HIV in Russia: A Growing Epidemic
Elizabeth King’s attraction to Russia runs deep. As an undergraduate, she majored in Slavic languages and literatures. She also lived in Russia for four years before starting her MPH. Now an assistant professor of health behavior and health education at U-M SPH, she’s focused on the prevention and treatment of HIV among females who inject drugs and those who engage in sex work—populations with double the risk of contracting the HIV virus.
The situation “is pretty gloomy,” King says. The UNAIDS 2014 Gap Report showed that Russia was one of a half dozen countries, including Indonesia and Nigeria, where the HIV epidemic is still growing, and treatment coverage is low. The findings surprised King, since Russia is a high-income country that theoretically has the resources to address the problem.
King spent the summer of 2015 in Russia researching access to HIV testing and, for women diagnosed with HIV, the barriers to getting enrolled in HIV treatment programs. Her goal is to create programs that would support women to enroll in HIV treatment and adhere to the treatment services. The efforts in Russia have fallen short. Many of the original harm-reduction activities offered by treatment programs, including needle exchange and distribution, condom distribution, health education, and referrals for HIV testing, did not fully account for women-specific needs.
So outreach vans specifically for women were created. For her dissertation fieldwork, King spent a year traveling around in these mobile vans, which are designed to reach out to women with heightened risk for HIV acquisition in different hot spots around the city. Because the vans “catered toward women involved in street-based work,” King says, they have proven to be “an effective outreach service that reaches women where they are.”
She and her colleagues in Russian nongovernmental organizations and Russian universities are currently working on a research grant to develop a pilot program for interventions for women who are most at risk. “We’re looking at the gender constraints on their access to HIV treatment, doing a gender assessment of access to their services to understand where we could really make a difference,” King explains.
Her work is consistent with overarching global health goals. “Curbing the HIV epidemic is a global public health goal, and Russia is one country where the epidemic is growing most rapidly,” she says.