12.08.2010. «We speak the same language with our patients…»
On 12 August 2010 the United Nations Development Programme and the Russian Association of people living with HIV organized a round table discussion on topical issues of the institutionalization of peer counseling on HIV/AIDS in Russia.
People living with HIV (PLHIV) are in need of medical and psycho-social support. In view of the current level of HIV prevalence in Russia, the medical support is being provided to the majority of people living with HIV. However, psycho-social support, which is ensured by law is short in supply as the state system of social support to PLHIV is not developed.
To obtain this support, PLHIV appeal to non-governmental organizations, which apply the adapted international methodologies. One of them is the so called “peer counseling”, which is in fact a confidential dialogue between two people living with HIV, one being a consultant and another - a client. The peer consultant is supposed to have successful experience of living with HIV infection and possess a set of knowledge and skills required for counseling. Peer counseling aims to assist a person living with HIV to cope with stress and make informed decisions about life with HIV.
The discussion was called by the results of the first in Russia sociological survey on peer counseling on HIV/AIDS. According to Tamara Glushakova, the General Director of Ri-Vita Consulting, which conducted the research commissioned by UNDP, the term ’peer counseling’ is not yet understood by everyone. Therefore one of the main objectives should be the increased information sharing about the role, meaning, and possibilities of this methodology, particularly among people living with HIV and health care personnel in AIDS Centres.
As the meeting was attended by various stakeholders, including federal entities, such as Rospotrebnadzor, regional AIDS Centres, the PLHIV Association and peer consultants, the topic was addressed from various angles. The peer consultants from Ekaterinburg, Tyumen, Orenburg, Khabarovsk, Ulan Ude, and Yakutsk shared their work experience and practices. Anastasia from Tyumen said that her main goal was to assist her interlocutors to accept the diagnosis, to realize the need and necessity to take ARV medicines regularly, with no interruptions. The main problem of PLHIV is the lack of adherence to treatment and irregular intake of medication that has a negative impact on their well-being and life span. By their own life experience, the peer consultants prove that people with such a desease can and shall live and at the same time, they can be useful for other people and the society at large.
The AIDS Centres’ physicians emphasized the necessity of interaction between peer consultants and medical personnel. On the one hand, it is important for upgrading the consultants’ skills , and on the other hand, it is necessary for physicians to understand the benefits of consultants’ work, and also to raise the effectiveness of their joint efforts. Ksenia from Sverdlovsk AIDS Centre suggested that joint trainings should be organized for physicians, nurses and peer consultants. In her opinion, peer counseling is the thing, which is really needed and it should be institutionalized as soon as possible. Now, most of peer consultants provide their services on their own initiative and on a voluntary basis. At the same time, AIDS Centres’ physicians recognize the importance and the invaluable contribution of peer consultants in the psycho-social support to PLHIV. “Peer consultants take up a great part of our work”, underlined the physicians, who were present at the round table discussion.
Larisa Dementieva, the Rospotrebnadzor representative thanked the organizers for the valuable and timely discussion. It is necessary to create an evidence-based database with detailed normative information so that the government could take a decision on the official status of peer consultants and integrate them in the AIDS Centres staff schedule.
This is what the Russian Association of People Living with HIV (PLHIV) is focused on at the moment. Igor Pchelin, the Executive Director of the Association, raised the issue of evaluation of the work effectiveness of peer consultants. This evaluation should be clear for all stakeholders including the government. Certification issues, reporting requirements, monitoring of peer consultants’ services are the most important and inherent elements of peer counseling on HIV introduction.
At the end of the discussion, the round table participants signed a resolution on the necessity of the inclusion of issues regulating peer counseling into the draft document by the Ministry of Health and Social Development, ‘Procedures for medical assistance to the PLHIV’. The institutionalization of peer counseling as one of the elements of psycho-social support system for PLHIV could help the government overcome the consequences of HIV/AIDS epidemic in Russia.
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