Mikhail Grishankov, a member of the Russian Federation Parliament who has been working on AIDS issues for many years and a longstanding advocate for women and girls, called for greater cooperation between all stakeholders in addressing the needs of women in the HIV response. “Without political leadership and a united civil society, we will not be able to move ahead on this issue,” said Mr Grishankov, who also serves as Vice-Chair of an inter-parliamentary working group on AIDS and other diseases.

Sveta Izambaeva, member of the Russian Network of Women affected by HIV

Mr Grishankov also underscored the need for wider public awareness of HIV in Russia using various media channels. He committed to organizing a highly visible follow-up meeting between parliamentarians, women’s groups and HIV experts to review the immediate challenges faced by women affected by HIV in obtaining appropriate services.

“We need a fundamental change in the way that this region is responding to HIV,” said Luiz Loures, Director of the UNAIDS Executive Office. “If we want to make progress in this region, we need to look at the epidemic through a woman’s eyes,” concluded Dr Loures.

The International Forum on MDG-6, hosted in Moscow from 10-12 October by the Russian Federation, aimed to foster a strategic discussion on progress towards the Millennium Development Goal 6 in Eastern Europe and Central Asia. UNAIDS will ensure immediate follow-up to the Forum, engaging women’s organizations and partners.

Panellists in the session included (from left to right): Women’s World Cup champion Lorrie Fair; Russian HIV activist Alexandra Volgina; Chinese television news anchor James Chau; UNAIDS Executive Director Michel Sidibé; and Indian actress Preity Zinta.

On the opening day of the International Forum on MDG-6 in Moscow, Indian actress Preity Zinta, women’s World Cup champion Lorrie Fair, Russian HIV activist Alexandra Volgina and UNAIDS Executive Director Michel Sidibé engaged in a lively discussion on how to turn the Millennium Development Goal 6 (MDG-6) into reality. The panel session, moderated by Chinese television news anchor James Chau, highlighted the important contribution by BRICS countries to the HIV response, and also the challenges ahead to achieve an AIDS-free generation.

Brazil, Russia, India, China and South Africa—often referred to as the “BRICS” countries—are home to 40% of the global population and nearly one third of all people living with HIV in the world.  While all BRICS countries have made progress in expanding HIV prevention and treatment services for their populations, the goal of universal access remains a critical challenge: In four of five BRICS countries, for example, only one third of people eligible for HIV treatment are receiving it.

With Eastern Europe and Central Asia facing a significant number of new HIV infections among people who inject drugs, Mr Chau, a UNAIDS Goodwill Ambassador, highlighted China’s national achievements in expanding harm reduction services. “Last week, I visited a methadone maintenance therapy clinic and saw first-hand how access to harm reduction is changing lives,” he said. Mr Chau noted that after years of a zero tolerance policy on injecting drug use, China began its harm reduction programme in 2005 and now has more than 700 clinics offering methadone maintenance therapy.

A supporter of social equality, Ms Zinta, who is also a Goodwill Ambassador for UNAIDS, cited the sports and film industries as important platforms to reach people of all ages with HIV prevention messages. “In India, the film industry has incredible influence and reach. So does cricket—the most popular sport in my country. If we succeed in using both mediums to spread awareness around HIV prevention, we will not just have healthier populations, but more caring ones too,” she said.

Ms Volgina, an advocate for the women’s network EVA, shared a personal story of the stigma she has faced as a woman living with HIV. “I have a goal to try and change HIV policy in Russia, so that when children impacted by AIDS—like my own daughter—reach school age, they won’t be discriminated against in any way,” said Ms Volgina, who recently gave birth to an HIV-negative baby. Ms Volgina highlighted how the HIV epidemic in the Russian Federation continues to grow, and increasingly affects women.

UNAIDS Executive Director Michel Sidibé and Indian actress and UNAIDS Goodwill Ambassador for India Preity Zinta

Ms Fair brought the discussion to South Africa, where she is currently working for the Charlize Theron Africa Outreach Project in the rural area of Kwa-Zulu Natal. Her work supports the use of mobile health units to provide HIV treatment, testing and counselling, education, and basic health care for communities spread out over great distances. “Bringing these services directly to people who need them is an important strategy to curb the HIV epidemic—not only in South Africa, but in any place where people would otherwise not have access,” said Ms Fair.

