“humanitarian action” the saint-petersburg charitable foundation for medical and social programs...
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““Humanitarian Action” Humanitarian Action” The Saint-Petersburg The Saint-Petersburg
Charitable Foundation for Charitable Foundation for Medical and Social Medical and Social
ProgramsPrograms
HAFHAF
June 2001 – date of official June 2001 – date of official registration of the Foundationregistration of the Foundation
HAF was created on the basis of HAF was created on the basis of projects of “Medecins du Monde – projects of “Medecins du Monde – France” in Saint Petersburg France” in Saint Petersburg
All HAF programs All HAF programs include activities related include activities related
to HIVto HIV
WHY?WHY?
Epidemic situation in Russia in Epidemic situation in Russia in 2004 2004
305 242 registered HIV cases since 305 242 registered HIV cases since starting the epidemic processstarting the epidemic process
Number of deaths caused by AIDSNumber of deaths caused by AIDS 6 350, 6 350, includingincluding 302 302 childrenchildren
11 530 11 530 children born from HIV+ children born from HIV+ mothersmothers
HIV in RussiaHIV in RussiaNegative tendencies during 2 Negative tendencies during 2
last yearslast years
Increasing on Increasing on 87% 87% of mortality among HIV+ of mortality among HIV+
people people
2,7 times increasing of number of children 2,7 times increasing of number of children
born from HIV+ mothersborn from HIV+ mothers
Increasing on 189% of HIV infected children Increasing on 189% of HIV infected children
and adolescentsand adolescents
HIV Epidemics in St Petersburg in HIV Epidemics in St Petersburg in 20042004
DuringDuring 2004 2004 the number of new cases the number of new cases was was 4 576 4 576
165 165 new cases among young people new cases among young people aged 15 -18 yearsaged 15 -18 years
Since Since 1987 1987 toto 2004 2004 number of deaths number of deaths due to HIV was ofdue to HIV was of 1004 1004, including 122 , including 122 people in the stage of AIDSpeople in the stage of AIDS
HIV in St Petersburg in 2004HIV in St Petersburg in 2004
A decrease of 10% of new HIV A decrease of 10% of new HIV cases is observed among all cases is observed among all groups of population. groups of population. Young people Young people 15 – 29 15 – 29 years old years old areare 74,9% 74,9% of all number of HIV + of all number of HIV +
HIV in St Petersburg in 2004HIV in St Petersburg in 2004
The parenteral way is still very The parenteral way is still very important (65,1%)important (65,1%)
But less important than 1n 2003 (87%)But less important than 1n 2003 (87%)
HIV in St Petersburg in 2004HIV in St Petersburg in 2004Dinamics of sexual and parenteral ways of Dinamics of sexual and parenteral ways of
transmissiontransmission
HIV in St Petersburg in 2004HIV in St Petersburg in 2004Number of HIV+ pregnant womenNumber of HIV+ pregnant women
HAF programs HAF programs in Saint Petersbourgin Saint Petersbourg
Program of medical, social, psychological Program of medical, social, psychological help to street children – since 1995help to street children – since 1995
Harm reduction program for drug users – Harm reduction program for drug users – since 1997since 1997
HIV prevention program among street HIV prevention program among street commercial female sex workers – since commercial female sex workers – since 20002000
Out-patient center run in partnership with Out-patient center run in partnership with the Botkin hospitalthe Botkin hospital
TB prevention among HIV+ peopleTB prevention among HIV+ people Working out adherance in treatment Working out adherance in treatment
among IDU (case management)among IDU (case management) Lobbying of HR and of access to treatment Lobbying of HR and of access to treatment
for IDU for IDU
Medical, social and Medical, social and psychological help to street psychological help to street
kidskidsMain services:Main services:
- Outreach workOutreach work- Day drop-in centre for consultationsDay drop-in centre for consultations- Short term night centreShort term night centre- VVССT (HIV, hepatitis, syphilis)T (HIV, hepatitis, syphilis)
Prevention information provided in all Prevention information provided in all moduls.moduls.
