Recommendations from the Porto meeting concerning migrant populations and HIV-prevention More information is a must. Definitions, epidemiological investigations, risk factors etc. ”Concerted” EU-level actions are necessary. ”Ombudsman”? Representatives of migrant populations must be involved in the work (cultural sensitivity) Combined antiretroviral treatment must be available to all who need it.

HIV in Murmansk Region

HIV in Murmansk Region

Working principle Services are provided with “low-treshold”-principle indicating that anybody is welcome to use the services free of charge and anonymously, if desired. The centre provides condoms and clean needles and syringes, and on-site HIV and HCV tests. It works in close collaboration with the AIDS centre and narcological and rehabilitation organisations

Characteristics of the visits to ”Doverie”-centre in Murmansk 2005 2006 2007(8 Mo) Visits 56 1480 1312 Males % 51 71 52 IDUs% 62 43 61 >20 Y% 23 15 13 HIV + 21 514 526 HIV+/IDU 334 413 AIDS 3 63 54 Pregn/HIV 2 37 cARV 67 78

HIV- and HCV-rapid tests in ”Doverie”, Murmansk 2005 2006 2007(8 Mo) HIV-tests 14 768 638 HIV+ 26 32 HCV-tests 412 275 HCV+ 7 121 91

Demographic data of clients interviewed in the doorstep survey Males Females Number interviewed 84 63 Average age 26 24 Average history of drug use 7.1 y 6.8 y HIV + 39% 60% HCV + 70% 89% Heroin 93% 90% New syringes available 95% 100%

Examples of other projects HIV/AIDS prevention and care among drug users and in prison settings in Estonia, Latvia and Lithuania (UNODC) ”Border-cross” involving Ger, Pol, Baltics Scaling-up treatment and care for HIV and Tb and accelerating prevention within the health system in the Baltic states (WHO/EURO)

How to measure the impact? Example: Recommendation: Promote effective VTC with special emphasis on reaching the vulnerable groups. Objective: Access to VTC should be easy and nondiscriminating and coverage should be monitored on a regular basis Suggested criteria : How big proportion of IDU:s and CSW:s are covered? Are there agreements with law-enforcement authorities to get undisturbed function?

Problems/outstanding issues Tb-expert – collaboration with the prison group Co-lead partner – suggestion to involve the HIV-group of the Barents programme as a subgroup Formal nomination of representatives of partners

Prospects for 2008 Thematic report (database) Two meetings (Estonia April, Canada September) New projects Nordic-Baltic Conference on Infectious Diseases, St. Petersburg, September