Stipends for Dutch Based Delegates to Visit EECAAC 2018

VI Eastern Europe and Central Asia AIDS Conference (EECAAC 2018)

“Mobilizing resources: experience, investments, innovations”

18-20 April 2018, Moscow, Russian Federation

The organizers of the VI International Eastern Europe and Central Asia AIDS Conference (EECAAC 2018) provide 10 stipends for Netherlands-based organizations to participate in the Conference. The forum will be held three months before the XXII International AIDS Conference (AIDS 2018), which will be hosted by Amsterdam on 23-27 July 2018.

The Dutch Ministry of Foreign Affairs acts as the observer in the EECAAC 2018 Organising Committee to enable clear links and continuity of discussions at both conferences. Why is it important? One of the five objectives of AIDS 2018 is to spotlight the state of the epidemic and the HIV response in Eastern Europe and Central Asia with a focus on investments, structural determinants and services. EECAAC 2018 is a platform for scientific exchange in the EECA region and will open the dialogue on partnerships and joint effort coordination in HIV response which will be continued at AIDS 2018.

The main goal of EECAAC 2018 is to focus on measures for eliminating the HIV epidemic and other public health concerns in Eastern Europe and Central Asia, present high-performance programs and provide experience exchange opportunities for scientists, experts, policy makers, healthcare professionals, activists and public figures in relation to the best HIV response strategies.

VI International Eastern Europe and Central Asia AIDS Conference is expected to convene up to 3000 participants and will feature:

  • Presentation of innovative approaches to the prevention and treatment of HIV/AIDS, opportunistic and concomitant infections.
  • Strengthening the link between science and practice.
  • Development of regional healthcare systems.
  • Exploring ideas around the new “AIDS/HIV-free generation”.
  • Expanding the role of sport in HIV response.
  • Discussing HIV and migration.
  • Expanding the role of partnerships and joint effort coordination in HIV response.
  • Examining economic aspects of HIV response.

 Conference organizers:

  • Joint United Nations Programme on HIV/AIDS (UNAIDS)
  • Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)

Why stipends for Dutch organizations?

The stipends will be provided to 10 representatives of Netherlands-based organizations in order to stimulate greater presence of these organizations at EECAAC 2018 as well as facilitate cooperation between the Netherlands and the EECA countries in HIV/AIDS response and related areas. The XXII International AIDS Conference will be specifically featured at EECAAC 2018.

Representatives of the Dutch NGOs and scientific institutes, activists working in the field of HIV/AIDS, SRHR, HIV and co-infections are invited to apply for a stipend to visit EECAAC 2018 and support the Dutch delegation at the Conference. Representatives will also be encouraged to occasionally represent the Netherlands at the Dutch Booth and/or to promote their NGO at the Community Village.

What do the stipends cover?

  1. Return economy class flight.
  2. Airport – hotel – airport transfer.
  3. Hotel – Conference – hotel transfers.
  4. Accommodation in the hotel (3-4 stars).
  5. Meals (breakfasts, lunches or dinners) for all days of the Conference.
  6. Per diems will not be provided.
  7. Support in obtaining visa if required.

Who can apply?

Individuals complying with all of the following criteria may apply:

  1. The applicant is 18 years of age by the time of the Conference and a staff member of an NGO, community-based organisation, scientific institution, network, association, or non-registered entity, located in the Netherlands
  2. An organisation, represented by the applicant, works in one of the following areas:
    1. HIV/AIDS prevention or service provision.
    2. HIV/AIDS and co-infection with TB and/or viral Hepatitis prevention or service provision.
    3. HIV/AIDS related non-medical research.
    4. HIV/AIDS and co-infection with TB and/or viral Hepatitis research.
    5. Support and service provision to the most vulnerable population including people using drugs, sex workers, LGBTQ, MSM.
    6. HIV/AIDS prevention and/or sexual health education for young people.
  3. An organisation, represented by the applicant is non-profit.
  4. An organisation, represented by the applicant, is working in the EECA region or has a demonstrable interest in this region.
  5. The applicant commits to actively participate in the whole duration of the Conference.
  6. The applicant is eager to contribute to the preparation for AIDS 2018 after the return from EECAAC by sharing knowledge and experiences at the events, which will be eventually organised in the run of the AIDS 2018 in the Netherlands.

