Scope and Purpose

Engaging the Unengaged in HIV/AIDS Control
Planning Meeting, Moscow
6 December 2005

Background

One in a hundred Russians is now HIV positive! In 1992, South Africa had a 1% adult prevalence rate - now it is over 24%! While conditions in South Africa were and are very different from those in Russia, the capacity for this epidemic to escalate rapidly must not be underestimated, particularly as evidence mounts of a shift in new Russian cases[1] from injecting drug users to the general population.

The HIV/AIDS Ask and Act - It's Your Health campaign is a globally-supported, locally-applied set of activities aimed at enhancing HIV/AIDS prevention and treatment information, education and public awareness (and supportive policies) by engaging and strengthening the capacity of health leaders, people living with HIV/AIDS (PLWHA) and information mediators, eg health professionals, media, policy spokespeople, NGO advocates, and private sector advertisers, to respond effectively. It is not about starting new projects but enhancing the effectiveness of existing initiatives.

Information has been identified as a key challenge to rolling back the HIV/AIDS epidemic in Europe and beyond.  "Inadequate awareness and insufficient evidence-based information breeds ineffective, even harmful, responses to HIV/AIDS." (UNDP, 2004) Addressing the critical need[2] for local policy environments that can openly address the problem of HIV/AIDS, provide leadership, accommodate civil society action, and be responsive and accountable to the communities most affected, the Ask? & Act! initiative is coordinated by municipalities involved in the WHO Healthy City networks. Key principles of Healthy Cities include commitment to health for all, joint action between sectors, active community participation, innovation, healthy public policy and international solidarity.

Media Audits

HIV/AIDS media/communication surveys done this year[3] in Izhevsk, Kaliningrad and St Petersburg revealed that there has been a gradual shift from denial of the epidemic ("the enemy will not attack"), through seeing it as a marginal issue affecting only drug users and prostitutes ("it is there but it is not our problem") to more recently, HIV/AIDS being pictured as the "Plague of modern times". Media monitoring revealed, however, that when it came to identifying action to control the epidemic, the voices of PLWHA and health professionals were generally absent. Stigma, discrimination, myths and stereotypes were identified as major 'message-shaping' issues and obstacles to effective control action.

In addition, there was little information about changing risk groups, protection measures for health professionals, the social aspects of HIV and AIDS, social integration of PLWHA and legal provisions. Similarly, there was little coverage of treatment, prevention and availability of support.

This planning meeting

This meeting will utilise Healthy City capacities to convene and lead and will bring together young people, PLWHA, health professionals (doctors, nurse and pharmacists) and media to explore ways to "engage the unengaged " and add value to ongoing efforts.

The need for partnerships, coalitions and alliances was a recurring theme in the previous Copenhagen and Turku meetings. Participants felt that the current epidemic could be much better addressed in cooperation with all stakeholders, avoiding fragmentation and waste of resources, enabling the presentation of a stronger case to policy makers and raising HIV/AIDS awareness amongst the general public. Particularly in high stigma environments where PLWHA and IDU are especially vulnerable, visible courageous leadership and support from credible trustworthy sources such as health professionals, industry and municipal governments can help to reshape/reframe the environments.

It is now well recognised internationally that "communication expertise and planning is as essential to outbreak control as epidemiological training and laboratory analysis." [4] To this end, the meeting will review examples of good campaign practice in different Russian and other European cities. In particular, the roles of media, health professionals and PLWHA in engaging young people will be reviewed. Current prevention and treatment projects will be identified and described. Participating cities will agree actions they can take to enhance effectiveness of current programmes by engaging young people through information, education and public awareness initiatives.

Aims:


Expected Outcomes:

    * Agree Healthy City HIV/AIDS prevention and treatment plan, linked to national and CCM activities.
    * Establish Healthy City based HIV/AIDS communication network to support activities of CCM.
    * Produce HIV/AIDS Communication guide as a tool to help in this process.

 

[1]Current HIV/AIDS profile in Russian Federation:

    * Transmission is mainly IDU related, but 20-25% now heterosexual (up from 6% in 2001)
    * 75-85% of all cases are males
    * Up to 30% of infected females are IDU and 50% are partners of IDU
    * 30-70% of all HIV infections are among younger than 25 years
    * Vulnerable Groups: IDU, migrants, ethnic minorities, sex workers
    * Access to HAART (Highly active anti retroviral treatment) treatment very low

[2] "Where AIDS decision making is not open the circle of those who are able to provide insights and information is reduced, leading to less informed policy. On the other hand, where political process allows for the participation of civil society, where media can speak out about HIV/AIDS issues, where individuals have rights to freedom of speech, freedom of association and freedom of movement protected by law, then positive policy environments for successful responses to HIV/AIDS can follow." (Stiglitz, J., World Bank, quoted in PANOS 2003)

[3]Reported at the HIV/AIDS Ask? and Act! It's Your Health campaign planning meeting in Turku, Finland, (June 2005) convened with the support of World Health Communication Associates, WHO Healthy Cities Baltic Centre, and Johnson & Johnson.

[4] WHO(2005) Outbreak communication Guidelines.