AIDS Foundation East West

Today, the HIV epidemic has established a secure foothold in Russia, with current estimates putting the number of HIV cases in the country at close to a million. Although the epidemic is concentrated among injecting drug users, there has been a sharp increase in the number of cases attributed to heterosexual transmission. This trend has been accompanied by a growth in the number of mother-to-child HIV infections, and recent government figures indicate that 11% of people living with HIV in the country are children. Part of the problem is that in many regions of Russia specialist psycho-social services for mothers living with HIV are almost entirely absent. At the same time, these women often face high levels of stigma and discrimination, both in their local communities and in the medical institutions that they turn to for assistance.

Prevention of mother-to-child transmission (PMTCT) is a core component of AFEW’s project portfolio in Russia. From 2004-2009, AFEW’s PMTCT programme introduced essential services for women living with HIV and provided training to medical staff in 10 regions of the country. A pilot training programme for HIV+ mothers and their families was first held under this project in the summer of 2008 in Orenburg. The school offered mothers guidance on the medical and psychological care of children living with HIV or children from families affected by HIV. It provided a valuable opportunity for HIV-positive women to forge friendships and support networks, as well as to strengthen contacts with providers of social and medical support.

Now, in order to continue and expand this scheme into other regions of the Russian Federation, AFEW has launched a new project – ‘The Health School for Mothers and Children’. The project is running in the Republic of Tatarstan, Samara and Ulyanovsk regions, where HIV prevalence is higher than the national average and service provision remains very low. Participants of the programme include young women living with HIV who have children under 6 years old or who are pregnant, as well as pregnant women from populations at higher risk of HIV (injecting drug users and sex workers).

The school curriculum. During the training course, mothers acquire knowledge about the medical and psychological aspects of healthcare for themselves and their children. Topics include: disclosure of HIV status, talking to children about HIV, building support networks, social integration of people living with HIV, legal and human rights issues. Confidence-building classes develop leadership and advocacy skills that women need to take control of their families’ healthcare and to play an active role in their communities. By the end of the course, successful participants will be qualified as peer educators who can pass skills and knowledge to other women.

Specialist support groups. In each region, a specialist working group (peer counsellors, psychologists, medical professionals and non-governmental activists) will meet with training participants. Their engagement will be crucial to assisting women in expanding their medical and social support networks, as well as in facilitating a healthy provider-patient dialogue.  

Development of services in the NGO sector. During the programme cycle, a four-day skills-building event will be held for activists and staff working in non-governmental organisations in the three regions. The aim of the event is to assist civil society in developing social and psychological services for young families affected by HIV.

Information packs on PMTCT, disclosure of HIV status and community leadership skills will be developed and distributed to women living with HIV, as well as informational brochures for NGO partners.

Supply of milk formula. Women living with HIV who have access to safe milk formula and clean water are advised not to breastfeed their children due to the risk of HIV transmission through breast milk. AFEW provides free supplies of milk formula to mothers living with HIV in the project regions for the first six months of their child’s lives in order to boost take-up of this prevention method among families coping with difficult economic circumstances.