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

Basilisa Ndonde has a big smile on her face as she walks into her office at Tanzania Health Promotion Support, a civil society organization. It is a special day for her—World Cancer Day, commemorated on 4 February each year. Ms Ndonde is at the forefront of the response to cancer on the ground, coordinating the Afya Jali project to raise awareness about, and uptake of, cervical and breast cancer services among women living with HIV.

Women living with HIV are four to five times more likely to develop cervical cancer than women who are HIV-negative. HIV weakens the immune system and reduces the body’s ability to fight opportunistic infections, such as the human papillomavirus (HPV), which causes 70% of cervical cancer cases.

The United Republic of Tanzania has the sixth highest incidence of cervical cancer in the world and has 1.4 million people living with HIV.

Ms Ndonde is proud of the achievements of the Afya Jali (which means “Taking care of your health” in Swahili) project so far, just a few months after its inception. In collaboration with the Ministry of Health, Community Development, Gender, Elderly and Children and the Tanzania network of women living with HIV, Ms Ndonde has facilitated the development of resource materials for health and community workers to sensitize women on the need to be screened for cervical and breast cancer. “For the first time in the country, we now have comprehensive guidelines for health workers on the prevention, screening and treatment of the cancers of reproductive organs,” she says.

Ms Ndonde has obtained the support of local government authorities in all four regions in which the project has been implemented. She has also organized a training of trainers workshop in the same regions for 30 women living with HIV, who sensitize other women on cervical and breast cancer and encourage cancer disclosure to mitigate stigma. “Each participant had to practice and demonstrate in front of the workshop’s audience that they know how to deliver the messages back to their respective communities,” says Ms Ndonde.

The project is funded by UNAIDS as part of the Pink Ribbon Red Ribbon (PRRR) initiative, a global partnership of governments, nongovernmental and multilateral organizations, foundations and corporations with a shared goal of reducing deaths from cervical cancer and breast cancer in low- and middle-income countries. PRRR’s mission in the United Republic of Tanzania is to build on existing health-care programmes to integrate cervical cancer prevention, screening and treatment and breast cancer services and to increase access to HPV vaccination.

UNAIDS is working with countries to achieve the commitment made by counties at the United Nations High-Level Meeting on Ending AIDS in 2016 to take AIDS out of isolation through people-centred systems to improve universal health coverage, including treatment for tuberculosis, cervical cancer and hepatitis B and C.

The International Day of Women and Girls in Science is celebrated on 11 February. As part of UNAIDS’ Right to Health campaign last year, UNAIDS Special Ambassador for Adolescents and HIV and champion for young women in science, Quarraisha Abdool Karim, spoke with her daughter about her life’s work and the importance of women’s involvement in science and health.

Mother and daughter, Quarraisha Abdool Karim (Q), the Associate Scientific Director of the Centre for the AIDS Programme of Research in South Africa, and Aisha Abdool Karim (A), a student at the Columbia University Graduate School of Journalism, spoke about health and what that means for young women in South Africa.

A: For me, growing up I was surrounded by science and it was part of my daily life, but what got you interested in science and health?

Q: Probably for most of my life I thought about science and its application to leaving people better off. So, I wanted to be a scientist and I wanted to do something that would help people.

A: Science continues to be a male-dominated field, like many others, so I feel like you brought an interesting perspective to your research. How do you think your experience as a young woman influenced your research?

Q: My very first study, when I was relatively young, 28, was when I did the first population-based survey in South Africa. The data were very clear, that young women had a four-times higher HIV infection rate than young men and that women acquired HIV about five to seven years earlier than men. And that intrigued me a lot and I spent the next 20-odd years trying to really understand that better. To understand why young women were getting infected but not young men and to understand what some of the factors were that were influencing young women to become sexually active.

A: It’s interesting to me that you chose to focus on understanding why women are becoming sexually active, because I feel like my high school education was very focused on abstinence. Even though we did have a version of sex education, it wasn’t very informative or useful. Do you feel like there’s been a change in education around topics like reproductive health since you were in school?