The UNAIDS Executive Director Michel Sidibé emphasized that people—not data or statistics—must be at the centre of efforts to reach MDG-6. “What inspires and guides my work are women like Alexandra who are breaking new ground in the AIDS response in Russia,” said Mr Sidibé. Achieving the UNAIDS vision of Zero new HIV infections, Zero discrimination and Zero AIDS-related deaths is “entirely possible” in Russia and beyond, he said.

The International Forum on MDG-6 is a three-day meeting hosted by the Russian Federation in collaboration with UNAIDS, the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Its aim is to foster a strategic discussion among key stakeholders on how to mobilize resources and partnerships to achieve MDG-6.

Panelists at the opening of the MDG-6 Forum including (left to right): Michel Sidibé, UNAIDS Executive Director; Alexey Kudrin, Governor of the World Bank Group and the IMF for the Russian Federation; Elena Salgado, First Vice President, Government of Spain; Arkady Dvorkovich, Aide to the President of the Russian Federation and Chair of the MDG-6 Forum; Sergey Lavrov, Minister of Foreign Affairs, Russian Federation.

On the opening day of the International Forum on MDG-6 in Eastern Europe and Central Asia, the three international Co-chairs of the meeting—UNAIDS, World Bank, and the Global Fund to Fight AIDS, Tuberculosis and Malaria—unveiled a new joint statement calling for accelerated action on MDG-6 in the region.

The three-day meeting in Moscow, hosted by the Government of the Russian Federation, brought together high-level representatives from government, civil society, the private sector and scientific community. The Forum is an unprecedented platform to redouble progress towards the sixth Millennium Development Goal (MDG) in the region.

MDG-6—one of eight development goals adopted by world leaders in 2000—calls for halting and reversing the spread of HIV, malaria, tuberculosis and other diseases by 2015. While the countries of Eastern Europe and Central Asia are on track to reach several of the MDGs, progress on MDG-6 is generally seen as behind.

Speaking at opening plenary on 10 October, Arkady Dvorkovich, Aide to the President of the Russian Federation and Chair of the MDG-6 Forum, underscored the critical link between achieving MDG-6, economic growth and sustainable development. “Russia has always considered fighting infectious diseases to be a priority for development. In view of the current economic situation, it has never been more important to ensure that our results are sustained and that commitments are kept,” he said.    

Sergey Lavrov, Russia’s Minister of Foreign Affairs said that Russia’s development assistance strategy in the region includes programmes related to HIV and other infectious diseases. “The health of all people in all times has been the most important asset for any state—that is why our work on HIV is so important,” he said.

Since the G8 Summit in St Petersburg in 2006, Eastern Europe and Central Asia has made significant progress in its response to HIV—one of the main pillars of MDG-6.  Across the region, more than 90% of pregnant women living with HIV now receive services to prevent new HIV infections in their children.  

Access to antiretroviral therapy has also expanded rapidly. In the Russian Federation, nearly
80 000 people were receiving life-saving antiretroviral therapy in 2010, compared to just 5,000 people in 2005—a sixteen-fold increase.

Despite progress, Eastern Europe and Central has the fastest-growing epidemic in the world. Over the past decade, the number of people living with HIV in the region has nearly tripled, from 530 000 in 2000 to 1.4 million in 2009. Approximately half of all new HIV infections in the region result from injecting drug use.

“Experience and science have shown us that without a holistic approach to the HIV response—including harm reduction and substitution therapy—we will not stop the transmission of HIV,” said UNAIDS Executive Director Michel Sidibé, in his opening address at the Forum. “Inaction will be very costly—if we don’t pay now, we will pay forever.”

Elena Salgado, First Vice President of Spain, also underscored the importance of harm reduction programmes in preventing HIV transmission among people who use drugs. In recent years, Spain has adopted a pragmatic—rather than moral—approach to injecting drug use which has led to a steep decline in new HIV infections, she said.

A new MDG-6 Action Plan will be launched on the final day of Forum, with an emphasis on financing and regional partnerships. The plan provides a road map to achieve a 50% reduction in new HIV infections across the region, among other goals.

Arkady Dvorkovich, Aide to the President of the Russian Federation (pictured left) and UNAIDS Executive Director Michel Sidibé deliver short remarks before a charity soccer match in Moscow on 9 October.

On the eve of the International Forum on Millennium Development Goal (MDG)-6, the Government of the Russian Federation and the Joint United Nations Programme on HIV/AIDS (UNAIDS) co-organized a charity soccer match at the Luzhniki Olympic Stadium in Moscow in support of women and children living with HIV in Russia.

