In spite of growing rates of HIV infection among women, partnerships between the United States and Russia have contributed to a dramatic lowering of HIV transmission from mothers to their newborns - from 19.3% in 2000 to 6.2% in 2007.
Since 2001, the proportion of women among newly registered HIV cases in Russia has nearly doubled, from 24% to 44%, and the vast majority of these HIV-positive women are of reproductive age. According to the Russian Ministry of Health, by the end of 2006 over 33,800 newborns had been exposed to HIV, and HIV infection was confirmed in 2,043 of these babies. In Russia, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has focused on two regions, St. Petersburg and Orenburg, in which HIV prevalence in pregnant women is more than twice the national level.
PEPFAR is providing critically needed support for prevention of mother-to-child HIV transmission (PMTCT) in Russia. The impact of PEPFAR-supported programs was significantly strengthened and expanded in 2005 by the Government of Russia's declaration of PMTCT as one of its key health goals under the National Priority Project.
In one partnership, PEPFAR is supporting collaboration with the St. Petersburg City Government to enhance PMTCT surveillance and conduct a pilot project of rapid testing for pregnant women in labor with unknown HIV status. During the pilot project, 80% of women tested for HIV using rapid tests received their results before delivery and 98% of HIV-exposed infants received antiretroviral prophylaxis to prevent infection. The project demonstrated the effectiveness of rapid testing in enhancing the delivery of ARV prophylaxis to mothers and infants, and helped inform Russian Government deliberations that led to widespread implementation of rapid testing programs in labor and delivery departments.
In another case, PEPFAR supported a partnership with the Moscow Medical Academy to compete for one of the first Government of Russia grants on HIV prevention in 2006. They won a grant of $755,000 to disseminate new PMTCT guidelines, developed in partnership with U.S. experts, to 17 Russian regions. A subsequent government grant of $400,000 was awarded to the St. Petersburg Medical Academy of Postgraduate Studies to roll out a new PMTCT curriculum, developed with PEPFAR support, to medical schools throughout Russia. As a result, more than 320 medical and infectious disease specialists have received critical knowledge and skills related to the prevention of mother-to-child HIV transmission. A core group of trainers now routinely teach health care professionals and medical students across Russia how to prevent infection in newborns.
Partnerships between the Russian Government and PEPFAR-supported organizations are building sustainable, high-quality PMTCT programs throughout Russia. Indeed, these partnerships are so successful that PEPFAR support will be phased down while the Russian government and non-governmental organization (NGO) partners continue to work together to expand effective PMTCT practices that will enable Russia to achieve significantly lower rates of transmission.
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