Q: You know, I grew up in a much more conservative era, where having relationships in high school and being sexually active were much more frowned upon. But I think that teachers still feel very uncomfortable talking about sexual health and choices and generally about reproductive health issues in South Africa, or, I would go so far as to say, in Africa.

A: I agree, I think there's still this hesitance to discuss sex openly at school. While the topic of sex might not have been off limits in our home, it definitely made some of my friends uncomfortable if I brought it up in conversation.

Q: You’re reminding me of something else that I’ve learned in working with young people, which is that they don’t like getting information from adults and people they’re familiar with. They're more comfortable getting information from their peers. It shows how knowledge is important, but also how it’s viewed in the community and how the society you live in influences your ability to act.

A: Well, you’re talking about the role of the community, which extends beyond just education and policies. Nowadays, I think people are becoming more aware of the intersectionality of issues and health is no exception. Young women have been a central part of your research. What are some of the other factors that affect their lives?

Q: I’ve learned that the vulnerability of young women is very much tied into gender power differences in society and these disparities are very important for perpetuating the vulnerability of young women socially, economically and politically. And that extends way beyond HIV.

A: The reality of gender power dynamics is something I only really began to understand when I was at university, because it wasn’t really an issue for me when I was at my girls high school. Do you think that the political landscape of South Africa changing to a democracy has had an impact on these gender dynamics?

Q: Although the politics has changed, that has not been translated to the grass-roots level. Younger women needed to understand that they are now in a different world in South Africa, with many more opportunities.

A: That comes back to the idea of gender dynamics and community. I feel that there’s this idea of girls lacking independence and that makes it more difficult, especially for young women, to feel like they can make their own decisions when it comes to their bodies.

Q: So, I think there is this tension, and I think you are in a better position to talk about women of your age or younger. There used to be this thing about how women should be ignorant about their bodies and their partners will be able to tell them everything. Whereas I think to be empowered, you actually need to know about your own body. It’s so important for young women to have access to information about health. We need to be encouraging an attitude where young women are no longer ashamed to know about their own bodies. Do you think there’s a way we can address this?

Q: Having a social environment that is supportive of those norms is critically important, because young women themselves have very little agency. But in order to create that climate and context, it will necessitate men taking greater responsibility, boys taking more responsibility for themselves and their behaviours.

A: Education is such a key part of creating that environment and addressing the topic of health. Being able to see the impact that your research had on public perceptions gave me a sense of the power that information can have and was part of the reason why I decided to be a journalist. This is something particularly important in this day and age, when we need to combat the spread of misinformation and debunk myths in health care and beyond.

A baby abandoned at a health clinic, an abusive boyfriend, dating woes and fake medicines are all plot twists in C’est la Vie (That’s Life), a television series based in, and produced in, Africa. Shot in Senegal, the sitcom takes place in the fictitious Ratanga health clinic, where midwives interact with patients and work on various cases. Their life stories and office politics come into play, adding intrigue, but the overall aim is to raise health awareness through entertainment.

The series, a first in western Africa, was inspired by Mexican pioneer Miguel Sabido—who used telenovelas to promote literacy and family planning—as well as by the educational television series Shuga. Shuga, the MTV English-language series, is now in its six season and has been so successful that it has moved its filming location from Kenya to capture new stories from Nigeria and South Africa.

Réseau Africain d’Education en Santé (RAES), a nongovernmental organization backed by several United Nations agencies and the French Government, founded Keewu, a production company, to launch the show.

RAES founding member and now Keewu producer Alexandre Rideau’s motivation for launching C’est la Vie was to reach millions via television. “The statistics speak for themselves in western Africa,” Mr Rideau said. “Young people are clueless about sexuality, HIV prevention and simple things like menstruation.” He also added that it was obvious from the many questions received that people had real difficulty in accessing information.

The show highlights many of the realities of the region, from high levels of maternal deaths to HIV infection. Four in five children living with HIV in western and central Africa are still not receiving life-saving antiretroviral therapy and AIDS-related deaths among adolescents aged 15–19 years are on the rise in the region, according to a UNAIDS/United Nations Children’s Fund report, Step up the pace. 