Since 7 years more than 4000 children were provided with help within the framework of the program activities
Risks related to the street lifeRisks related to the street life
Engaging in criminal structures or Engaging in criminal structures or activitiesactivities
Absence of social protectionAbsence of social protection
Sanitary risksSanitary risks
Sanitary risksSanitary risks
PromiscuityPromiscuity Drug useDrug use Absence of informationAbsence of information
Street children and drugsStreet children and drugs
19919988 20020044
TobaccoTobacco 329 (55,6%)329 (55,6%) 726 (74,5%)726 (74,5%)
Heavy drugsHeavy drugs 50 (8,5%)50 (8,5%) 324 (33,3%)324 (33,3%)
SniffingSniffing 88 (14,9%)88 (14,9%) 223 (22,9%)223 (22,9%)
AlcoholAlcohol 169 (28,6%)169 (28,6%) 597 (61,3%)597 (61,3%)
Comparative evaluation of the HIV-rate Comparative evaluation of the HIV-rate ((for for 1000 1000 populationpopulation, 2002), 2002)
4,18
104,4
0
20
40
60
80
100
120
Saint-Pet in general
Street children
Testing resultsTesting results
0,62,3
23,8
4,1
0,8
8,7
19,8
9,510,8
5,6
23,6
6,2
10,4
0,8
25,6
1,60
5
10
15
20
25
30
1999 2000 2001 2002
HIV Hepatitis B Hepatitis C Syphilis
Average age of HIV-positive Average age of HIV-positive street childrenstreet children
15,9 15,9 years oldyears old
Harm Reduction programHarm Reduction program
Bus – an outreach unitBus – an outreach unit
Provided services:Provided services:- Needle exchangeNeedle exchange- Distribution of condomsDistribution of condoms- InformationInformation- Medical and psychological consultationsMedical and psychological consultations- VCT (HIV, hepatitis B and C, syphilis)VCT (HIV, hepatitis B and C, syphilis)
Harm reduction bus activities in Harm reduction bus activities in 20042004
Number of clients - Number of clients - 11906906Number of visits - Number of visits - 8 200 8 200 Number of exchanged syringes - Number of exchanged syringes - 232 232
000 000 Number of tested people - Number of tested people - 563 563
20.7% - positive results20.7% - positive resultsAverage age of clients:Average age of clients:- women -women -23,323,3 - men men 25,525,5Main drug – heroine (85%)Main drug – heroine (85%)
HIV prevention program forHIV prevention program for street street commercial sex workerscommercial sex workers
Van – an outreach unitVan – an outreach unit
Provided services:Provided services:- Condoms’ distributionCondoms’ distribution- Needle exchangeNeedle exchange- InformationInformation- Medical and psychological Medical and psychological
consultationsconsultations- VCT (HIV, hepatitis B and C, syphilis)VCT (HIV, hepatitis B and C, syphilis)
Data for 2004Data for 2004
Number of street female commercial sex-Number of street female commercial sex-workers (CSW) - workers (CSW) - 8000–100008000–10000
95% of them are intravenous drug users 95% of them are intravenous drug users (UDVI)(UDVI)
Number of contacts - Number of contacts - 88764764 Number of women contacted - Number of women contacted - 21216969 Number of condoms distributed - Number of condoms distributed - 56621 56621 Number of syringes distributed – Number of syringes distributed – 6300063000 Average age – Average age – 23,923,9
Infections among female CSWInfections among female CSWStudy of the end of 2003Study of the end of 2003
HIV – 48%HIV – 48% Syphilis – 44%Syphilis – 44%
Lobbying of HR andLobbying of HR and access to access to treatment. Why?treatment. Why?
- HR is still rather tolerated but not really HR is still rather tolerated but not really accepted by the authoritiesaccepted by the authorities
- Drug use is criminalizedDrug use is criminalized- Access to health structures is very Access to health structures is very
difficultdifficult- No political will of government to change No political will of government to change
situationsituation
Access to treatmentAccess to treatment
About 150 people receive ARV in St About 150 people receive ARV in St PetersburgPetersburg
About 300 need ARV and are on the About 300 need ARV and are on the waiting list, but real need unknownwaiting list, but real need unknown
IDU are practically excluded of this IDU are practically excluded of this numbernumber
What is being done by HAF?What is being done by HAF?
- Creation of a network of specialists of Creation of a network of specialists of concerned medical structures and concerned medical structures and trainings for themtrainings for them
- Trainings for police officersTrainings for police officers- Creation of an out-patient structure in the Creation of an out-patient structure in the
Botkin hospital for infectious diseasesBotkin hospital for infectious diseases- Institutional development of the Institutional development of the
community of PLWHAcommunity of PLWHA
IDUs as percent of registered IDUs as percent of registered HIV/AIDS cases; IDUs as recipients HIV/AIDS cases; IDUs as recipients
of any form ARVof any form ARV
18%
82%
23%
77%
IDUsNon-IDUs
Source: Central and Eastern European Harm Reduction Network, 2002
Causes of Discrimination Causes of Discrimination against IDU’s in Health Care against IDU’s in Health Care
SettingsSettings
41%
27%
18%
14% Dr.'s beliefs
Registration of IDUnames at hospitals
Sharing of informationw/law enforcement
Other (e.g. notreatment if not drugfree)
Three necessary components for an Three necessary components for an effective response to HIV in our effective response to HIV in our
regionregion Scaled up prevention efforts for Scaled up prevention efforts for
vulnerable populations – drug users, vulnerable populations – drug users, sex workers, street kidssex workers, street kids
HIV care for everyone that needs it HIV care for everyone that needs it with special attention paid to with special attention paid to marginalized groupsmarginalized groups
Reassessment of drug policies and Reassessment of drug policies and bringing them in line with European bringing them in line with European discourse discourse
Alexander TsekhanovichAlexander TsekhanovichHumanitarian Action FoundationHumanitarian Action Foundation
197197 110, Russia, Saint-Petersburg 110, Russia, Saint-PetersburgOfitsersky pereulok 6-2Ofitsersky pereulok 6-2
+7 812 237 14 95+7 812 237 14 95+7 812 237 18 21+7 812 237 18 21
www.humanitarianaction.orgwww.humanitarianaction.orgoffice@humanitarianaction.orgoffice@humanitarianaction.org
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