How to apply?

In order to apply, please follow these simple steps:

  1. Follow this link in order to register for the Conference.
  2. Fill in the required fields at STEP 4 of the registration process.3. Wait for the decision of the Selection Commission regarding your application.

Applications submission closes at 15 January 2018.

Stipend awardees announcement: 31 January 2018.

The Selection Commission

The Selection Commission will consist of representatives of the AFEW International, the Dutch Ministry of Foreign Affairs, GNP+, and independent consultants. The selection of the candidates will be based on criteria listed above and the following considerations:

  1. Even representation of the different areas and target groups.
  2. Strong commitment for active participation in EECAAC 2018.
  3. Strong commitment to share knowledge and experiences after returning to the Netherlands.
  4. Preference will be given to those candidates who otherwise wouldn’t be able to visit EECAAC 2018.
  5. A maximum of one representative per organization.

AFEW Builds Models for the Future with Improved TB/HIV Care

AFEW, Hivos and PharmAccess and KNCV representatives after the presentation on the Dutch congress ‘Soa.Hiv.Seks’

The ‘Improved TB/HIV Prevention & Care – Building Models for the Future’ project was presented during the Dutch National Congress ‘Soa.Hiv.Seks’ on 1 December 2017 in Amsterdam, the Netherlands. Three working models from Kazakhstan, the Philippines, and Nigeria implemented by AFEW, Hivos and PharmAccess with KNCV Tuberculosis Foundation as the lead agency were shown to the Congress audience.

HIV and TB are two of the biggest public health threats in the world. Mounting challenges associated with these mutually reinforcing diseases are both medical and socio-political. In the efforts to address many of the common challenges, AFEW, HIVOS, PharmAccess and KNCV, with support from the Dutch Ministry of Foreign Affairs, collaborate in different parts of the world via the ‘Improved TB/HIV prevention and care-building models for the future’ alliance to jointly design and pilot innovative models of cooperation between the public, private and community sectors involved in the fight against HIV and TB, to find new ways of ensuring and expanding affordable, patient-centred and high quality access to care for key affected populations.

“After the project has started in Almaty, Kazakhstan, we can observe positive changes. A patient has information about good quality care, knows where to go for treatment and support, and has a choice in seeking care in the public sector, private sector and civil society,” the executive director of AFEW International Anke van Dam is saying. “Self-support groups and client management for TB patients are being organized and the HIV and TB working group is supported by the head of the Almaty City Health Department.”

Private clinics in Kazakhstan are now engaged in the public healthcare sector. They are integrated into the national monitoring and evaluation system for public/non-public TB/HIV care provision in Almaty city.

AIDS Day in Ukraine: Online Test, Quest for Adolescents

Author: Yana Kazmirenko, Ukraine

On December 1, an online HIV test was presented in Kyiv

On December 1, a wide range of activities marked the World AIDS in Ukraine. On this day, the first in Ukraine online test for HIV was presented in Kyiv. It is available at HIVtest.com.ua or via a mobile application ‘HIV test.’

“The test makes an audit of your health, rapidly assessing the risk of infection, and offers information about the nearest testing sites,” said Dmitry Sherembey, the Chairman of the Coordination Council of the All-Ukrainian Network of PLWH.

Four weeks before the campaign, organizers placed billboards with the intriguing social advertising – a dangerous blade hidden in a juicy burger ­– in the streets of Kyiv. Dmitry Sherembey reveals the intrigue: for many people HIV is invisible, with 130 thousand out of 250 thousand people living with HIV in Ukraine not aware of their diagnosis.

The test contains about two dozen of questions – their number depends on the respondent’s lifestyle. For example, the question “Do you use condoms when having sex or not?” is relevant in Ukraine, where 51% of people living with HIV get infected through the sexual route of transmission. After a person answers all the questions, the test will show the probability of HIV infection and will show the information about the nearest clinic or confidential counseling room to get tested. The online test has been developed for two months and, according to Dmitry Sherembey, it shows the result that person is getting after the testing in 40% of cases.