The two teams—captained by Arkady Dvorkovich, Aide to the President of the Russian Federation, and Michel Sidibé, UNAIDS Executive Director—were composed of prominent politicians, business leaders and former international and Russian sports stars.

Members of the UNAIDS Red Ribbon United Team included internationally-known soccer players Daniele Massaro, Luigi Di Biagio, Gianfranco Zola and Lorrie Fair.  A number of high level government officials joined Dvorkovich on the Russian Rossich Team, including Sergey Lavrov, the Minister of Foreign Affairs, and Alexander Zhukov, Deputy Prime Minister.

“The aim of this game is to bring attention to the issue of HIV,” said Mr Dvorkovich. “I hope this event will encourage governments and companies to join efforts to support women, children and families affected by HIV,” he added.

Thanking the Russian Government for taking the lead in hosting the match, the UNAIDS Executive Director noted: “This is not just a game—I am confident that this event will help break the upward trajectory of the HIV epidemic in the region.”

According to government figures, a growing proportion of women across Eastern Europe and Central Asia are living with HIV. In Russia, HIV prevalence among young women is two times higher than among than among young men. Throughout the region, stigma and discrimination prevent women and children from accessing much-needed HIV and other health services.

The two teams—captained by Arkady Dvorkovich, Aide to the President of the Russian Federation, and Michel Sidibé, UNAIDS Executive Director—were composed of prominent politicians, business leaders and former international and Russian sports stars.

Speaking on behalf of women living with HIV in the region, Alexandra Volgina, an advocate for the Women’s Network EVA said, “This is the first time that we have come together in this region to talk about HIV at such a high level. I hope that we can all join forces to ensure that political declarations of commitment become a reality on the ground.”

Donations collected during and after the match will be used to finance a project in St Petersburg that helps women, children and families affected by HIV. On World AIDS Day, UNAIDS will publicly announce the results of the fundraising campaign.

This week, the Government of the Russian Federation, UNAIDS and partners will co-host an International Forum on MDG-6—a high-level meeting of representatives from government, civil society, the private sector and scientific community. The aim of the Forum is to foster discussion on progress towards MDG-6, with a specific focus on financing and regional partnerships in Eastern Europe and Central Asia.

MDG-6—one of eight development goals adopted by world leaders in the year 2000 at the United Nations in New York—calls for halting and reversing the spread of HIV, malaria, tuberculosis and other diseases by 2015.

UNAIDS Executive Director Michel Sidibé (left) plays with a two-year-old boy at a specialized centre for children living with HIV near St Petersburg, Russia.

On the first of a four-day mission to the Russian Federation, UNAIDS Executive Director Michel Sidibé and UNAIDS Goodwill Ambassador James Chau visited a specialized HIV clinic near Saint Petersburg that cares for children who have been orphaned by AIDS and pregnant women living with HIV. The UNAIDS delegation toured the facility with its chief physician, Dr Evegeny Voronin, a leading AIDS expert in Russia.

“We receive children from all over Russia—mainly, the most severe cases of HIV infection,” said Dr Voronin, head of the Centre for Prevention and Treatment of HIV Infection in Pregnant Women and Children. “The overall strategy is that children are treated in their place of residence and sent to us only when there is no other choice,” he added.

Providing high quality treatment is just half the battle, says Dr Voronin.  After addressing a child’s medical needs, he and his team of social workers turn their attention to the social and psychological environment—crucial elements in the health and development of any child, particularly one living with HIV.

“Here at the Centre, we try to do everything we can so that the children don’t feel different from children in families,” said Dr Voronin, adding that his team encourages the children to dance, play music and participate in group activities to help them become more socially engaged. “But this Centre will never be a substitute for a real family,” he said.

During their tour of the Centre, Mr Sidibé and James Chau were treated to a musical performance by five pre-school age girls and one male toddler. “Being here gives me great hope,” said the UNAIDS Executive Director. “When they first came to this Centre, many of the children were unwell and couldn’t speak. Now they are dancing, singing, healthy and thriving,” he said.

According to government statistics, an estimated 5200 children under the age of 15 were living with HIV in the Russian Federation in 2010. More than 22% of children living with HIV are orphans or have been left behind without parental care.

