Russia: Treatment, Care and Support for People Living with HIV/AIDS

Activities aimed at early detection, prevention and treatment of TB among HIV patients

The USAID Health Care Improvement Project (HCI), formerly the USAID Quality Assurance Project (QAP) has been working in the Russian Federation since 1998 assisting health care providers and leaders in improving quality of health care services. HCI utilizes the improvement collaborative approach where care providers from government and NGO organizations work together in teams focused on common goals for improvement of services.

Since 2004, the programmatic focus is placed on improving a comprehensive model for delivery of HIV/AIDS treatment, care and support services in four regions: Togliatti, Engels in Saratov Oblast, Orenburg City, and Krasnogvardeisky District of St. Petersburg City. Improving TB care delivery to HIV-positive patients was one of the four main avenues of work of the Project. All work is implemented by the teams of care providers in cooperation with national and international experts with technical assistance provided by HCI staff.

Since 2007, HCI has been supporting the Ministry of Health of Orenburg Oblast and St. Petersburg City’s Health Care Committee initiatives in scaling up improvements achieved by the project teams through the entire City of St. Petersburg and three districts of Leningrad oblast, and the entire City of Orenburg and three cities in the Eastern Zone of Orenburg Oblast: Orsk, Novotroitsk and Gai. These efforts are in concert with objectives set by the National Health Project and targeted at:  increase in coverage of PLWH with medical follow up and ART; decrease of TB incidence and deaths form TB among PLWH; competence improvement of primary care providers in the area of HIV infection and patient clinical management at a polyclinic level.

Major accomplishments

TB screening among HIV-positive patients

Testing of HIV patients for TB in polyclinics has become a routine and integral part of patient’s medical follow-up.

• Orenburg Oblast: The practice of TB testing among HIV patients in polyclinics was institutionalized in May 2007 in Orenburg Oblast through the MOH’s Order No. 666. The order regulates implemen-tation of TB testing procedures, implement-tation of IPT, and patient records. Over 100 patients are now screened monthly for TB at the AIDS Center in Orenburg, and more than 200 tested in polyclinics of the three cities of Eastern Zone of Orenburg Oblast; before 2007, there was no screening in polyclinics.

• St. Petersburg: A similar regulatory document has been prepared by the City’s Health Care Committee in St. Petersburg, approved by the Collegiate meeting of the Health Committee to come into effect in the first quarter of 2009. Teams’ activities resulted in a 35% increase in number of HIV patients tested for TB in St. Petersburg in 2008 compared to 2007.

IPT

Improved TB screening among HIV patients helped increase coverage with IPT. Since November 1, 2006 to October, 2008, over 620 patients received  IPT in Orenburg, St. Petersburg, Togilatti and Saratov (Togliatti and Saratov continue to participate in the HIV/TB collaborative); a patient form for IPT developed by teams in the collaborative has been considered by the Federal TB-HIV Center for preparation of national guidelines on IPT.

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