Testing should become a routine procedure

Dmitry Sherembey shows the online test on his phone

According to Pavel Skala, Director of the Policy and Partnership at the Alliance for Public Health, the annual campaigns dedicated to the World AIDS Day should be changing and moving forward. On one hand, public awareness on HIV is growing, but on the other hand – people are losing interest in the repeating topics.

Testing should become a routine procedure for every Ukrainian, emphasizes Roman Ilyk, the Deputy Minister of Health. He says that over 50% of cases are diagnosed at the third and fourth clinical stages of HIV infection, when the person’s health is poor. 80% of people who die are 25-49 years old. The Ministry of Health called on Ukrainians to get tested for HIV and underlined that early detection of the disease allows to timely access treatment.

Interactive activities for teenagers

Every year, civil society organizations conduct campaigns for teenagers dedicated to the World AIDS Day. Alexander Mogilka, the coordinator of the social support project for adolescents at the Kharkiv Day Care Center for Children and Youth “Compass” thinks that the success of Ukraine in curbing the HIV epidemic largely depends on the progress in working with this target group. This year, “Compass” organized a quest called “The Safety Route” in Chervonohrad, Kharkiv region.

Teenagers from Chervonohrad walked the Safety Route

“The format of this game was developed by the German agency GIZ. The teams are to go through several checkpoints: contraception, routes of HIV transmission, environment assessment. When you answer a question, you may go to the next point,” tells Alexander.

He claims that 70% of “troubled” teenagers have experience of using drugs. Usually, these are children from dysfunctional families.

“Before, teenagers could access drugs through dens, but now they can just use internet and stashes hidden in agreed venues. There is a sad contrast: the drug business is developing and taking new forms and the prevention is lagging behind,” sums up Alexander.

He underlines that to develop new formats of working with young people – combining quests, flash mobs, and social campaigns – is a new challenge for civil society organizations.

The Train is off but HIV Stays

Author: Anastasia Petrova, Russia

Testing in Kurgan

From 8 July to 20 October 2017, a train carriage went throughout the territory of Russia offering HIV testing services to everyone interested. The campaign was aimed at raising the awareness and increasing the coverage with testing services among the general public.

The strategic train

The train offering HIV testing is a project of the Russian Ministry of Health in cooperation with the Russian Railways. The campaign was initiated within the State Strategy to Combat the Spread of HIV in Russia through 2020. Long-distance passenger trains were equipped with an additional carriage offering free and confidential testing. Project workers conducted pre- and post-test counseling and informed people about HIV and the ways of its transmission. The route lied from Vladivostok to St. Petersburg and included the regions most affected with HIV. Apart from offering HIV testing on the way, mobile laboratories were also functioning on the railway stations. The campaign was aimed at the first component of the global 90/90/90 strategy, which stipulates that 90% of people living with HIV should be aware of their status.

The silent epidemic

The carriage where the testing was conducted

The testing campaign covered 24 regions, with the following cities leading in terms of people tested: Chelyabinsk (2,039 people), Nizhnevartovsk (1,645 people), Irkutsk (1,446 people), Kurgan (1,290 people), and Samara (1,227 people). Moscow was the city with the lowest coverage – only 290 people got tested there. According to the Ministry of Health, within the campaign 25 thousand people were able to get tested and receive professional counseling in the carriage and in railway stations.

“The fact that those 24 regions were covered is important. Here in Russia, 10 out of 85 regions have 50% of new HIV cases, and as for the 24 regions covered, they have over 70% of such cases. That is why I think that this campaign has a concrete result as it is focused on the most affected regions,” the chief independent expert in HIV diagnostics and treatment at the Russian Ministry of Health, Yevgeny Voronin is saying.

Awareness-raising materials in the format of railway tickets

It is interesting that no official statistics was announced on the total number of HIV cases detected. However, according to the Minister of Health, Veronika Skvortsova, as of the date when the train was passing Moscow the number of HIV positive cases detected was 248. Thus, the total number of such cases is more than 250 or 1% of the people tested. Considering the fact that testing was conducted in the general population, this number shows the severe epidemiological situation in the country and proves the tendency of HIV epidemic going beyond the key populations.

The train is off

Such campaign is an unprecedented intervention aimed at raising the awareness of people in the area of HIV/AIDS. Apart from testing passengers, the campaign was an important newsmaker. Reports in federal and regional mass media allowed millions of people in Russia to learn about the importance of this problem and about the necessity of regular testing. A positive outcome is that after the train left mobile sites to continue testing remained at some railway stations.