In its second season, C’est la Vie has gained in popularity, so much so that actors are being recognized in the street. Mr Rideau recounted that a toll collector in a toll booth in Dakar would not let an actress who plays an unpleasant character in the series go through in her car.

Broadcast in western and central African countries on A+ and TV5 Monde Afrique, as well as local channels, the show reaches about 100 million viewers. Mr Rideau explained that the series may not necessarily change people’s behaviour, but it gets crucial conversations started about health issues. In Senegal and Togo, open debates about the show’s themes take place in town squares following an airing.

Mr Rideau said that he wants to roll the show out in six other countries in 2018. A radio spinoff in the Hausa language is now being distributed in Niger.

PROMO REEL - C'est la vie! - Saison 1 from Keewu Production on Vimeo.

Jimmie Earl Perry, the first UNAIDS National Goodwill Ambassador for South Africa, has died.

A seasoned singer and performer in theatre productions around the world, Mr Perry was notable for his work in using the creative arts to educate audiences. At the Africa Centre of HIV/AIDS Management at Stellenbosch University, South Africa, he staged HIV educational theatre productions that were performed to more than 3 million people in communities and workplaces nationally and internationally.

At the time of his appointment as UNAIDS National Goodwill Ambassador, Mr Perry said, “If we are to turn this epidemic around, South Africans have to really understand what the virus is, how it is spread, that it is not a death sentence thanks to medical treatment and to put an end to the fear and stigma of living with HIV.”

Michel Sidibé, UNAIDS Executive Director, said Mr Perry’s appointment in 2009 came at a critical time for the AIDS response in South Africa, with far-reaching policy changes announced by the President of South Africa, Jacob Zuma, on World AIDS Day of that year. “I decided to appoint Jimmie Earl Perry as National Goodwill Ambassador because of his capacity to inspire and his willingness to lead and empower others. He had a strong belief in the potential of people to rise above their circumstances and he encouraged the best in everybody he met.”

Mr Sidibé said Mr Perry’s passing was a great loss for the AIDS community. “Jimmie Earl Perry encouraged and inspired my global advocacy and efforts to end the AIDS epidemic as a public health threat by 2030. UNAIDS benefited a great deal from our association with Mr Perry, and we are grateful for his service and dedication. I am humbled and privileged to have counted him as my friend and brother,” he said.

Close to 10 years after its first edition, a fully updated International Technical Guidance on Sexuality Education published today by UNESCO advocates quality comprehensive sexuality education to promote health and well-being, respect for human rights and gender equality, and empowers children and young people to lead healthy, safe and productive lives.

“Based on the latest scientific evidence, the International Technical Guidance on Sexuality Education reaffirms the position of sexuality education within a framework of human rights and gender equality,” says UNESCO Director-General Audrey Azoulay. “It promotes structured learning about sexuality and relationships in a manner that is positive and centred on the best interest of the young person. By outlining the essential components of effective sexuality education programmes, the Guidance enables national authorities to design comprehensive curricula that will have a positive impact on young people’s health and well-being.”

The Technical Guidance is designed to assist education policy makers in all countries design accurate and age-appropriate curricula for children and young people aged 5 – 18+.

Based on a review of the current status of sexuality education around the world and drawing on best practices in the various regions, the Guidance notably demonstrates that sexuality education:

•  helps young people become more responsible in their attitude and behaviour regarding sexual and reproductive health
• is essential to combat the school dropout of girls due to early or forced marriage, teenage pregnancy and sexual and reproductive health issues
• is necessary because in some parts of the world, two out of three girls reported having no idea of what was happening to them when they began menstruating and pregnancy and childbirth complications are the second cause of death among 15 to 19-year olds
• does not increase sexual activity, sexual risk-taking behaviour, or STI/HIV infection rates. It also presents evidence showing that abstinence-only programmes fail to prevent early sexual initiation, or reduce the frequency of sex and number of partners among the young.

