Round Table on HIV/AIDS

A round-table conference on the Involvement of the Russian Orthodox Church in Preventing and Overcoming the Spreading of HIV/AIDS took place on January 30, 2003, within the section work of the 11th International Christmas Educational Readings.

It was organized and conducted by the Moscow Patriarchate Department for External Church Relations/Russia Round Table. It was attended by some 70 people including clergy and laity, representatives of church organizations, brotherhoods and sisterhoods, Russian and international NGOs engaged in preventing and overcoming HIV/AIDS and governmental bodies. The participants represented various regions in Russia and the near abroad including Moscow and it's region, St. Petersburg and its region, Arkhangelsk, Kiev, the Rions of Bryansk, Omsk, Region, as well as Ryazan, Minsk and its region, Svetlogorsk, Vitebsk and other cities, towns and regions.

Ms. L. Dementyeva, chief expert of the healthcare ministry in the HIV/AIDS prevention, described the present picture of the HIV/AIDS epidemic in Russia as follows: as of January 1, 2003, there were 228.545 HIV-infected people in our country; out of this number 4.775 are children, 777 people with AIDS including 183 children; 578 died of AIDS, including 122 children. These are only registered cases; actual figures are several times as high. Recently there has been a tendency of rapid growth in the number of people with AIDS, and their mortality rate is also growing.

The regions most affected by the epidemic are Moscow and the Moscow region, St. Petersburg, and the regions of Samara, Sverdlovsk, Irkutsk, Vladimir, Ivanovo, Orenburg and Tyument.

The number of HIV-infected children including orphans has increased. Since 1995, HIV-infected women gave birth to 4.422 children, with 2.126 children in 2002; 40% of these mothers have either not visited doctors to prevent the vertical transmission of the HIV infection, or came to doctors too late.

While the prevailing way of transmission is still the use of injected drugs, the portion of those infected heterosexually has considerably increased from 6% in 2001 to 15% in 2002. This means that the HIV has begun increasingly to spread beyond the traditional risk-groups to broad sections of the population.

The number of the HIV-infected people has also increased in the Russian Armed Forces. For the last years 5000 servicemen have been transferred to the reserve. There is an acute problem of giving them psychological and social assistance.

The participants had a lively discussion concerning the role of the Russian Orthodox Church in the HIV/AIDS prevention, the methods of work with people with HIV-AIDS and their relative and friends and work with drug-addicts. They shared their experience of work in these areas.

ROC Program for Preventing and Overcoming the Spreading of HIV/AIDS

The Russian Orthodox Church Program for Preventing and Overcoming the Spreading of HIV/AIDS was expounded for the participants by Ms. Margarita Nelyubova, DECR. It began in 2001 and has had two directions: basic prevention among children and youth and work with people with HIV/AIDS and their relatives and friends.

One of the components of the program is organization of training seminars for clergy and seminarians on the spiritual care of HIV-infected people and seminars to train church workers as hotline specialists in HIV/AIDS, counselors for people with HIV and their relatives and for manifold prevention work among children and youth. The program also provides for preparing and publishing educational aids for work in this area.

Under the program, a study course and a methodological aid have been developed for training nurses to take care and provide medical attendance for people with AIDS.

Among the important parts of the program is conducting prayer services for people living with HIV/AIDS diagnoses and their family. These prayer services are held monthly in several churches in various cities in Russia and the near abroad.

The program also provides for regular meetings of specialists from governmental and public organizations and church workers to work out mechanisms of cooperation and consolidation of efforts in preventing and overcoming HIV/AIDS.

Important for the program was the meeting that His Holiness Patriarch Alexy II had with the executive director of the UN Program for HIV/AIDS (UNAIDS), Mr. Peter Piot, on March 26, 2002. The positions of the UN and the Russian Orthodox Church concerning the ways of preventing and overcoming the spreading of the HIV/AIDS epidemic proved to be almost identical. Later, several working meetings took place between the ROC and UNAIDS leaders and workers.

On December 24, 2002, a reflection-action seminar on the Theological, Ethical and Pastoral Aspects of the Involvement of the Russian Orthodox Church in Overcoming the Spreading of HIV/AIDS took place in Moscow. The work of the seminar resulted, among other things, in setting up a working group for preparing a concept of the involvement of the Russian Orthodox Church in overcoming the spreading of HIV/AIDS and work with the HIV-infected people. The results of the seminar and the establishment of the working group were approved by the Holy Synod.