Closing ceremony in St. Petersburg

Alongside with that, if the data about one percent of the HIV cases detected in the general population is confirmed, it will mean that the situation has got out of control. In this case, the measures taken by the Ministry of Health are to be scaled up a hundred times and are to be aimed not only at awareness raising and detection of new cases but also at treatment. Testing as it is is not a measure of response to the epidemic. Every patient should receive therapy in order to achieve minimal viral load not to transmit the virus to other people. However, in Russia less than a half of people living with HIV get the necessary medications.

 

In Kazakhstan Students Debated on HIV

Author: Marina Maksimova, Kazakhstan

Opening ceremony of the first international debate tournament in Almaty “SpeakUp: AIDS”

Over 400 students from universities of the CIS countries took part in the first international debate tournament on HIV “SpeakUp: AIDS” in Almaty, Kazakhstan.

“Almaty is the city of students and active young people, who are interested in gaining knowledge, in particular in the area of healthy lifestyle and HIV prevention. Out of 5 000 people living with HIV in Almaty one-third is young people. Our city has a tradition to conduct spectacular campaigns dedicated to the World AIDS Day. This year, it was the first time we held debates on this topic among young people,” said Murat Daribayev, deputy akim (akim  is the head of a local government in Kazakhstan and Kyrgyzstan – note of editor) of Almaty.

Among the debate participants, there was the best 2017 speaker in the world representing the international debate movement, the main judge Raffy Marshall (Oxford), students from the major higher educational institutions of the country as well as from the UK, Kyrgyzstan, Russia, Tajikistan, and Sweden. The international panel selected 120 teams to take part in debates on this critical social issue. The tournament was held in line with the British parliament model.

The right to argue

Aleksandr Semenov, a student of the law department at the Kazakh National University is not a newbie in the debate movement. For the seventh year in a row, he wins his right to take part in the debates. He got through to the final round ten times, won five tournaments and even trained other debaters.

“The debates are a separate culture. It is sort of a recharger for your brain to always keep you thinking and analyzing to be able to assess a problem from various points of view. Additionally, you have to do it as fast as possible. The topics are always different: politics, culture, religion, sports… It was the first time when we had our debates on HIV. Therefore, the first conclusion is that we cannot keep silent, we should talk about it and ruin the stereotypes. Young people may be the opinion leaders,” says Aleksandr.

There are two people on his team: he and Altynay Dzhumasheva, a student of the American University of Central Asia from Kyrgyzstan. For debaters, it is not important which country or university the team members represent, the main thing is the efficiency of their joint efforts, mutual support, ability to swiftly catch the idea voiced by the partner and develop it in an emotional and convincing manner.

Stronger arguments

At the tournament, the debaters could use any of the three languages: English, Kazakh or Russian. The organizers selected several key topics. They included digitalization of the health care, drug use problems, sexual education, HIV and children, stigma and discrimination of people living with HIV. The participants were to be competent in all the topics.

“One of the rounds addressed the topic of drug addiction. What should change in the countries and in minds to give information about drugs and for drug users to have a choice of treatment and rehabilitation options? Our “opposition” team had to resist a storm of arguments from the “government.” Finally, the victory was ours! Our arguments on the need to adopt an efficient state drug policy and open state rehabilitation centres appeared to be stronger,” tells Altynay Dzhumasheva.

Counting on the young people

Debates among young people in Kazakhstan are a new instrument in response to AIDS. Organizers of the debates included the local Almaty administration, the Ministry of Health of the Republic of Kazakhstan, the Republican AIDS Center, the Health Department of Almaty, UNAIDS, and UNICEF.

Search for the new formats of HIV prevention among young people is an important topic to be discussed at the International AIDS Conference (AIDS 2018) in Amsterdam.

“Kazakhstan has already started its preparations to declare the elimination of mother-to-child transmission of HIV. We hope that information about HIV will continue to be accessible and accurate. The progress we have achieved has been to a great extent made possible thanks to people not being silent and youth being actively engaged,” HIV/AIDS Specialist from UNICEF Ruslan Malyuta is saying.

