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Controlling the spread of HIV/AIDS in the Barents and Northern Dimension Partnerhip Programme Regions, phase II

Project title Controlling the spread of HIV/AIDS in the Barents and Northern Dimension Partnerhip Programme Regions, phase II
Database Data inserted through the NDPHS Project Pipeline
ID in the source database 82
Thematic area HIV/AIDS
Topic Prevention of HIV in the Northern Dimension Partnership and Barents regions through multilateral and multisectoral collaboration
Project geographical area Russia
Substate level / administrative units /regions
  • Arkhangelsk Oblast
  • Kaliningrad Oblast
  • Karelia Republic
  • Komi Republic
  • Leningrad Oblast
  • Murmansk Oblast
  • Nenets AO
  • St. Petersburg
Lead partner (organisation) National Institute for Health and Welfare, International Affairs, Finland
Lead partner (owner or/and project manager) no data
Partner organisations
Start date 2009-01-01
End date 2009-11-30
Duration (months) 11
Target audience 1. Health and social authorities and professionals in the Russian Barents Region (especially Murmansk Region)
2. Intravenous drug users, commercial sex workers, youth, people living with HIV/AIDS
3. HIV/AIDS expert group partners in Norway, Sweden, Russia, Estonia, Latvia, Lithuania, Poland, Germany, France, Portugal and Canada
Summary The programme and activities described above are based on the Working Program/Strategy for the collaboration in the prevention of HIV within the context of Northern Dimension, elaborated by the Expert Group (EG) on HIV/AIDS of Northern Dimension Partnership in Public Health and Social Well-Being (NDPHS) and multi-sectoral HIV/AIDS programme, drafted under the management of the Barents Working Group on Health and Social Issues (WGHS).

The Presented program is a very important component in the regional effort against HIV/AIDS and it plays big role in contributing to the implementation of the Northern Dimension Partnership in Public Health and Social Well-being. That is achieved through the intensive co-operation of the Barents HIV/AIDS programme and HIV/AIDS international activities of the ND Partnership coordinated by EG. This close cooperation enables wider geographical scope and effectiveness of carried activities compared with an individual project.

This project plan continues the work started in the project "Controlling the spread of HIV/AIDS in the Barents and Northern Dimension Partnership Programme Regions in 2005–2007". The Project combines three components:
1. Coordination of Barents HIV/AIDS Programme
2. Further development of low threshold services in Murmansk and Kantalahti
3. Technical assistance to the HIV/AIDS Expert Group of Northern Dimension Partnership in Public Health and Social Well-being (NDPHS)

Programme includes implementation of a section of the Barents project package -“Providing preventive services for vulnerable groups” in Murmansk region within the subproject "Further development of low threshold support services in Murmansk and Kantalahti". This subproject is continuation and expansion of the pilot project "Development of low threshold support centre in Murmansk Region" (2005-2007). Murmansk project implementation is designed in way that enables to duplicate this kind of project in any part, town or city in the Barents Region or North - West Russia. The programme design also helps to gain a more precise picture of the overall situation and the underlying reasons behind the HIV/AIDS problem in Barents Region, and to bring together different authorities. Furthermore, it will promote co-operation between the authorities in order to respond to the situation, providing even more opportunities to stop the spread of HIV/AIDS.

The combination of the Barents HIV/AIDS programme implementation, the co-ordination of its parts, and the work of the NDPHS HIV/AIDS EG creates a unique opportunity to bring all the key players of the region together. That provides not only co-ordination between the authorities, but also horizontal co-operation between competence areas in, for instance, primary health care, HIV/AIDS, TB and education and training.
Background The HIV epidemic is continuing to spread in Finland’s neighbouring regions. HIV remains one of the major threats to the wellbeing and social stability within the region covered by the ND partnership. The numbers of HIV infected people, in the first phase almost exclusively injecting drug users and, recently, more and more their sexual partners, are still growing.