Perceptions around HIV slowly shift

Dr Voronin notes that in Russia’s larger cities, social stigma towards people living with HIV is less pronounced than in remote regions of the country, as people tend to have access to more information. “Here in St Petersburg, HIV is not a rare disease—there are more than 40 000 people living with HIV,” he told the UNAIDS delegation. “People recognize that HIV-positive people are the same as everyone else.”

As HIV becomes more widely understood and accepted in Russia, the number of adoptions of children living with HIV is on the rise, says Dr Voronin. Five years ago, he says, only 10 out of 350 abandoned children were adopted in Russia—mainly by employees at his Centre or people of religious faith. Today, 100 per cent of girls under the age of seven at the Centre are adopted by families.

“These children are sons and daughters,” said James Chau, a well known television personality in China who works with UNAIDS on stigma and discrimination issues. “If we succeed in breaking the last barrier—social stigma—we will turn a fundamental corner in the HIV response. I am incredibly encouraged by what I see at Dr Voronin’s Centre.”

Preventing new HIV infections in children

In addition to caring for children living with HIV, the centre works to prevent new HIV infections. “Over the past two years, we have achieved zero per cent transmission of HIV from mother to child among 300 women seen at our centre,” said Dr Voronin.

He noted, however, that about 15% of pregnant women living with HIV across Russia seek treatment too late in their pregnancies—immediately before or during labor—and give birth to about 50% of all HIV-positive children in the country.

UNAIDS Executive Director Michel Sidibé (left) pictured with Arkady Dvorkovich, Assistant to the President of the Russian Federation and Chair of the Organizing Committee for the International Forum on MDG 6.

In a one-day visit to Moscow on 29 June, UNAIDS Executive Director Michel Sidibé praised the commitment and leadership of the Russian Federation in national and regional efforts to achieve Millennium Development Goal (MDG) 6—a global target that calls for halting and beginning to reverse the spread of HIV and other diseases by the year 2015.

The President of the Russian Federation, Dmitry Medvedev, has called for a broad debate on reaching MDG 6 in Eastern Europe and Central Asia. In response to his call, the Russian Government will host the International Forum on MDG 6 from 10-12 October 2011, bringing together scientists, government officials and representatives from civil society.

“Russia’s leadership is vital to addressing the HIV epidemic in Eastern Europe and Central Asia,” said the UNAIDS Executive Director at a meeting of co-chairs for the MDG 6 Forum, led by Arkady Dvorkovich, Assistant to the President of the Russian Federation. “Victory in this region’s HIV response will only be possible with Russia’s leadership,” he added. Co-chairs of the Forum include the Government of Russia, UNAIDS, The World Bank and the Global Fund Fight AIDS, Tuberculosis and Malaria.

 “The fact that this Forum will take place in Moscow and is being organized by the Presidential Administration, the Ministry of Finance and the Ministry of Foreign Affairs sends a strong signal that MDG 6 is a political priority for Russia,” said Dr Gennady G. Onishchenko, Head of the Russian Federal Service for Surveillance on Consumer Rights and Human Wellbeing, in a meeting with Mr Sidibé on 29 June.

Eastern Europe and Central Asia is one of the only regions of the world with a rising HIV epidemic. Between 2000 and 2009, the estimated number of people living with HIV in the region nearly tripled, from 530 000 to 1.4 million. Most people in the region are infected with HIV through injecting drug use. However, in recent years, an increase in the sexual transmission of HIV has been documented.

Russia and its neighboring countries in Eastern Europe and Central Asia are drawing on a number of strengths to address the regional HIV epidemic, including a high level of education among the population, a strong medical research community, highly competent health professionals and a strong culture of monitoring and case reporting. More than 90% of HIV-positive pregnant women in the region receive services to prevent mother-to-child transmission of HIV (PMTCT)—among the highest regional rates of PTMCT coverage in the world.  

Civil society highlights need for targeted HIV prevention

In a meeting with the UNAIDS Executive Director on 29 June, 21 representatives from civil society organizations in Moscow underscored the need for considerable scale-up of HIV prevention measures for populations at higher risk of HIV infection, particularly people who inject drugs.

“We see that the government is becoming more open and ready to listen to us and to work with us,” said Igor Pchelin, Executive Director of All-Russian Union of People Living with HIV, a non-governmental organization based in Moscow. “We have to leverage this transformative moment. Civil society organizations stand ready to partner with the government in reaching out to key populations and ensuring the sustainability of prevention measures in the country,” he added.