The winner of the English league of the first international debate tournament on HIV was a team from the People’s Friendship University of Russia. The best team in the Kazakh league was from the Taraz State University (Kazakhstan), and in the Russian league – from the Eurasian National University (Astana).

“I have HIV and it is not a verdict”

Amina from Tajikistan lives with HIV for nine years

Author: Nargis Hamrabaeva, Tajikistan

In her memories, her life is divided into ‘before’ and ‘after’ she learned she had HIV. As strange as it may seem, with the therapy ‘after’ is not a verdict, not a tragedy, not the end…

We are meeting 29-year-old Amina (the name has been changed) in one of the coffee houses in Dushanbe, Tajikistan. She came to our meeting after work, short of breath, as she was afraid to be late. Good looking, with a glow of health on her cheeks, a strand of hair appearing from under her neatly tied headscarf, and snow-white teeth. One could say that she was to the full of her health.

Sipping her coffee, she tells her story. Amina has been living with HIV for nine years and she is not at all ashamed of her status. She is convinced that a person with such diagnosis may live the same life as with any other chronic disease. The main thing is to take antiretroviral (ART) therapy on time and attend medical check-ups.

Fire, hospital, blood transfusions…

In 2007, Amina married her distant family member. In fact, as it often happens in Tajik families, her parents arranged their marriage.

“It happened that my two sisters married the relatives of my father and to keep some kind of “balance,” my marriage was arranged with my mother’s family relative. I struggled. We lived in the house of my husband’s parents. My sisters-in-law, who moved back to their parents’ house after the divorce, also lived with us. I could only dream of a quiet life,” tells Amina.

Sometimes, the young woman became an object of her sisters-in-law’s vengeance after their quarrels with her husband. Once, after another big quarrel, Amina made a bonfire in the yard and was cooking some food in a big pot. She already had a one-year-old and was pregnant with her second baby. The girl was throwing more brushwood into the fire to make it stronger when suddenly someone approached her from behind and pushed her right into the flame…

Amina woke up in a hospital ward several days after. She was in awful pain – she had 40% of her skin burnt. Ahead, she had two months of hospital stay, treatment, loss of her baby, interrogations of police officers and many blood transfusions. It turned out that it was one of her sisters-in-law who pushed her into the fire.

After several months, the wounds of her body and soul were healed and Amina got pregnant again. As all pregnant women, she did all the required tests, including an HIV test. It came back positive. She was worried, desperate, scared. She did not know what to do. Professional psychologists of the AIDS center talked to her and explained that it was not the end, that she would need to take her therapy and would be able to live a normal life with certain conditions.

“You have HIV and you will die in half a year”

However, the conversation with her husband was hard.

“He also got tested and his result was negative. He blamed it all on me; said that if I have HIV, I would die in half a year. He said that he wanted neither me nor our child. Soon I gave birth to our second son, but it did not save our marriage. We broke up. Both my boys are HIV-negative,” adds Amina.

She thinks that she got infected during one of the blood transfusions in the hospital.

“After the diagnosis, you can and should go on living your life,” the woman is saying now. Earlier, she was alone and hopeless. Her children were her only comfort. For them, she was fighting for her life. “I have been taking ART for five years. It includes several drugs, each of which influences a certain stage in the HIV replication cycle. In other words, when a person takes the therapy, the virus no longer replicates in the cells of his immune system.”

Building a house and finding a true love

A local organisation working with HIV-positive women helped Amina to become stronger and believe in herself. Now the young woman works as an outreach worker there, helping other women who are diagnosed with HIV to overcome their fears and depression. Her two wonderful boys are growing up. One of them goes to the third grade, and the second one has started his first year in school.

“To my ex-husband’s surprise, I am still alive, though nine years have already passed,” she says with a smile on her face. “Money that I make here is enough for us, but I am afraid to think about what can happen if the project is closed. Now there is a crisis everywhere. I could go to Russia to earn some money, but there I would have to make a mandatory HIV test to get a job and then I might face deportation.”

“What is your dream?”, I am asking her.

“Now I am on a waiting list to get a land plot and I would like to build a house for my children,” says Amina. Currently, she lives with her mother and her brother’s family. “They are all well aware of HIV, they know the routes of transmission, so they are not afraid to give me a hug or to eat from one bowl with me, and my brother’s wife sometimes leaves her children for me to look after.”

