Combatting the HIV Epidemic in Russia

The Center for AIDS Intervention Research (CAIR) at the Medical College of Wisconsin has received new grant awards totaling $4.1 million from the National Institute of Mental Health (NIMH) and the World AIDS Foundation to launch HIV prevention research and research training projects in Russia, a country at the brink of a major HIV epidemic.

The new initiatives are part of efforts by NIMH and the World AIDS Foundation to apply HIV prevention lessons learned in the United States to the global struggle against AIDS. The World Health Organization (WHO) estimates that 38 million persons worldwide have contacted HIV infection. Of that 38 million, over 37 million live outside the United States.

"The HIV epidemics raging in Africa and parts of Asia are well-known," says Jeffrey A. Kelly, PhD, CAIR Director and Professor of Psychiatry and Behavioral Medicine. "Less well-known is the HIV epidemic that is just beginning to unfold in Russia and other countries of the former Soviet Union and Eastern Europe."

Russia's economic collapse, limited public health resources and growing problems of drug use and sexually-transmitted diseases (STDs) among young people are contributing to a rapid rise in HIV infections. Forty thousand HIV cases have been diagnosed in Russia, almost all in the last three years, and Russian health authorities expect that one million new cases are likely within two years.

To combat this threat, a CAIR research team headed by Dr. Kelly is training Russian behavioral, social, medical and biological scientists from St. Petersburg State University (SPSU) in HIV prevention research methods. Seven SPSU faculty and postdoctoral investigators spend periods of six to eighteen months training at CAIR before returning to Russia to lead HIV prevention efforts in their home country. The World AIDS Foundation grant will support HIV prevention projects with three vulnerable populations in Russia: young drug users, young men who have sex with men and young men and women who have contracted STDs. These projects will determine the prevalence of high-risk behavior and the HIV prevention needs of each group so that effective prevention programs can be implemented. This work is being undertaken with community-based AIDS organizations in St. Petersburg.

In the five-year NIMH project, CAIR investigators will collaborate with colleagues at SPSU to design, implement and evaluate the effectiveness of community-level HIV prevention programs for young adults who live in 12 large public dormitories. Each dormitory provides housing for 300-800 young adults enrolled in vocational trade programs. The intervention to be carried out is one that identifies and trains popular opinion leaders -- persons well-liked in their circles of friends -- to serve as HIV prevention educators and advocates to other peers who live in the same dormitories. The program's effectiveness will be determined by studying changes in risk behavior and STD rates in the dormitory populations. This intervention approach has proven successful in past programs directed by Dr. Kelly in the United States. The NIMH study is the first to apply this approach in an international setting. If successful, the intervention will be expanded to other areas of the country.

MCW CAIR faculty co-investigators in the projects include three members of the Department of Psychiatry & Behavioral Medicine: Anton M. Somlai, EdD, Assistant Professor; David W. Seal, PhD, Assistant Professor; and Seth C. Kalichman, PhD, Associate Professor. Also co-investigating is Timothy L. McAuliffe, PhD, Associate Professor of Biostatistics.

The Russian collaborators include Andrei A. Kozlov, PhD; Olga Borodkina, PhD; Roman Dyatlov, PhD; Juliana Granskaya, PhD; and Alla Shaboltas, PhD, all faculty at St. Petersburg State University.

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