 The publication identifies an urgent need for quality comprehensive sexuality education to:

• provide information and guidance to young people about the transition from childhood to adulthood and the physical, social and emotional challenges they face.
• tackle the challenges posed by sexual and reproductive health issues, which are particularly difficult during puberty, including access to contraception, early pregnancy, gender-based violence, sexually transmitted infections (STIs) and HIV and AIDS
• raise awareness of HIV prevention and transmission, of which only 34 per cent of young people around the world can demonstrate accurate knowledge
• complement or counter the large body of material of variable quality that young people find on the internet, and help them face increasingly common instances of cyberbullying.

The Guidance was produced in collaboration with UNAIDS, United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF), UN Women, and the World Health Organization (WHO).

Aisha Abdallah never misses her regular medical appointments at the Zanzibar Youth Education, Environment, Development Support Association (ZAYEDESA) care and treatment centre for HIV, located on the outskirts of Stone Town, Zanzibar.

She was diagnosed with HIV in 2006. “I went with a group of friends to get tested. I was keen to know my status because of my lifestyle. And I tested HIV-positive,” she says.  

Ms Abdallah is engaged in sex work. “I was in a steady relationship with the father of my daughter,” she says. “But when he started to mistreat me, I had to run away from the Tanzania mainland to Zanzibar and find a way of living alone.” She says she often cries at the thought of leaving her daughter behind.

ZAYEDESA runs the only community-based HIV clinic in Zanzibar. Ms Abdallah found out about the new clinic in 2014 from a community outreach worker and a former sex worker. “In the first care and treatment centre where I used to go, I was treated like a kid and not getting the services which I needed. At ZAYEDESA, health-care workers talk to me in a friendly manner and understand my concerns,” she says. At the centre, she has also benefited from tuberculosis screening and treatment and family planning services, including condoms. “I trust the clinic. I know if I get ill I can get good service there.”

ZAYEDESA has established four youth-friendly health centres on both islands of Zanzibar, Unguja and Pemba, an anonymous toll-free AIDS helpline and a text message service to deliver HIV and sexual and reproductive health information. It is at the centre of the community-based AIDS response in Zanzibar and plays a critical role in offering stigma and discrimination-free services to key and vulnerable populations.

Stigma remains one of the major obstacles to accessing prevention, treatment and care services in Zanzibar. Ms Abdallah would like to pass on one message, “I want people to understand that HIV can affect anyone, anywhere.”

Ms Abdallah, who prefers not to use her real name, is on life-saving HIV treatment. “I know the importance of adhering to my antiretroviral treatment. My mum is very supportive, she calls me every day to check on me and remind me about the medicines.”

UNAIDS has supported the refurbishing of youth-friendly centres managed by ZAYEDESA. Currently, UNAIDS provides support to ZAYEDESA to ensure its meaningful participation in the development, implementation and review of the United Nations Joint HIV Plan in Zanzibar and on supporting its resource mobilization efforts.

Suhaila Msham Mwarimwana is 19 years old and lives in Zanzibar City. She was born with HIV and lost both parents before she was nine. But, despite the difficulties she faces, she is an inspiration for other adolescents and children living with HIV. 

“When I was about 12, I overheard neighbours saying I was HIV-positive. So I asked my oldest sister and she told me I had a bone-related disease,” she says. “But I sensed this was not the truth, so after some time I insisted and she took me to the Zanzibar Association of People Living with HIV/AIDS and I discovered my HIV status.”

Ms Msham Mwarimwana says her first thought was for her youngest brother, who also tested HIV-positive. She felt hopeless and desperate. “I thought HIV was a death sentence,” she says.

At a Zanzibar Association of People Living with HIV/AIDS (ZAPHA+) children’s club, Ms Msham Mwarimwana was given information and advice on how to live positively with HIV. She started HIV treatment and has stuck to the regime since, despite a lack of adequate nutrition, which she says makes adherence difficult.

After she finished secondary school she began volunteering for ZAPHA+. She facilitates clubs for children and adolescents. “We exchange ideas, share our challenges and advise one another,” she says. Her only wish is that the club had more space and was able to provide refreshments, particularly for the younger children. “We stay there and talk for a long time!” she says.

