Prevention of Mother-to-Child Transmission of HIV
Russian Federation

Project Duration:  January 2003 through June 2006
Donors:   
Dutch Postcode Lottery / Nederlands Postcode Loterij (www.npl.nl)
Dutch AIDS Fund (www.aidsfonds.nl)
MATRA – Social Transformation Programme of the Netherlands Ministry of Foreign Affairs (www.minbuza.nl)

Partners:      
International Antiviral Therapy Evaluation Centre (IATEC), Amsterdam (www.iatec.com)
PharmAccess International (PAI), Amsterdam (www.pharmaccess.org)
Research Centre of Obstetrics, Gynaecology and Perinatology, Moscow (www.pregnancy.ru)
World Health Organisation (WHO) ( www.who.int)

Regions:  Republic of Tatarstan; Irkutsk, Omsk, Chelyabinsk and Penza Oblasts; Moscow

Background:

The registered number of children living with HIV/AIDS (CLWHA) in the Russian Federation (RF) as of 1 June 2004 stands at 9 918¹, compared to just 6 only in 1996.  Mother-to-child transmission (MTCT) remains the primary mode of transmission for nearly all of the estimated 5.1 million HIV-positive children worldwide².  Over 15 000 children were registered as HIV-positive in Eastern Europe and Central Asia in 2001 alone³.  

In the RF, 25 to 40% of all HIV-positive women who are delivering a baby do not seek prenatal care⁴.  In such cases, HIV infection is detected only during delivery.  If pregnant women living with HIV/AIDS (WLWHA) do not seek care prior to delivery, prevention efforts of disease transmission to the child are hindered.  In 2002, AIDS Foundation East-West (AFEW) initiated an MTCT pilot prevention programme in collaboration with domestic and international partners in selected regions around the RF.  It is expected that between 500 and 1 000 children will be borne to WLWHA each year in the pilot regions.  This pilot programme follows the recommendations formulated by the World Health Organization.

Overall Objective:

The overall objective is to prevent HIV transmission from WLWHA to their (unborn) children through the implementation of a co-ordinated and sustained MTCT prevention programme throughout the RF based on international experience and standards.

Target Audiences:

• Parents-to-be

• Women living with HIV/AIDS (WLWHA)

• Pregnant women and mothers living with HIV/AIDS

• Children born to WLWHA

• Medical personnel of treatment institutions

• Administrators, healthcare professionals and NGO staff

Specific Objectives:

1. To prevent HIV infection among parents-to-be

2. To prevent unintended pregnancies among WLWHA

3. To prevent the transmission of HIV from WLWHA to their (unborn) children

4. To improve treatment, care and support services for WLWHA, their infants and families

Expected Results:

• Development, production and distribution of a collection of articles on the prevention of mother-to-child transmission of HIV and the monitoring of children born to HIV-positive women

• Development of training and curriculum on the prevention of MTCT, voluntary counselling and testing, treatment of sexually transmitted infections (STIs), antenatal care, prevention strategies, and safe delivery practices

• Development and implementation of peer counselling for and by WLWHA

• Development of  clinical treatment protocols on the prevention of MTCT

Expected Success:

• Improved knowledge and skills on the prevention of HIV infection among parents-to-be in the pilot regions

• Improved knowledge and skills on the prevention of unwanted pregnancies amongst WLWHA in the pilot regions

• Decreased rate of transmission of HIV from WLWHA to their (unborn) children in the pilot regions

• Improved care and support services for WLWHA, their infants and families in the pilot regions

Expected Materials Production:

• Readers on ARV Therapy, PMTCT and Peer Counselling

• Guidelines on Pre- and Post-HIV Test Counselling, Peer Education, Prevention of MTCT and STI diagnosis and treatment

• Booklets on Pregnancy and HIV, Family Planning and HIV/STI Prevention, Post-Exposure Prophylaxis

• Posters on HIV/AIDS, Prevention of MTCT and Testing

Research Completed and Planned by AFEW:

• AFEW will monitor and evaluate programme impact through focus group discussions and through KAPB surveys among the target audience

• In co-operation with partners, an assessment of local laboratories capacities and readiness for HAART will be conducted

For further information, please contact:

Dmytro Donchuk
Senior Programme Advisor, Care and Support Programmes
E-mail: dmytro_donchuk@afew.org

Vika Dollen Project Manager, Russian Federation
E-mail: vika_dollen@afew.org

Office Address:
Chayanova St. 15/5
Moscow 125047 Russian Federation
Tel:  + 7 495 250 6377
Fax:  + 7 495 250 6387
Website:  http://www.afew.org

International Postal Address:
AFEW
P. O. Box 75752
1070 AT Amsterdam
The Netherlands

International Postal Address:
AFEW
P. O. Box 75752
1070 AT Amsterdam
The Netherlands

¹ Russian Federal AIDS Centre, ‘HIV-Infection, Information Bulletin, No. 25 (in Russian)’, Moscow, RF, 2003.

²World Health Organisation, ‘Prevention of Mother-to-Child Transmission of HIV: Selection and Use of Nevirapine’, Technical Notes, WHO, WHO/HIV_AIDS/2001.3, 2001, Geneva; Joint United Nations Programme on HIV/AIDS and World Health Organisation, ‘AIDS Epidemic Update: December 2002’, UNAIDS/WHO, Geneva.

³ Joint United Nations Programme on HIV/AIDS, Report on the Global HIV/AIDS epidemic: July 2002, UNAIDS, Geneva.

⁴ Ministry of Health of the Russian Federation, ‘Pregnancy and Births Among Women Living with HIV/AIDS in the Russian Federation, 2000-2001’, 27 June 2002, Moscow, Russian Federation.