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For me, it is crushing

Since the start of January, antiretroviral therapy has not been disbursed to people with HIV at the chronic viral infection regional branches in Saint Petersburg.

Patients can still make a doctor’s appointment at the regional branches, but in order to receive the vital medications, they must make a trip into Saint Petersburg to the AIDS Center.

UPD: Attention! At the regional branches they are once again disbursing ART pills. “We resumed the disbursement of medication in clinics where it previously took place. Additionally we propose to expand the number of offices for this prevention work at each of the clinics where there is a patient who has this disease” the vice governor of the city Anna Mityanina announced at a meeting devoted to this issue. Thank you to all for taking action.

How it was:

Initially the chronic viral infection regional branches were established first and foremost to lessen the burden of the municipal AIDS center and secondly to give people living with HIV an opportunity to receive treatment in a convenient location. In Saint Petersburg 8 branches were opened and for many patients with HIV it was a life saver, especially for people with limited health or for single mothers with small children.

EVA’s peer counselors themselves encouraged their clients to visit the regional branches and recorded a video where Maxim Alekseevich Gerdiy, the head of the Krasnogvardeiskiy regional branch spoke about the benefits of regional branches.

The website of the Patient Control movement contains the following data: “In October of 2018, chronic viral infection regional branches existed in ten regions of the city and 6,295 patients were monitored at them, of whom 4,171 (78%) received ART. This means that over 21% of patients with HIV in Saint Petersburg who take ART received it from regional branches.

How it became:

The city changed the method of providing treatment to people with HIV. Now patients must go to the AIDS Center in every case. The AIDS Center’s pharmacy is already preparing for the increase in the flow of residents, however it’s clear that some must drop their treatment.

We spoke with women who previously received their treatment from a regional branch about the new procedure for receiving medicine for citizens who live with HIV:

  1. disabled, lives with HIV for 19 years: “I just yesterday learned that in our regional branch it will no longer be possible to receive treatment. Traveling to the AIDS Center is extremely inconvenient – I don’t leave my house for long, it’s hard for me to walk, and the trip to Obvodny [the AIDS center] takes an hour and a half. I haven’t been to the AIDS Center in ages, I have been receiving my pills from the regional center all this time. Prior to that my boyfriend helped me as he too went to the AIDS Center for treatment. He’s no longer around and I don’t know what to do. All my hope on the girls – the peer counselors.”
  • Disabled, lives with HIV for 19 years: Now it will be very inconvenient for me to receive treatment: I need to get the prescription in one place and then go to Obvodny for the treatment. I must make it during the working hours of both of the locations, and they take breaks and have their own systems for getting appointments and you have to arrive at just the right time. I have a level three disability and I have chronic back pain which makes things hard for me. Also it costs money for transportation. And on top of that, my child also has a disability, but his medication is easier to procure. For me, now it’s like this. How can the problem be solved? Well I was put into this situation and so I will do what I must, what else remains?”

Comments from expert, peer counselor, and Equal to You Project Coordinator Natalia Zamanskaya: A large part of the citizens who we support are people with great disadvantages. The regional branches provided an opportunity for them to avoid wasting time and money on travel. Also it was convenient for women who don’t have anyone to watch their children when they travel to the AIDS Center to receive treatment at the regional branches. People started taking their medicine once again after gaps or began to take it for the first time because the service was accessible.

For me, what is happening now is crushing. It crushes the trust that we have worked to build with patients – we transferred many people to the regional branches and it bore fruit. Of course there are cases when peer counselors receive treatment at the AIDS Center by proxy for all those who have difficulty traveling there themselves, but we clearly can’t manage this.

After all, formally we are not denied treatment. But article 4 of the Federal Law No. 323-ФЗ “On the Principles of the Protection of Citizens’ Health” states that the interests of patients is a priority in the main principles regarding the provision of medical care as well as access and the quality of the healthcare provision. At the same time, article 10 of this same law states that the accessibility and quality of medical care is provided by “the organization of providing medical care based on the proximity to one’s residence, place of work, or study.” In general, that was the case. The organization of the regional branches in Saint Petersburg was a unique project for Russia and it is an ideal solution for large cities. And now it is deemed meaningless and there are a great amount of issues related to the return to the municipal AIDS center.”

Elena Ivanova, Coordinator of the rights defense project Peers Defending Peers, proposes the following solution for those who would like to revive the right to receive medicine in one’s neighborhood:

  1. Call the city health hotline at 635-55-77 and state your request to revive the system of providing treatment in the regions;
  2. File a complaint about the lack of medication at the regional branches in the online system for the Health Committee;
  3. Write an email to the Head of the AIDS Center (aidscentr@zdrav.spb.ru) and to the website Pereboi.ru.

In the letter be sure to include the difficulties that are created by no longer providing medication at the regional branches. For example, if you have full-time work, if you are disabled, low income, or have small children, it’s worth mentioning.

There is no format for the letter. You for example, can write, “I, Ivanova E.V. am a patient at the AIDS Center in Saint Petersburg. Since 2016 I have been treated at the regional branch of the AIDS Center where I receive my vital ART medications. This service has recently been discontinued, which has severely impacted my life. I can not travel regularly to the AIDS Center because I have small children and low income. I request that the ability to receive ART from the staff at the regional branches is revived. Thank you in advance for your understanding.” This is just a loose template.

“Despite the challenges, do not stop taking your treatment,” Elena says. “If you are unable to make the trip to get your treatment yourself, give your prescription to a loved one and ask them to pick up your prescription (notarization is not necessary). ART is available for pick up Monday-Friday 9:15am-7:30pm as well as Saturday 9:15am-2:00pm.”

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