She is also a member of the Young Reporter Network, a national consortium of community-based children’s radio projects that reaches millions of listeners. She and other young reporters produce a 30-minute programme each fortnight, using audio diaries, commentaries and interviews to share their stories.

Ms Msham Mwarimwana has big dreams and plans to study journalism. She is proud of her contribution to the AIDS response in her country. “My role towards getting to zero—zero new HIV infections, zero discrimination and zero AIDS-related deaths—is to get my story heard to confront stigma and discrimination and draw attention to community issues that affect children and youth,” she says.

Looking back, Ms Msham Mwarimwana says she would have liked her parents to tell her she was HIV-positive. She says it is very important for children to know their HIV status. “I could have started my treatment even earlier,” she says. “Parents of HIV-positive children need to educate society that HIV can affect anyone and there is no shame.”

She believes that AIDS-related illnesses are a leading cause of death among adolescents in eastern and southern Africa because many adolescents are unaware of their HIV status and do not know that there are life-saving treatment and support structures available to them. “ZAPHA+ is my second home,” she says. “I am so thankful for the support I have received there.”

She has a simple message for her peers. “Accept and be open about your HIV status, be confident and believe in yourself.” 

UNAIDS has been supporting ZAPHA+ since its establishment through financial and technical support. UNAIDS supports the ZAPHA+ Secretariat to coordinate its activities in the 10 district clusters to ensure meaningful participation of ZAPHA+ in the development, implementation and review of the United Nations Joint HIV Plan in Zanzibar. UNAIDS also supports its resource mobilization efforts. Other United Nations agencies are closely engaged, in particular the United Nations Children’s Fund.

The young people spilled out of the bus, happy to have reached Côte d’Ivoire. Not only could they stretch their legs following the last leg of their journey, but they had arrived at their final destination, the International Conference on AIDS and STIs in Africa (ICASA). The Youth Caravan had started with 10 young people in Nigeria, followed by 10 more joining in Benin and a further two stops in Togo and Ghana.

Along the three-day, 1000 km, trip more than 40 young people shared their stories and experiences and talked about HIV, stigma and empowerment of young people in cities along their route.

One of the participants, Jefferson Kudolo from Ghana, couldn’t believe how fun the trip was, despite the distance, “The travelling brought us closer together and we forgot the kilometres,” he said. Another participant, Dayo Sunday from Nigeria, agreed. He loved connecting with people with similar tales from other countries.

Each day, the Youth Caravan led or attended an event, which included screenings of HIV-related films, meeting the First Lady of Benin, debates and an international dance competition.

Mr Sunday said music and dancing not only got the group to unwind, it allowed them to interact with other young people along the way. A peer educator at the Nigerian Teens and Kids nongovernmental organization, he said, “Dancing is one of the best tools to attract people who may be too shy to come to HIV-related events.”

“I know what works, and music definitely works,” Mr Kudolo said, explaining how he and the other participants of the Youth Caravan would distribute condoms and lots of practical advice at the venues. UNAIDS and partners started recruiting participants for the Youth Caravan nearly a year ago.

Kodo Ngabane, UNAIDS Youth and Social Organization Officer for the western and central African region, beamed with pride as the bus pulled into Abidjan. “We constantly say that young people need to be involved, and here is a clear example of doing just that,” he said. “We listened to them and they were in the driver's seat.” Without missing a beat, he added, “Figuratively, not actually driving the bus.”

Eric Gunn, accompanying youth participants from an association of girls in Togo, Action de Soutien au Developpement et l’Education de la Jeune Fille, said he was touched to see such enthusiasm. “A real esprit de corps took hold regardless of country, language, gender, sexual orientation,” he said. “Even us elders joined in the fun and were bombarded with questions.”

The Youth Caravan was welcomed at the ICASA Community Village by the Côte d’Ivoire Minister of Health, Raymonde Goudou-Coffie, King Oyo from Uganda, UNAIDS Executive Director Michel Sidibé and others.