From left: Jean-Louis lamboray, Director of The Constellation, one of the facilitators of the AIDS Competence project; Sveta Izambaeva, Niayaz Illiasovich Galiullin, Chief Doctor of the Kazan’s AIDS Center; Dr Denis Broun, Director of UNAIDS Regional Support Team for Europe

"You should not expect a solution to come from the outside. You need to look for it in the very communities and their people,” says the director of the international non-governmental organization The Constellation, Jean-Louis Lamboray during a recent presentation of the AIDS Competence project, in Kazan, Russia.

The objective of this initiative is to mobilize local responses to AIDS by promoting awareness within communities of their own strengths and capacities and facilitating the exchange of experiences within the communities. To accomplish this objective, the AIDS Competence project uses an approach called SALT— Stimulate, Acknowledge, Listen and Transfer—where trained facilitators visit communities to help them identify needs, formulate ideas and to form a leadership team from representatives of the community.

“People have enough wisdom and understanding of the risks. Our challenge is to encourage them to respond to the epidemic. Many communities and people are scattered and we have to help them form the right connections and networks,” added Mr Lamboray.

The meetings between communities and facilitators in Kazan show that when, a community openly acknowledges the risk of HIV, it can take action and mobilize support from within.

“I am a mother and grandmother,” said Irina, who took part in the meeting. “I worry about my family and want to know what I can do to protect them from HIV."

"If we want to get rid of stigma, we have to start from small groups, at home, at work,” said Natalia, whose husband Sergei uses drugs and is HIV positive. “Let’s have a discussion about it with the families in our neighborhood.”   

AIDS response in the Russian Federation

Eastern Europe remains the only region in the world where the epidemic is still on the rise. According to the Federal AIDS Centre in Russia, there are about 160 new registered cases of HIV infection daily in the country and more than 590,000 people are living with HIV. HIV transmission in the country is mainly driven by injecting drug use but heterosexual transmission is on the rise.

“The mobilization of the local response is critical for keeping the HIV epidemic under control in Russia as the lack of funding for HIV prevention programmes at the federal level may cause a serious setback in results achieved in the AIDS response,” said Dr Denis Broun, Director, UNAIDS Regional Support Team for Europe and Central Asia.

UNAIDS seeks to encourage community activism in the country and so it concentrates its advocacy work at decentralized levels for example by linking municipal authorities and civil society groups to help them share experiences and consolidate best practices around HIV prevention.

Anastasia Solovieva, head of “Unity Fidelity Advocacy" (left) and Maria Godlevskaya, member of the network and head of the charity foundation Candle (right) during the official presentation of the Russian network of women living with HIV. Saint Petersburg, 5 March 2011.

“Women need help to overcome fear and to defend their rights,” says Anastasia Solovieva, head of the first Russian network of women living with HIV, called “Unity Fidelity Advocacy".

The network, launched on the eve of the International Women's Day in Saint Petersburg is supported by UNAIDS. It unites women and organizations supporting them from various parts of Russia to improve the quality of life of women affected by HIV. Through integrated HIV services, the network advocates for wider access to HIV treatment, care and support and the protection of human rights. 

In the past decade the spread of HIV has shifted in Russia. HIV transmission has moved from injecting drug use to include heterosexual transmission. And there has been a rise in the number of women living with HIV.

Natalya Ladnaya, chief officer of the Russian Federal AIDS Centre, points out that 65% of women who became infected in 2010 were infected through sexual contact. Many women have been infected by their husbands, and first learned of their HIV-positive status during pregnancy.

According to Ms Ladnaya, lack of HIV prevention programmes among women and very low levels of awareness about the virus and how to prevention transmission are some of the reasons behind this situation. “Women often do not insist on using a condom,” added  Maria Godlevskaya, member of the new network and head of the charity foundation Candle.

In Russia, as many as 95% of pregnant women living with HIV receive antiretroviral therapy to prevent HIV transmission to their babies. However the country still faces many challenges in the wider area of sexual and reproductive health. Many women at higher risk of HIV infection do not have access to services for the prevention of mother-to-child HIV transmission (PMTCT).

According to reports from civil society organizations in different regions of Russia, stigma in society and even among healthcare workers discourages pregnant women living with HIV to approach healthcare facilities. Additionally, sex workers and women who inject drugs are even less likely to be able to access PMTCT services for fear of discrimination.

"It is especially difficult in the remote regions of Russia,” said Ms Solovieva. “We need to work together to adapt the health system to the needs of women affected by the epidemic.”