According to the Thematic report of the Expert Group on HIV/AIDS of NDPHS "significant change has taken place through the possibility to widely implement highly active antiretroviral treatment (ART) not only improving the situation of those infected but also by enhancing prevention efforts and reducing the stigma and discrimination known to drive the epidemic further. The future of the epidemic in the region is markedly shaped by the ability to use ART so that all vulnerable groups, injecting drug users (IDUs) and their partners in particular, can be reached. At the same time, the message of the importance of prevention should be kept renewable and fresh so that new generations are aware of the risks and empowered to make the correct choices for their future." (HIV/AIDS in the Baltic Sea Region and Northwest Russia, click here to view paper )

The epidemic of HIV infection in Russia has passed into the stage of concentration in vulnerable groups and continues to grow actively, largely owing to unsafe injecting drug use. According to the data of the Federal AIDS Prevention and Control Centre, 428,154 HIV/AIDS cases were registered in Russia as at June 1, 2008, 27,253 of whom had died. Meanwhile, statistics indicate a growth of the sexual transmission route, suggesting that the epidemic has spread to the heterosexual group of the population.

The HIV situation in Northwest Russia
According to the Northwest District AIDS Centre, altogether 7233 new HIV cases were registered in NW Russia during 2007 (the biggest no of cases was in St. Petersburg – 4,548, and in Leningrad Oblast – 1,165). By the end of 2007, cumulative number of HIV positive people was 57,803 (deaths excluded). Prevalence per 100,000 population was 424.4 in January, 2008.

Transmission routes in NW Russia during 2007 were the following: IDU – 39%, sexual contact – 20.4%, mother-to-child – 1%, not known – 39.6%. Gender balance among newly infected was: men – 62%. By the end of 2007, cumulative number of children born to HIV positive mothers was 5208. In 2006, mother-to-child transmission took place in 9.6% of children born to HIV+ mothers.

Murmansk Region
In terms of HIV/AIDS prevalence figures, Murmansk Region continues to rank fourth in Northwest Russia after the city of St. Petersburg, Leningrad Oblast and Kaliningrad Oblast. A second wave of the epidemic is observed; 241 cases of HIV infection were registered in 2005, 372 cases in 2006, 416 cases in 2007. Like in the Russian Federation as a whole, the epidemic of HIV infection in Murmansk Region can be described as concentrated in the population group of injecting drug users. Among the newly detected cases of HIV infection, injecting drug users accounted for 64% in 2005, 72.6% in 2006, and 73% in 2007.

The total cumulative number of registered infection cases in Murmansk Region as at December 31, 2007 was 2,360; prevalence per 100,000 was 274.2 (277.5 in the Russian Federation as a whole). In 2007 as before, the most affected areas in Murmansk Region were Kantalahti (Kandalaksha) District, Kolsky District and the city of Murmansk that together accounted for 79.5% of the total number of registered infection cases in the Region.

The young remain to be the group of the population that is most vulnerable to HIV infection. In the age structure of HIV positive cases, persons aged 20-29 account for 67% of the total number of detected cases. Especially alarming is the growth of new HIV positive cases among girls in the age group of 15-17 compared to boys of the same age. Overall, 109 cases of HIV infection were detected in the age group 15-17, of these 67 were girls 63% of whom were infected through intravenous drug use.

Situation in Murmansk Region during 5 months of 2008
During 5 months of 2008, 155 new cases were registered compared with 173 cases in the same period of 2007. The total number of HIV positive cases detected in the Region as at June 1, 2008 was 2,515. As before, the most affected areas are Kantalahti District, Kolsky District and the city of Murmansk. The principal HIV transmission route in the Region remains to be infection through injecting drug use, 70%.

In Murmansk Region, Kantalahti is a city with the highest HIV prevalence level. As from the start of the epidemic’s spread (2001), 406 HIV infection cases were detected in this city with a population of 58 thousand as of June 1, 2008.

The problem of drug use among youth remains to be urgent and takes on dimensions that are threatening for the Region. According to official statistics, 2,739 drug users are registered by medical institutions in the Region, including 1,566 (57%) with the diagnosis of drug addiction; 18% of drug users are women and 3% are under the age of 18. The proportion of non-registered drug users is high; their number is 6-8 times higher than that of registered drug users.

Conclusions of the HIV situation
The recent response to counteract the epidemic in Russia has significantly intensified. In 2008, 30,000 patients are estimated to become recruited to sustained antiretroviral treatment. In 2007, 6,239 pregnant HIV-positive women received full course of preventive medication. In addition, new preventive measures sponsored by the federal government were implemented including those targeted at vulnerable groups. Also the capacity of the laboratories, AIDS centres, sexually transmitted infection (STI) centres and other centres providing service to people infected or at risk for HIV, has been improved by state initiatives, supported by the Global Fund and the World Bank. (Thematic Report HIV/AIDS in the Baltic Sea Region and Northwest Russia, click here to view paper)

Financing for HIV/AIDS has increased every year, and preliminary budget plans cover the period until the end of 2010. The biggest part of financing comes from the national project "Health", some amount from the programme against socially significant diseases, and part from Global Fund and international projects.