After a standing ovation and lengthy clapping for the participants, Mr Sidibé addressed the crowd. “We count on you! You are not the leaders of tomorrow, but the leaders of today,” he said. “We will not end AIDS without young people.”

Mahabad Asanova’s first daughter was found to be living with HIV after being rushed to hospital with a high fever. For her second pregnancy, Ms Asanova had to wait 18 months before finding out that her son was HIV-negative.

By the time of her third pregnancy, however, things had changed dramatically. Within a month of her birth, Ms Asanova had been told that her daughter was HIV-negative. A revolutionary method of HIV testing of infants, dried blood spot (DBS) testing, had by then been introduced, significantly cutting the time for diagnosis.

“Waiting 18 months to know about the HIV status of my child was terrible,” Ms Asanova said. “I’m so relieved—dried blood spot testing completely changed my life.” Before DBS, children had to wait a year or more to be tested.

DBS is simple: no sophisticated equipment or invasive testing methods are needed. After a prick on the newborn’s heel, a drop of blood is collected on filter paper and dried. The sample is sent to a laboratory for testing and the results are known before the infant is a month old, allowing infants living with HIV to be treated immediately with life-saving antiretroviral medicines.

“Before dried blood spot testing was widely introduced in 2013 in Kyrgyzstan, only around 15% of infants were diagnosed early,” said Edil Tilekov, HIV Programme Officer for the United Nations Children’s Fund (UNICEF). “In 2017, that figure grew to nearly 90%.”

Today, HIV science and diagnostics are becoming ever-more sophisticated. UNICEF is promoting point-of-care HIV diagnostic methods for infants that would yield an HIV diagnosis a mere two hours after collecting blood.

The introduction of DBS and improved training for doctors has helped to defuse some of the stigma against people living with HIV.

“Stigma among medical staff began to decrease as antiretroviral medicines were integrated into the primary health-care system,” Elmira Narmatova, Director of the Osh Oblast AIDS Centre, said. “It became more like a chronic disease, mortality declined.”

Children who are treated early fare better and the more the medicines work, the more confident parents become. Today, in part as a result of DBS, more than 95% of children living with HIV in Osh, Kyrgyzstan, access antiretroviral therapy.

Yet pockets of resistance remain. Despite early diagnosis, not all infants receive the medicines they need. “We are interviewing parents and medical staff to find out why some parents still don’t want to give their infants antiretroviral medicines,” said Mr Tilekov.

Informal conversations already provide clues: resistance may be due to religion, to scepticism about immunization or even to urban myths.

“Although much has been done to provide parents with information and train medical staff, there is still a lack of resources and trained personnel, so some parents will slip through the net and might not be briefed properly about side-effects,” said Mr Tilekov. “So, if their infants lose weight or don’t eat well after starting antiretroviral therapy, parents blame the medicines.”

When an infant or mother is tested for HIV in Osh, the laboratory sends the results to the Osh AIDS Centre, a pleasant house set among trees in a leafy suburb, its gates open in welcome. The hallways are decorated with images of the popular Vitaminka fairy tale, a comic strip that helps health workers and parents explain to children the importance of taking their antiretroviral medicines regularly.

By providing child-friendly spaces and psychosocial support in addition to medical treatment, the centre makes parents feel welcome and encourages them to visit, pick up prescribed medication and get tested regularly.

The centre, upgraded by the Ministry of Health together with UNICEF and UNAIDS with support from the Government of the Russian Federation, now treats more than 200 children and a psychologist provides psychosocial support to children living with HIV.

Away from social pressures and among friends, parents can exchange hopes for the future and find much needed support at the centre.

Ms Asanova looks relaxed as her fingertips touch across her lap, her olive-green dress contrasting with her cream-coloured hijab. Mahabad Asanova isn’t her real name, since she still worries about stigma and discrimination beyond the centre’s walls. But she isn’t afraid anymore, even though she is now expecting another child. Whatever happens, thanks to DBS, she will no longer face painful months of waiting for a diagnosis.