Besides, Amina is dreaming about meeting her true love and creating a family. This strong and self-confident young woman may be a role model for many people living with HIV.

Undetectable means Untransmittable: Anti-Stigma Campaign in EECA countries

Informational materials of the campaign

AFEW International supports the large-scale campaign “Неопределяемый значит не передающий” (Undetectable means Untransmittable) aimed at overcoming stigma against people living with HIV. Experts and activists from Eastern European and Central Asian countries also take part in the flash mob.

Research studies confirm the effectiveness of the “treatment as prevention” approach to prevent the sexual pathway of the spread of HIV. In 2014, the PARTNER study conducted in 14 European countries, showed no cases of HIV transmission in 44,000 cases of unprotected sex in discordant couples (1,145 couples totally took part in the study). The study report, published in 2016, showed a complete absence of HIV transmission in more than 58,000 cases of condomless sex.  In July 2017, the Opposites Attract study gave additional evidence in favor of the fact that HIV is not transmitted if the viral load is undetectable. This study was conducted in Australia among 358 serodiscordant gay couples in Australia, Thailand, and Brazil, and showed zero cases of HIV transmission among HIV positive people with undetectable viral load and their sexual partners. Just recently, in September 2017, the US Centers for Disease Control and Prevention (CDC) confirmed the thesis that undetectable viral load prevents sexual transmission of HIV. In November, the Lancet HIV wrote that “CDC officially backing the science behind the campaign is another key step towards U=U being the most important message of 2017 in the fight against HIV.”

Michel Kazatchkine, United Nations Secretary-General’s Special Envoy for AIDS in Eastern Europe and Central Asia

“Н = Н” is the Russian-language part of the global U = U (Undetectable means Untransmittable) campaign, which was launched by American activist Bruce Richman in early 2016. Its core is the Consensus Statement of experts and professional organizations that undetectable viral load prevents sexual transmission of HIV. By November 2016, more than 475 organizations from 65 countries of the world joined the campaign. Currently, more AIDS centers, NGOs, and activist organizations from the EECA countries keep joining the campaign. Signatures have been received from Armenia, Belarus, Georgia, Ukraine, Moldova, Kazakhstan, Kyrgyzstan, Russia, and Estonia. In our region, the campaign is supported by Life4me+.

Today, the science provides more and more evidence that undetectable viral load prevents sexual transmission of HIV, but in Eastern Europe and Central Asia a few people except experts are aware of it. The first Russian-language campaign “Н=Н” (Неопределяемый значит не передающий, Undetectable means Untransmittable), aims to convey this information to as many people as possible. For this purpose, the Consensus Statement and information about the campaign have been translated into Russian.

From October 16 to December 1, 2017, the participants of the campaign tell that today there is an opportunity to curb the spread of HIV through broad access to treatment, early detection and high adherence, and that the stigma of people living with HIV is based on groundless fears and outdated views on the epidemic. The key message of the campaign is that HIV is no longer the “plague of the XXI century.”  It is a chronic infection, with which one can have a good quality of life. With HIV, people can create families and have children, run marathons and make great careers, grow old and retire, just like people without HIV.

It is important to remember that “U=U” does not mean the possibility of not using other means of prevention. Unprotected sex can still lead to sexually transmitted diseases and unwanted pregnancies. In addition, due to limited access to treatment or other reasons, people may have obstacles to achieving an undetectable viral load.

Everyone from any Eastern Europe and Central Asia country can join the campaign. Organizations can sign the Consensus Statement, and individuals are invited to participate in an online flash mob by making a photo with the campaign logo and uploading it on social networks with a hashtag “НравноН.”

 

Donbass: the HIV Epidemic Growing on Both Sides of the Border

Member of the Donbass battalion Aleksey with his wife. When he was taken captive, his wife secretly brought him medications. Photo: Mikhail Fridman

Author: Yana Kazmirenko, Ukraine

HIV is rapidly spreading in the east of Ukraine, which for over three years remains the area of military actions. For two years, pregnant women have not been tested for HIV, and medications could only be delivered illegally.

