Experiences of the Russian Red Cross in Providing

Experiences of the Russian Red Cross in Providing Medical/Psychological Assistance to HIV+ women and Children born to HIV+ mothers Irkutsk City (East Siberia) Russian Federation

Facts about the HIV/AIDS Epidemic in the Russian Federation • Russia has the biggest AIDS epidemic in all of Europe • Approximately 350, 000 HIV cases have been ‘officially’ registered in the Russian Federation (Russian AIDS Centre, 2005) • Actual number of total infections is believed to be over 860, 000 (UNAIDS, 2004) • Young injecting drug users are fueling the epidemic (340, 000 IDUs registered in 2004)

The HIV/AIDS Epidemic in Irkutsk Region (East Siberia) Dramatic increase in HIV: • 4, 500 cases in 2000 • 20, 000 cases in 2005 Rapidly changing dynamic: • In 2000, the epidemic was fueled almost entirely by IDUs • Today, 50% of all cases are among women who were infected through heterosexual transmission More than 2, 000 children born to HIV+ mothers since 1999

“The Care & Support Project for PLWHA” Project Goal: Improved quality of life for PLWHA, including HIV+ pregnant women and children born to HIV+ mothers Target beneficiaries: PLWHA, including HIV+ pregnant women and children born to HIV+ mothers Start date: February 2003 Donor: Private Funding by U. S. -based Foundation, in partnership with the American Red Cross

Project Goals and Objectives Objective 1: Improve healthy behavior and disease management skills for PLWHA Objective 2: Decrease experiences of fear or stigma reported by PLWHA (from themselves, healthcare workers, family and friends) Objective 3: Reduce risk of mother-to-child transmission (MTCT) of HIV Objective 4: Improve psychological and physical development of children (0 -6 years old) born to HIV+ mothers

Objective 3: Reduced Risk of Mother to Child Transmission (MTCT) of HIV Interventions/Activities • Providing home visits and counseling to HIV+ pregnant women and new mothers • Partnership with AIDS Center on referral system • Monitoring adherence to ARV therapy in coordination with the AIDS Center

Objective 4: Improve the physical and physical development of children born to HIV+ mothers Interventions/Activities • Distribution of food parcels and vitamins to families • Psychological support for children born to HIV+ women • ‘Stigma and discrimination’ trainings for teachers and health workers

Program Strategies Information and Counseling Center (ICC “Steps”) • HIV/AIDS Information and Counseling Center (ICC “Steps”) • HIV/AIDS Hot Line • Peer support group for PLWHA (first of its kind in Irkutsk)

Program Strategies Information and Counseling Center (ICC “Steps”)

Program Strategies Visiting Nurse (VN) service of the Russian Red Cross • The VN service of the Russian Red Cross was established 60 years ago • During the Soviet times, the VNs provided care for vulnerable populations, particularly elderly populations • Post-Soviet Union, the range of services provided by VNs has grown to include care for vulnerable children, TB patients, and PLWHA

Program Strategies Visiting Nurses & HIV programming Activities/Interventions • Regular monthly screening visits to vulnerable families with children born to HIV+ mothers, coordinated with the AIDS Center • Counseling of parents about prenatal prevention of HIV infection, nutrition and, adherence to ARV therapy • Monitoring of mental/physical development of children born to HIV+ mothers

Program Strategies Visiting Nurses & Home-based care Activities/Interventions: • Psychological support to HIV+ pregnant women and young mothers with the purpose of preventing social abandonment of children • Delivering food packages to children and ensuring the intake of essential vitamin supplements • Training for health workers on home -based care in coordination with the Pediatric services of the AIDS Center

Manual on Care & Support of PLWHA: for Visiting Nurses and Caregivers • Epidemiology of HIV • AIDS-related diseases • Nutrition • Treatment • PMTCT • HIV prevention among caregivers • Psychological needs of PLWHA • Legal and human rights of PLWHA

Manual on Children and HIV Infection: for Teachers, Psychologists, and Social Workers • Social/psychological needs of PLWHA and their family members • Needs of children affected by HIV infection • HIV prevention • Prevention of social abandonment of children born to HIV+ mothers • Promotion of legal rights and integration of HIV affected orphans

Program Strategies Partnerships with Local/Regional Government Ministry of Health (Mo. H) AIDS Center: • Coordination of home visits to affected families • Joint training for health workers on needs of PLWHA • Sharing of data and M&E reports Hospitals/Health Clinics • Information dissemination and education • Referral system for clients

Key Program Results 92% of pregnant women participating in the project stated that they are taking better care of themselves 84% of young mothers started visiting AIDS doctors regularly and became for conscientious about taking ART 98% of project beneficiaries stated that their knowledge of HIV improved

Best Practices and Lessons Learned • Strong partnership and coordination with local authorities, including the AIDS Center • Greater involvement of PLWHA into project activities • Prevention of ‘stigma and discrimination’ among health care workers • First of its kind peer support services and counseling led by PLWHA

Partners & Collaborators • American Red Cross (ARC) • International Federation of Red Cross and Red Crescent Societies (IFRC) • Pact’s Community REACH • US Agency for International Development (USAID) • International Research and Education Exchange (IREX) • UNICEF • Pfizer (USA) • All-Russian Network of Harm Reduction (Russia) … and many more!

In Loving Memory of Margaret Ann Cargill (1921 - 2006)

Thank you for your time! For more information please contact : Dr. Anna Zagaynova Russian Red Cross/Irkutsk Oblast 664011 Irkutsk 35 B Sverdlova Street Telephone/fax: +7 (3952) 344 -158 +7 (3952) 200 -393 Email: hivirk@ mail. ru www. redcross. irk. ru Mr. Ramine Bahrambegi, Health Delegate American Red Cross Moscow, 117036, Russia 5 Cheriomushkinsky Proezd, Tel/Fax: +8 (495) 937 -5267/5263 Mobile: +8 (916) 921 -5443 Email: ramine. bahrambegi@ifrc. org