In spite of active work against HIV and AIDS, some problems remain in the Russian Federation, for example:
- Exchange of needles and syringes is allowed only in official institutions. There is still no support from legislation to this activity.
- Methadone treatment is still not allowed and it is not probable to see change of attitudes in the near future.

The following conclusions can be made on basis of the development of the epidemic situation:
• The HIV infection epidemic in Russia has been lasting for two decades including 10 years against the background of an epidemic of heroin drug addiction.
• There are a growing number of people living with HIV/AIDS (PLWHA), potential sources of infection.
• There is no pronounced trend towards a significant decrease in drug use.
• Availability and prices of illicit drugs have significant influence in the development of HIV situation
• The number of HIV positive cases that require specific therapy and other types of medical aid is growing.
• The HIV/AIDS epidemic in the Region is currently concentrated in the most vulnerable groups
• Based on real conditions of the social nature of the HIV/AIDS epidemic, it is necessary to further expand HIV prevention activities targeted on population groups that are most exposed to the risk of infection in order to limit the spread of the epidemic into the general population.
Objectives The overall objectives of the Project are: The spread of HIV/AIDS epidemic is under control in the target areas. Social, health, economic and security consequences of the epidemic are minimized.
Specific objectives/indicators Project purpose is: Coordination of activities in Northern Dimension and Barents regions to control HIV and AIDS and reduce harmful consequences

The Project consists of three components:
I Coordination of Barents HIV/AIDS Programme
II Further development of low threshold services in Murmansk and Kantalahti
III Technical assistance to the HIV/AIDS Expert Group of Northern Dimension Partnership in Public Health and Social Well-being (NDPHS)

I Objectives of the Barents HIV/AIDS Programme
The Programme has six specific objectives:
1) Existing legislation for effective national policies to control the HIV epidemic updated
2) Technical, partner and response capacity for programme or project planning and implementation improved
3) Comprehensive and realistic prevention and surveillance activities are implemented
4) ARV treatment affordability and accessibility within the public health system correlate to individual needs
5) Programmes ensuring respect towards human rights, including persons living with HIV/AIDS (PLWHA) are implemented
6) Coordination between HIV/AIDS services and primary health care, educational, penitentiary and social services and sectors is established.

II Objectives of the Murmansk and Kantalahti project (Component II)
The Component II responds to many of the objectives of the Barents HIV/AIDS Programme, especially to 2, 3 and 6 (see above).

The overall objective is:
To stop and better control the spread of HIV in the Murmansk Region
The purpose of the Component II is:
Capacity of Murmansk Region to provide and sustain services preventing HIV/AIDS among high-risk groups increased

III Objectives of the HIV/AIDS Expert Group of NDPHS
The objectives of the NDPHS EG include promotion of regional collaboration around the Baltic Sea and other partners through activating common projects and creating networks of researchers, NGO:s etc. Another objective is to enhance harmonisation of procedures when it comes to primary and secondary prevention, surveillance, case management etc. Monitoring tools for these objectives are being developed and will include programmatic, output- and outcome indicators.
Results Expected results of the component II are:

1. Low threshold support centre in Kantalahti established
2. Personnel of Kantalahti LTSC trained
3. Murmansk LTSC supported and developed further by ensuring infrastructure and providing additional training for the personnel
4. Peer education programme launched and implemented among IDU and sex workers
5. Training organised for primary health care and other sectors specialists
6. Information on HIV prevention distributed among drug users, sex workers and youth
7. Annual monitoring and research among IDU and CSW to find out risk behaviour patterns and improve services implemented
Total foreseen budget EUR 355,878
Total implementation costs
(for completed projects, if available)
no data
Conversion to € was done on
(according to the relevant
exchange rate at
Infoeuro Monthly Files)
no data
Financing agencies / organisations Ministry for Foreign Affairs of Finland
Project's URL / project's website no data
Papers associated with this project no data
Further information no data
Last posted: on 2011-03-12 at 18:42:19

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