The armed conflict between Russia and Ukraine divided Donbass into two parts: areas controlled by the central Ukrainian government and the so-called Donetsk and Lugansk People’s Republics (DPR and LPR). The latter are controlled by pro-Russian separatists.

This Russian-Ukrainian conflict demonstrated the differences in the approaches of the two countries to HIV/AIDS treatment and prevention. Thus, in Russia opioid substitution treatment (OST) for people who inject drugs is banned. After Ukraine no longer supplied OST drugs to Donetsk and Lugansk, relevant programmes were also terminated in the areas not controlled by the Ukrainian government. According to experts, the war brought the region back to the 90s in terms of the spread of HIV.

Only half of those in need take the therapy

Sergey Dmitriyev, member of the Coordination Council of the All-Ukrainian Network of People Living with HIV says that there are 16 thousand HIV-positive people living in the areas of Donetsk region not controlled by the Ukrainian government. Only half of them take the therapy. In the Lugansk region, the situation is similar: 2.7 thousand people living with HIV registered, 1.4 thousand – taking the therapy.

On the territory controlled by the Ukrainian government, 13.6 thousand people with HIV positive status are registered, and over seven thousand receive the therapy. It is not surprising that the level of HIV prevalence here is 676.9 per 100 thousand people, which is 2.2 times higher than the average indicator in Ukraine. The highest rates are recorded in Dobropole (1,459.6 per 100 thousand people) and Mariupol (1,154.5).

Apart from the official statistics, the number of undetected HIV cases is at least the same as the number of cases registered as the epidemic in Donbass has long gone beyond the vulnerable populations.

AIDS centres across the border

Natalia Bezeleva, Head of the NGO “Club Svitanok”

Natalia Bezeleva, Head of the NGO “Club Svitanok,” thinks that during the three years of armed conflict only services and deliveries of medications have been re-established in the region. Currently, in the Ukraine-controlled areas , here are 22 sites to prescribe antiretroviral therapy. She remembers the deficit of antiretroviral drugs as a bad dream – her organization had to smuggle the drugs for over a year. Since 2016, the Global Fund has also joined the delivery of supplies, providing the necessary drugs, while UNICEF – the United Nations Children’s Fund – has been bringing the supplies to the “LPR” and the “DPR”.

Ms. Bezeleva illustrates failure of the established HIV/AIDS diagnostics and treatment system with the following fact: in 2014, the Donetsk regional AIDS centre remained on the territory not controlled by the Ukrainian government. Polymerase chain reaction (PCR) tests have not been transported through the newly created border, so for two years, no HIV diagnostics was done for children. Another big challenge was the deficit of doctors – most health professionals left the area of the armed conflict.

According to Ms. Bezeleva, the situation improved in 2016, when the Donetsk regional AIDS centre was opened in Slavyansk. Today, thanks to the support of the Global Fund PCR tests of adult patients are taken to Kharkiv and children’s PCR tests are delivered to Kyiv. There are also first achievements in diagnostics: in 2016, over 113 thousand people or 5.8% of the total population of the region were tested for HIV, and in the nine months of this year 84 thousand people have already been tested.

The military: testing for the contracted soldiers

A social worker visits an HIV-positive TB patient in the TB treatment clinic in Donetsk. Photo: Mikhail Fridman

Even in the peacetime, the military face the risk of infections, in particular HIV, tuberculosis and hepatitis, which is 2-5 times higher than in the general population. At war, this risk grows 50-fold.

In the area of armed conflict, there are 60 thousand of Ukrainian soldiers. According to the result of the research study conducted by the Alliance for Public Health, about 4% of the military enter the conflict area with an HIV positive status, while the percentage of HIV-positive soldiers leaving the area is doubled and reaches 8-8.5%.

Activists of civil society organizations say that the military should be covered with prevention programmes and convinced that they need to be tested. Another important issue is equipping the military first aid kits with condoms.

People Living with HIV Can Live Longer

Brussels, 29 November 2017 – Experts unveiled a set of recommendations to address health problems facing people living with HIV. Treatments are helping people with HIV live long lives, but they face higher risk than others of serious illnesses – from cancer to heart disease to depression.

As people living with HIV require access to a range of health services beyond just their HIV treatment, a coordinated and personalised approach to long-term HIV care is needed, according to the HIV Outcome recommendations, which were unveiled at an event at the European Parliament.

