Round Table on the Russian Orthodox Church's Participation in Preventing and Overcoming HIV/AIDS

On January 27, 2020 a Round Table on the Russian Orthodox Church's Participation in Preventing and Overcoming HIV/AIDS was held, as part of the XXVIII Christmas Readings, at the Moscow Patriarchate's department for external church relations. It was attended by 42 clergy and laity of the Russian Orthodox Church from 8 dioceses, representatives of Protestant and Catholic communities as well as governmental organizations and NGOs. The Round Table was chaired by Archpriest Maxim Pletnev, head of the Coordinating center for overcoming drug and alcohol abuse, St. Petersburg diocesan Department for church charity and social service.

The participants have heard six reports and discussed problems of the HIV/AIDS epidemic in Russia and worldwide today; cooperation between Church related and governmental organizations in the field of HIV/AIDS; primary prevention of this disease among children and youth; palliative care for people living with HIV and AIDS (PLWHA) and participation of sisters of mercy and volunteers therein etc.

Larisa A. Dementieva, expert on epidemiological issues of the Central Research Institute of Epidemiology of Rospotrebnadzor, made a report on the situation of HIV infection, and the measures taken in the Russian Federation for the prevention of the spread of this disease.

She noted that according to UNAIDS, within the three and a half decades since HIV has been discovered, more than 78 million people were infected worldwide. By 2017, 39 million people had died from HIV infection, the number of people living with HIV today is 36.9 million. According to WHO, the European region has registered an increase in new HIV cases by 18%, a decrease in the number of deaths by 7% as compared to 2010.

The problem of the spread of HIV infection continues to be extremely urgent worldwide, despite the advances in science in the field of therapy, for example, the new therapy that can lead to prolonged remission.

In the Russian Federation at the end of 2019 there were more than 1 million Russians diagnosed with HIV, 80,118 new cases of HIV infection were registered, which is 7.5% lower than in 2018. In 2019, 760.306 HIV-infected people were registered in specialized medical organizations (66.9% of those living with HIV). The proportion of people infected with HIV through heterosexual contacts was 58.9%, while the rate of those through drug use dropped to 37.4%. In 2019, HIV infection was mainly diagnosed among Russians aged 30-49 years (71.5% of new cases).

Among the positive trends in the development of the epidemiological situation, the speaker noted the following:

• a decrease in the growth of the incidence rate: in 2011-2015 it averaged 10%, in 2016 - 5.3%, in 2017- 0.9%.
• an increase in the number of HIV tests (in 2019 - 40.8 million, which is 6.3% more than in 2018).
• a decrease in the HIV incidence rate in the country (in 2019 it was 7.5% less than in 2018; in 2018, a decrease by 2%).
• an increase of therapy coverage for HIV-infected patients registered in dispensary, from 37% (2015) to 68.8% in 2019.
• a decrease in the proportion of adolescents and youth aged 15-20 years among newly diagnosed HIV cases, from 1.6% (2012) to 0.8%, and the rate of youth aged 20-30 years from 35.3% ( 2012) to 20% in 2019.
• a decrease in the incidence of tuberculosis (first detected) by 7.9%, CVHB by 6.4%, CVHC by 5.8% as compared to 2018.

L.A. Dementieva noted the following negative trends:

• an increase in the number of regions with a high HIV prevalence of more than 0.5% of the population (up to 36 regions in 2019), where more than 59.6% of the country's population lives.
• increase in the proportion of HIV-infected among pregnant women (in 2018 - 0.99%).
• maintaining the trend of HIV spread among the population of the most active working age.
• mother-to-child transmission of HIV through perinatal contacts: in 2019, 503 children born to HIV-infected mothers were diagnosed with HIV for the first time, including 165 children born in 2019. In total, at the beginning of 2020, 11.322 children with HIV infection were living in Russia.
• the growth of patients with HIV infection, which is clinically manifested in the form of malignant tumors, is recorded (in 2018, 4.5 times more than in 2010). The proportion of HIV patients who die from cancer is growing: among all those who died in 2018, they were 6%, in 2017 - 5%, and among non-HIV-related death causes, 7% and 6%, respectively.

The speaker noted that in Russia since 1987, more than 355,000 PLWHA have died, including 33.577 prs. in 2019. This is 9.0% less compared to the same period last year (36.868 people) and more compared to previous years (2017 - 31.898, 2016 - 30.550, 2015 - 27.564). The most likely cause of high mortality associated with HIV infection is the late initiation of HIV treatment and the low proportion of patients with suppressed viral load. Tuberculosis remains the leading cause of death among HIV-infected people. 48.892 patients with active tuberculosis combined with HIV infection were registered in 2019.

L.A. Dementieva spoke about the objectives of the State strategy to combat the spread of HIV infection in the Russian Federation for the period up to 2020 and the future perspective, as well as about the activities carried out as part of its implementation. She especially noted the experience of public and charitable organizations working in the field of HIV prevention in different regions of Russia.

In conclusion L.A. Dementieva expressed her hope for continued mutually beneficial cooperation between state and religious organisations in the prevention of HIV-infection and in care for people affected by the disease.

Priest Vyacheslav Inyushkin, rector of the Intercession of Mother of God Church and Zerkaliy N.G, supervisor of the educational network project "School of Strong Family" from the city of Zarechny, Sverdlovsk region, presented their experience in spiritual and ethical education of children from kindergarten to college.