Care for HIV-infected orphans

The Round Table gave special attention to the problem of care for HIV-infected children, especially orphans. The director of the Regional Clinic for Infectious Diseases at Ust-Izhora, Mr. Ye. Voronin, spoke in detail about the work of his ward for HIV-infected pregnant women, which, using a special therapy, managed to raise the birth rate of healthy children from HIV-infected mothers to 99%. Unfortunately, the problem of stigmatization and discrimination of HIV-infected children and their parents by society remains acute. Having noted the positive experience of the work with HIV-positive mothers and children in Ust-Izhora and the experience of the clinic's cooperation with the Church, the participants stressed the need, still existing in other cities, to provide spiritual care for these children. It was noted that there is no need for specialized orphanages for children born from HIV-infected mothers; it is necessary rather to include them in the regular system of social care and to search for adoptive families for them.

Pastoral care for HIV-infected inmates of prisons and penitentiaries

Mr. I. Pchelin, who represented AIDS-Infoshare limited liability company, shared an experience of work at the women's penitentiary at the town of Mozhaisk. In this penitentiary, special seminars have been conducted for guards, attendants, medics, psychologists and inmates, including those with HIV, to help inmates with HIV develop a positive attitude to life, the understanding that life does not end at the moment when the positive diagnoses is received and that plans should be made for the after-release future. Significantly, the number of inmates turning to God is growing.

Ms. Tatyana Kotova, who represented the Christian Inter-Church Diaconal Council in St. Petersburg, shared an interesting experience of work in penitentiaries and pre-trial cells in St. Petersburg and the Leningrad Region, in which there are some 3.000 HIV-infected inmates. In these penitentiaries, just as in many other prisons, people with HIV are segregated to special units and special facilities, which makes it difficult for them to communicate with other inmates. The absence of any information about the progress, side effects and transmission of the virus tends to generate incredible rumors, causing the stigmatization of the HIV-infected inmates and fear among the prison personnel.

HIV-infected inmates are forbidden to work at the numerous workshops existing at the penitentiaries because they are believed to spread infection in case of injuries or cuts. For the same reason, they cannot attend prison schools. Teachers at specialized general education schools at penitentiaries refuse to give lessons to special units for fear of infection.

A pilot project called Names has been carried out by the Imena regional public charity in cooperation with the CIDC at Penitentiary No. 7 and Pre-Trial Cell No. 1 in St. Petersburg. The aim of the project is to help inmates change the quality of their life and the attitude to them on the part of other inmates and the prison personnel. Under the program, small creative workshops have been organized in the special units to produce souvenirs and other applied-art handicrafts with the use of traditional prison techniques. The products are sold and the gains are used to buy foodstuffs, medicines and other essentials for HIV-infected inmates. Specialists and volunteers involved by the program come to the prison on a regular basis to counsel and talk to the HIV-infected inmates themselves, as well as those around them, seeking to give them all possible information about HIV/AIDS.

Ms. Yelena Grigoryeva, who represented the Round Table for Inter-Church Aid in Belarus, offered her experience in providing comprehensive aid to HIV-infected women upon their release. At present this work is carried out in the Minsk and Gomel Regions, and it is planned to broaden it.

The work with these women begins in the penitentiary and continues after their release. In the penitentiary, special training sessions on the HIV problem are conducted for both inmates and the personnel. After release, former inmates are accompanied in their social rehabilitation, such as search for habitation and job. They are given legal advice, medical assistance and spiritual care; they are also helped in arranging their leisure time.

Participants in the rehabilitation program are involved in seminars and meetings for them to acquire new social connections. Recently, a rehabilitation center called Lestvitsa (Ladder) has been opened to provide employment for former convicts at a workshop for sewing ethnic dresses and to ensure at least partial self-financing of the center.

AIDS prevention work with children and youth

The prevention work among children and youth is seen as one of the most important areas of anti-AIDS effort both by governmental and church organizations.

Ms. I. Govorova of the Public Education Ministry made a report on the governmental programs for HIV prevention. Much attention is given at present to the establishment of experimental centers for work with youth. There are 14 such centers today. The method called "Equal to Equal" in which young volunteers work with their mates has proved very effective. However, what is still disturbing is the poor development of basic prevention, especially in remote provinces.

In order to deal with this problem, federal contests have been held to identify the best technologies of basic prevention work among teenagers. This year, this contest attracted 170 contenders for the support and financing from the federal public funds. Unfortunately, only one of them was an Orthodox organization.

