1. HIV/AIDS Expert Group Progress report and future plans Pauli Leinikki and Outi Karvonen CSR 15-16.10.2009 16/10/09 1

2. Long-term objective for HIV EG: Facilitate regional collaboration of health authorities and civil societies focusing in issues dealing with HIV/AIDS that have special relevance to the people in the region. 16/10/09 2

3. Remarks related to Long Term Objectives The epidemic has followed different patterns of evolution in different countries– an opportunity to learn from each other The epidemic is unusually prevalent among most-at- risk-populations that are socially marginalised and often hard to reach for support, care or intervention 16/10/09 3

4. Mid-term plans Development and implementation of Barents region collaboration with spin-offs in other regions. Several projects established and implemented Cross-border activities between Estonia and Leningrad Oblast established as a project Projects dealing with the prevention of TB/HIV dual infections in high-risk populations have been initiated The expert network is supported by regular meetings and planning and implementation of new relevant projects through it. 16/10/09 4

5. Long term Priorities Regional collaboration, (learning from each other) Prevention of HIV among drug users Prevention of HIV/TB dual infections Enhancing cross- border activities Prevention of HIV among men who have sex with men Close collaboration with social welfare Promoting harm reduction among IDU:s Prevention of mother-to-child transmissions 16/10/09 5

6. Examples of activities 1: Prevention of HIV among drug users Development of working principles and practice in Low Threshold Service Health Centres (LTSC) for injecting drug users (IDU)in Finland in 1990:s Impact: Few cases of HIV linked with drug use today (in 2008 7 cases, in 2009 2) Based on this model LTSCs established in Latvia, Estonia, Murmansk, Kandalaksha, and negotiations going on elsewhere (Leningrad region) ENCAP project strengthening collaboration between the Baltic states 16/10/09 HIV/AIDS Expert Group of NDPHS6

7. Examples of activities 2: Prevention of HIV/TB co-infections and MDR TB Work among People Living With HIV and AIDS Low threshold service centres – important role in reaching the right population Collaboration between LTSCs, AIDS centres and Tuberculosis services established in practical and administrative level TB/HIV collaboration in Murmansk is a good example, new activities as a project proposal Project proposal with the Leningrad Region (collaboration with Finland and Estonia) 16/10/09 HIV/AIDS Expert Group of NDPHS7

8. Examples of activities 3: Integration of social and health care HIV work is closely linked with social care in prevention, treatment and care Project examples with special emphasis on social support: –“Psychological and social support to HIV-infected women in Leningrad Oblast”, 2007-2009 –“Further development of low threshold services in Murmansk and Kantalahti” 2008-2010 16/10/09

9. Examples of activities 4: Other priority areas Prevention of HIV among MSM –European MSM Internet survey on knowledge, attitudes and behaviour as to HIV and STI (project supported by EU) Policy harmonisation in HIV prevention and care (Project supported by France) Policy issues: Enhancing voluntary testing and counceling and link to “secondary surveillance” according to WHO criteria. Harmonisation of Post exposure prevention guidelines Collaboration with prison authorities and Prison Health Expert Group of NDPHS 16/10/09 HIV/AIDS Expert Group of NDPHS9

10. Activities after CSR in Gdansk, 2009 European AIDS Conference in Vilnius, April 28-30 Contributions to NDPHS E-newsletter Study tour from Archangelsk and Leningrad Region to Finland (May 13-15) Project planning seminar by Logical Framework Approach in Narva, Estonia (June 3-5) Logical Framework workshop in Murmansk (June 1-5) Project planning seminar on HIV/TB using LFA approach, Murmansk June 1-5 TB+HIV meeting with experts from Murmansk in Helsinki, August 7 16/10/09 10

11. Activities after CSR in Gdansk 2 Barents HIV/AIDS Programme Steering Committee meeting, St. Petersburg, Sept 22 Contribution to the 8 th Nordic Baltic Congress on Infectious Diseases, St. Petersburg, Sept 23-26 Expert Group meeting in Sopot, Poland, 1-2 October: themes –Social aspects of HIV and AIDS work –NGO:s as active players in Russia (NGO representative) –Impact of the new strategy proposal to the future work of the group 16/10/09 11

12. Activities after CSR in Gdansk 3 Application for continuation of funding for the coordination of the EG in 2010 (August) New project applications: –Development of low threshold services in the Leningrad Region (2010-2012) –HIV prevention among reproductive aged women in Karelia (Russia), 2010-2012 –Strengthening of municipal anti-drug networking in the Murmansk Region, 2010-2012 –HIV/TB collaboration in Murmansk, 2010-2012 16/10/09 12

13. Activities after CSR in Gdansk 4 Guidlines for provider-initiated voluntary medical examination, testing and counseling for infectious diseases in injecting drug users (Norway & EMCDDA) Commenting the OECD Accession Review of the Russian Health System for the Ministry of Social Affairs and Health, Finland (July) Memorandum on Arctic collaboration for the Ministry of Social Affairs and Health, Finland (August) 16/10/09 13

14. Administrative issues: A new member representing the European Center for Disease Control (ECDC) was appointed to the group Chair and co-chair arrangements will continue through 2010 Two Expert Group meetings – spring 2010 in Finland, autumn meeting to be defined later

15. Project status in August 2009 –18 projects ongoing –7 proposals under consideration –21 projects completed 16/10/09 15

16. Future plans in 2009 Participating to Eastern Europe and Central Asia AIDS Conference, Moscow, 28-30 October PAC and side event World AIDS Day, 1 December Study tours by groups from Archangelsk and Kaliningrad to low threshold services for injecting drug users in Finland – (November) Seminars for prison health and rehabilitation centre personnel on issues of HIV, TB and drug use (December) 12 th European AIDS Conference (Nov 11-14, Cologne) ECDC meeting on HIV testing (November 2-3) 16/10/09 16

17. Plans for 2010 Project activities will continue and new projects started depending on financing decisions Two Expert Group meetings – spring 2010 in Finland, autumn meeting to be defined later Update of thematic issues/new themes International AIDS Conference (Vienna 18-23 July) More detailed plans pending the new ToR for the Expert Group 16/10/09 17