The project is organized by an Orthodox school in the name of the Holy Royal Martyrs and Intercession of Mother of God Church and started with three prevention programs ("Ladya", "Living Water", "Way to Home"). Within a short time, the project trained teachers from all schools in the city who teach these programs in their educational institutions.

In the academic year 2019-2020, the project partners are 6 schools of the city, 11 kindergartens, the Ural College of Technology and the Beloyarsk polytechnic. 1637 schoolchildren, 600 college and polytechnic students, 536 preschool children, 950 students' parents and 118 teachers participate in the project programs.

Speakers told about the family club "Together", which aims at the spiritual and moral growth of all family members, popularization of traditional family values, strengthening of family relations among project participants, and formation of skills for free time activities for the whole family. Amateur theater, master classes, city events on memorable dates, hiking and many other forms of work are used in this project.

Project managers believe that the main directions of future activities shall be spiritual and moral education of youth in the spirit of traditional family values; work with teachers, parents and families.

Executive Director of the Diaconia Charitable Foundation E.E. Rydalevskaya (St. Petersburg) spoke about the experience of the fund using social advertising. One of the key areas of the Charity's work over the years is the prevention of the spread of HIV infection. Social advertising can solve several problems related to the prevention of this disease: information - providing information about HIV and testing possibilities; overcoming false "myths" about HIV; motivation - encourage people to get tested for the virus and find out their HIV status. Social advertising posters are placed in transport, clinics, public places of the city. Promotional videos are posted on the Internet. Popular artists are involved.

O. Y. Yegorova, the senior nurse of the St. Dimitry sisterhood nursing service, the head of the Palliative Care Resource Center made a presentation on "The experience of the Orthodox sisterhood in training personnel for the care for palliative patients, including those HIV-infected, in the long-term care system". She started noting that formation of a long-term care system, i.e. comprehensive support for people who have completely or partially lost the ability to self-care, as the task was set by the President of the Russian Federation back in 2017. The most important obstacle to creating such a system is the lack of qualified junior and mid-level nursing staff in medical facilities. Due to overload, medical personnel can carry out only 14% of the total amount of the assigned care service, 55% is carried out by relatives and 29% by nurses specially hired by relatives. About 50% of patients die at home due to unprofessional nursing care.

The Orthodox service "Mercy" and the St. Dimitry sisterhood have established their own long-term care system, which includes the Moscow City Hospital № 1 (600 patients per year), St. Alexiy Hospital (palliative departments, 800 patients per year), Infectious diseases hospital No. 2 (760 HIV -infected patients per year), home-care service (56 patients per month), home for elderly (20 regular patients). This system serves 2.236 patients per year. The system combines care for palliative patients in hospitals, care for them after discharge from hospitals at home and in the home for elderly. The St. Dimitry nursing school and the Training center of the St. Alexiy hospital, which opened in 2019 and has already educated 40 junior nurses from among motivated volunteers, are engaged in the training of medical personnel.

The school also participates in the STROKE Clinical and Educational Training Complex of the Russian Ministry of Health, whose task is to improve the provision of medical care to patients with vascular diseases. In this program, teachers of the St. Dmitry Sisterhood and sisters of mercy participated in conferences in 30 regions of the Russian Federation, trained 460 nurses, including 110 sisters of mercy, and conducted 145 workshops (181 teaching hours).

Executive Director of Bryansk NGO "Blago" V.G. Afonina spoke about the project of primary prevention of risky behavior of children and youth, which in 2019 was carried implemented in Bryansk. 120 prs. took part in the project: students from 4 universities and colleges, high school students and NGO employees. They attended the "Ladya" program, personal growth trainings, and training in creating social advertising posters, cartoons, and videos on the prevention of risky behavior. In 2019, Blago employees also conducted 12 training seminars on the "Ladya", "Living Water", and "Way to Home" programs and training workshops for trainer's skills in Zarechny, Omsk, Magnitogorsk, Smolensk, Moscow, and the Moscow Region. The trainees were 345 educational psychologists and school counselors.

N.V. Tsunik, project Manager of the Kovcheg Anti-AIDS Rostov regional NGO spoke about the STEP.RU information program on adherence to HIV therapy. This is a comprehensive program for the training of counselors on adherence to treatment, the main goal of which is the full participation of every HIV-positive citizen of Russia in the life of the society. The project prepares regional multi-professional teams, training and improving the qualifications of consultants, maintains an information resource on YouTube STEPru, establishes partnership between regional AIDS centers and NGOs in the south of Russia. The project is also preparing a large-scale forum on HIV prevention STEPru / Step Russia with the participation of infectious disease doctors, psychologists, social workers, peer counselors and outreach workers at AIDS centers in southern Russia. Its main goal is to discuss the issues and problems of the spread of HIV infection on a united information platform for the exchange of experience and the creation of regional multi-professional teams in the regions of southern Russia.

A.G. Imasheva, the head of the Christian psychological counseling service "Candle" said that the service provides free psychological counseling to people living with HIV / AIDS and their families. The service employs 6 specialists, of whom three are engaged in face-to-face counseling and three more are engaged in text (or online) counseling on the Internet. In 2019, 325 people received psychological assistance in the "Candle": 108 prs. were counselled face-to-face and 217 via the Internet. In 2019, "Candle" is 15 years old.

O.I. Shishova, the head of the training and recreation center "Celius" spoke about the impact of chronic diseases on the human immune system and the need for active support of the immune system, including premedical therapy.

DECR Communication Service