A forum held in Saint Petersburg gathered together doctors and patients who discussed issues of adherence to treatment for HIV infection.
On the 25th of November, a forum entitled Doctor and Patient : Adherence to Treatment for Patients with HIV was held in Saint Petersburg. The forum was organized by NP “E.V.A.” with funding by AbbVie. Infectious disease doctors, gynecologists, pediatricians, peer counselors, and activists from community organizations took part in the forum. The participants traveled from a multitude of cities including Ekaterinburg, Perm, Novosibirsk, Samara, Saint Petersburg, Minusinsk, Chita, Irkutsk, Chelyabinsk, and Naberezhnye Chelny.
In opening the forum, NP “E.V.A.” Project Coordinator Natalia Sukhova presented the results from a survey of clients from the Adherence to and Quality of ARVT project. 377 individuals from Ekaterinburg, Leningrad Oblast, Novosibirsk, Perm, and Samara responded to the survey. The point of the survey is to determine the client’s knowledge of ARVT, adverse effects, side effects, and the reasons for changing treatment regimes, if applicable. The surveys were completed by HIV peer counselors based on the the client’s words.
Based on the results of the survey the portrait of the ‘average’ client of the project was compiled:
51% men, 49% women. Age: from 15 to 54 years old. The majority of the respondents are aged 25 – 45. On average the diagnosis was determined from 2008–2013.
268 of those surveyed responded that their ARVT medication has been changed. The following reasons were listed to explain the change:
Side effects (lipodystrophy, polyneuropathy, pancreatitis, increased risk of cardiovascular disease, etc.) – 3,0 %
Adverse effects (dizziness, etc.) – 25,9%
Development of drug resistance – 5,2%
Ineffective treatment – 6,9%
Lack of medication – 24,6%
Patient’s volition – 6,9%
Optimization of ARVT treatment regime – 10,8%
No treatment regime changes – 28,9%
Other – 11,2%
The responses regarding interactions between infectious disease doctors and patients were broken down in the following manner:
The doctor is familiar with the client’s personal and family circumstances: 74 individuals.
The doctor is prepared to answer questions relating to ARVT treatment: 231 individuals.
The doctor listens attentively and records the client’s complaints in their medical record: 192 individuals.
The doctor silently writes a prescription for ARVT without asking questions about the patient’s health condition: 52 individuals.
The doctor examines the patient each time they visit: 114 individuals.
One of the important topics that was discussed at the forum is peer counseling. This is the approach when a person living with HIV has been specially prepared to provide emotional and psychological support for other HIV positive people and has been gradually been implemented in AIDS centers, but not in all. One of the barriers for more widely expanding this practice is the lack of a clear understanding of this approach and of the role of the specialists themselves: “Why are peer counselors even needed?”
The criteria of the efficacy and impact of peer counselors was discussed. The forum’s participants consider that the following are important to include in the criteria:
— The number of CD4-cells at the start of counseling and after a certain amount of time after the first counseling.
— Treatment adherence, medical examinations, decrease in the number of refusals to take ARVT.
— A registry of clients who receive peer counseling outside of the system of AIDS centers, such as in support groups.
— Peer counselor certification.
In order to highlight the significance of the issues discussed at the forum, a press conference was held. The speakers were:
— Evgeniy Evgenivich Voronin, Head of the RF Ministry of Health’s scientific-practical center for the prevention and treatment of HIV infection among pregnant women and children, Head Doctor at the Republican Clinical Infectious Disease Hospital,
— Stas Piekha, singer, musician,
— Irina Evdokimova, Executive Director, NP “E.V.A.”,
— Olga Yeremeeva, woman living with HIV,
— Anastasia Drapenko, radio host.
The core theme of the press conference was personal experience: in coping with one’s diagnosis, overcoming dependency, and working with HIV positive people.
Stas Piekha spoke about his personal experience overcoming drug dependency and about how it helped him to make the decision to open his own rehabilitation center. The singer is surrounded by people living with HIV and therefore the issue of HIV is relevant to him. He called upon his fans to remember to take care of themselves and their partners, to use condoms and regularly get tested for HIV.
The Radio Host Anastasia Drapeko assists the UNAIDS goodwill ambassador Vera Brezhneva in her work to prevent HIV infection. “To this day there are regions where women with HIV are not ready to take openly about their status and are not prepared to defend their rights because they are afraid of being judged and condemned because of their status,” Anastasia told the participants, “The stigma and discrimination that HIV people face has no place in the contemporary world and I am very grateful for mass media which has not remained indifferent to the issue of HIV and continues to raise awareness about it.”
NP “E.V.A.” Executive Director Irina Evdokimova spoke of the importance of HIV peer counselors, because it is these specialists in particular who are the first responders for individuals who are coping with their status.
This thought was developed by Olga Yeremeeva, a woman living with HIV. “I recently became a grandmother,” she shared. “And, of course, I couldn’t fathom that the issue of HIV infection would ever affect me. Now, looking back, I understand that we are accustomed to trusting our loved ones, thinking that we are untouchable. Partners must talk about their health, especially about HIV infection. Because getting tested on time can not only save your health, but also your life.”
The forum participants took selfies and a group picture with the celebrities and parted ways, with hope that such events will happen regularly.