Aleksei Bobrik, deputy director of the Open Institute of Health (OIH), presented the institute’s program for controlling HIV-TB co-infection in marginalized groups of the population that have limited access to general medical services. According to Bobrik, ignoring the problems associated with injecting drug users (IDU) leads to the establishment of epidemiological reservoirs of HIV and TB infection in society. Efforts by OIH in this area target the analysis of indicators and standards, as well as enhancing coordination among regional services to control HIV and TB in marginalized groups. OIH has recently completed six projects to control HIV and TB in IDUs and has successfully operated a training centre in Tomsk. The prevention of HIV in migrant populations was a component of the TB program. 

 

 

Bobrik outlined the primary elements of working with marginalized groups:

“We have chief elements: Access, the proximity of a free-of-charge service to an entire group; Voluntary Participation, decisions are made with participation of the client; Goodwill, the absence of discrimination by staff; and Trust, anonymity and peer-to-peer consultation”.

 

Olga Frolova, head of the Centre for Anti-Tuberculosis Aid to People Living with HIV under the Russian Ministry of Health and Social Development, presented on the topic “A System for Counting TB and HIV Infection Together.” 

 

She said that “more than 40% of patients with late-stage HIV infection have tuberculosis and late-stage HIV infection develops six to eight years after infection; therefore, there are more than 160 000 people in addition to those living with HIV that are not undergoing ARV therapy for tuberculosis.”

 

This conclusion has also been confirmed by the research project HIV-Infection and Tuberculosis in the Russian Federation, Saint Petersburg and Orenburg Oblasts: An Analysis of the Current Situation and Future Development that was conducted by the University Research Company. Anatoly Vinokur, monitoring and assessment advisor to the University Research Company, presented the study findings. He noted that “the coverage level of HIV-infected patients by drug prophylaxis and preventive exams for TB and the quality of these services remains unsatisfactory overall. If the current observed unfavourable HIV trends continue, particularly in combination with economic crisis and reduced funding for programs, the positive advances made in combating tuberculosis overall could lapse as early as 2009.”

 

Yelena Yurasova, medical specialist for the World Health Organization (WHO) in Russia, explained the WHO approach to the HIV-TB issue. She presented work from the fourth Round of the Global Fund and emphasized certain aspects, such as the renewal and provision of medical equipment for offices in tuberculosis  dispensaries that treat HIV-infected patients, as well as the conducting of seminars and conferences for healthcare specialists.

 

The presentations encouraged lively discussion and an exchange of ideas.