Meanwhile, the Church can play a significant role in the prevention work with children and youth. In contrast to the "preventive" programs, in which syringes are exchanged, contraceptives are distributed and "safe sex" is advertised, the Church should actively propagate the moral way of life, using all possible means, such as preaching, classes in Sunday and general schools, interventions in the mass media, etc.

Among the examples of positive cooperation between ecclesiastical and secular organizations is the Save and Preserve program of the Orthodoxy and Education center in Moscow and the Moscow Rescue Service. Under this program, a comprehensive approach is used for prevention, as work is carried out with both teenagers, through gatherings, camps, training sessions, and joint activities, and their parents.

Another prevention program is now being developed by the CIDC. It provides for comprehensive prevention work among teachers, psychologists, schoolchildren and their parents. The program will be implemented in several schools in St. Petersburg.

An interesting product was presented to the Round Table by the Center for Preventing and Overcoming AIDS and Infectious Diseases and the State Electrotechnical University in St. Petersburg. It is a CD-ROM Anti-AIDS computer game encyclopedia in two versions - for preliminary schoolchildren and teenagers. The aim of the CD-ROM encyclopedia is to help educate young people for the healthy way of life and for safe behaviour in the situation of the AIDS epidemic. The encyclopedia can be used by teachers and medics in schools and in prevention and information work among young people.

Church rehabilitation centers

Hieromonk Diomid of the Ploschansky Hermitage of Our Lady of Kazan shared the experience of a church rehabilitation center. This monastery has run a rehabilitation program for drug-addicts for 6 years and another program for HIV-infected people for the last 3 years.

The very atmosphere of monastic life, the spirit of obedience, prayer and good works makes a beneficial impact on whoever comes to the cloister. It is in a monastery therefore that rehabilitation works most effectively. The rehabilitation of drug-addicts is not understood in the monastery as just helping one to return to life in society, but first of all as the restoration of God's image in a person.

The HIV-infected boys are not segregated, they live together with others. As those HIV-positive are determined to change, their rehabilitation goes faster. The psychological trauma inflicted by the lethal diagnosis makes the difference.

From 10 to 15 people with different dependence records and personal characteristics undergo rehabilitation in the monastery at the same time. Some 20 to 30 percent of them are HIV infected. The usual monastery rehabilitation term is one year. It is long enough for a person to change for the better. In total, some 100 people have undergone rehabilitation under the monastery's program.

Other monasteries have a positive experience of work with drug-addicts and HIV-infected people as well. There are also Orthodox rehabilitation communities acting under the spiritual care of priests. Normally, they are located in the country where the rehabilitation participants stay for a certain period of time, from 3 months to a year, and even longer.

Church rehabilitation centers have proved very effective: the remission rate in them is several times as high as in regular secular rehabilitation centers.

Church Anti-AIDS Network

The Church Anti-AIDS Network unites 4 Round Tables running anti-AIDS programs in Russia and the CIS:

• Russia Round Table/Moscow Patriarchate Department for External Church Relations
• Round Table for Inter-Church Aid in Belarus
• Christian Inter-Church Diaconal Council in St. Petersburg
• Coordinating Committee for Inter-Church Aid in Ukraine

Every Round Table negotiates its work with its own church authorities and implements its projects in its own region, i.e. Ukraine, Belarus, Russian North-West, for which the CIDC is responsible, and the rest of Russia, responsibility for which lies with the RRT. Cooperation within the Network is needed to coordinate the work in order to enhance its efficiency and to avoid duplication, as well as to develop jointly the areas of common concern, such as palliative care, programs for teenagers, work with HIV-infected convicts, projects for HIV-infected children, training seminars for seminarians, publishing materials on these problems, etc.

The Network participants meet once in three months to discuss various issues of church work for preventing and overcoming HIV/AIDS.

Possibilities for cooperation between the Russian Orthodox Church and secular organizations working in HIV/AIDS area

The Round Table participants discussed prospects for cooperation between the Church and governmental bodies, such as the Ministry of Healthcare, the Ministry of Education, etc., and public organizations working for preventing and overcoming HIV/AIDS.

All the participants emphasized the need and importance of continuing the work of the Russian Orthodox Church in preventing and overcoming HIV/AIDS and drug-addiction. This concern was shared by all the representatives of secular organizations.

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