“There is huge room for improvement” said Nikos Dedes, Chair of the European AIDS Treatment Group (EATG) and Co-Chair of the HIV Outcomes Steering Group. “It is great that people living with HIV can live nearly as long as anyone else these days because of new treatments, but there are complicated health problems that are being ignored. The HIV Outcomes initiative has put together a list of suggestions that has the potential to improve the lives of Europeans who live with HIV.”

In a timely reminder ahead of World AIDS Day on Friday, 1 December, the HIV Outcomes initiative highlights that the advent of modern antiretroviral therapies (ART) has transformed the lives of people living with HIV. For those diagnosed and treated early, it is now a chronic, rather than a fatal, condition. However, this is no guarantee of good health outcomes or quality of life; further effort is needed to develop effective, lifelong approaches to the long-term treatment and care of people living with HIV.

To address these needs, the HIV Outcomes initiative has engaged in a year-long multi-stakeholder process to develop a series of five detailed policy recommendations. These call for an integrated and patient-centred approach to long-term HIV care, which should include services for the prevention, treatment and management of other health conditions (comorbidities), services for mental health conditions, personalised care plans, and advice and support on sexual and reproductive health. Other recommendations call for monitoring of how health systems currently respond to the long-term health challenges faced by people living with HIV as well as efforts to combat stigma and discrimination within health systems.

Recommendations

  1. Adopt an integrated, outcomes-focused, and patient-centred approach to long-term care.

  2. Expand national monitoring of long-term care and outcomes.

  3. Fund studies to provide information on the long-term health of people living with HIV.

  4. Combat stigma and discrimination within health systems.

  5. Upscale involvement of the HIV community in priority setting at country level.

The next step is to ‘road test’ the recommendations at national level in two countries – Italy and Sweden – during 2018. Both have already demonstrated their commitment to people living with HIV; Italy has published a ‘White Book’ on the chronic care model for HIV, while Sweden is the first country to achieve the UNAIDs ‘90-90-90’ targets.The three Member of the European Parliament (MEPs) supporting the event meeting, Christofer Fjellner (European People’s Party, EPP), Eva Kaili (Socialists and Democrats, S&D) and Gesine Meissner (Alliance for Liberals and Democrats in Europe, ALDE), agreed, “Having addressed the issue of longevity, society now needs to help people with HIV to retain good health and lead rewarding lives. As representatives of the European Parliament’s leading political groups, we fully support the aims of this initiative.

The learnings and best practice generated on a national level will ultimately be reported at a future event in the European Parliament in 2018 and should provide further refinements to efforts to improve the long-term health outcomes and quality of life of people living with HIV. It is time to expand our ambitions for the health and well-being of people living with HIV beyond just viral suppression.

HIV/AIDS Surveillance in Europe 2017-2016 Data Released

On 1st of December, we mark World AIDS Day (WAD) to raise awareness about HIV and its impact on individuals and societies around the globe. WAD 2017 in the WHO European Region will focus on the problem of late HIV diagnosis – the high number of people who are diagnosed with HIV at a late stage of infection with consequences for individuals’ health and survival, and for the community where HIV can transmit further.

With this message, we invite you to join us and mark the World Aids Day 2017 in your country.

On 28 November 2017, WHO/Europe and ECDC jointly released the annual report on HIV/AIDS surveillance Europe, containing the latest available surveillance data.

Similar to recent years, the highest proportion of HIV diagnoses (40%) was reported to be in men who have sex with men (MSM). However, for the first time in a number of years, several countries reported a decline in new HIV diagnoses, even after adjusting for reporting delay.

While the data in this year’s report indicate alarming rates and increases in new diagnoses in some parts of eastern and central Europe over the last decade, at the same time there has been a tendency towards stabilising or even decreasing rates in some EU/EEA countries.

Trends by transmission mode, for example, show that the number of HIV diagnoses among MSM in the EU/EEA decreased slightly in 2016 and the number of heterosexually acquired cases has decreased steadily over the last decade.

Moreover, in the EU/EEA, the number of AIDS cases, and the number of AIDS-related deaths, has consistently declined since the mid-1990s.

The report on HIV/AIDS surveillance in Europe 2017 – 2016 data is available here.