Drug Policy and HIV Prevention in Russia

Anton Somlai, Ed.D., Associate Professor of Psychiatry and Behavioral Medicine, Associate Director of the Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin

Urban Weber, Ph.D., Director, Russia Program, The Global Fund to Fight AIDS, TB, Malaria

Olga Borodkina is the Associate Professor of Faculty of Sociology of St. Petersburg State University. She has authored more than 40 scientific publications in the sphere of Social Management, Theory and Praxis of Social work, Social context of AIDS prevention etc. She has international experience working at the universities of Germany, France and Finland. She received training at Yale University, School of Epidemiology and Public Health from Oct.1989- May 1999 in the Fogarty program and from the Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin from Jun. - Oct.1999.
After her training in USA she has been working as a researcher in St. Petersburg State University in the Biomedical Center (St. Petersburg). She is currently the Russian Coordinator for the project "HIV Risk And Home Made Liquid Drugs".

Robert S. Broadhead is a Professor at the University of Connecticut affiliated with the Center for HIV/Health Intervention and Prevention (CHIP), the Department of Community Medicine and Health Care, and the Department of Sociology. He has been studying innovative methods to access and work with injection drug users in the community to prevent the spread of disease since 1988. He was the Principal Investigator of a five-year field experiment in eastern Connecticut, from 1993 to 1998, funded by the National Institute on Drug Abuse (NIDA), that led to the development of the "peer-driven intervention" (PDI) outreach model, an alternative to the NIDA Standard model. The PDI model relies on active drug users, rather than salaried outreach workers, to invest themselves in working to prevent HIV in their own communities by offering them nominal rewards for educating their peers and recruiting them for intervention services. In 1996, through support from the Open Society Institute's International Harm Reduction Development Program, he implemented and examined the feasibility of a PDI in Yaroslavl, Russia. This project led to a four-year field study funded by NIDA, from 2002 to 2006, in two different sites in Russia comparing a Standard- to a Simplified-PDI. This project is currently scaling up to include a third site that will offer drug users graduated vouchers that can be exchanged for groceries rather than graduated cash
rewards. He has also implemented and is comparing the efficacy of PDI projects implemented in northern Vietnam (Ha Giang province) and southern China (Guangxi province). Prof. Broadhead is a recent recipient of an Independent Scientist (K02) Award from NIDA, entitled "Global Expansion of Peer-Driven Interventions," which will enable him over the next five years to devote full-time study of the PDI model, as it being adapted and implemented especially in Asia and Russia where the HIV pandemic is being driven primarily by injection drug use.

Scott Burris is the James E. Beasley Professor of Law at the Beasley School of Law of Temple University, and Associate Director of the Center for Law and the Public's Health at the Johns Hopkins School of Hygiene and Public Health. He was the editor of the first systematic legal analysis of HIV in the United States, AIDS and the Law: A Guide for the Public (Yale University Press, 1987). His current research focuses on how law influences public health and health behavior, particularly the impact of laws and law enforcement practices on the health risks of drug users. His work has been supported by major health organizations, including the Robert Wood Johnson Foundation, the National Institutes of Health and the Centers for Disease Control and Prevention. With funding from the National Institute of Drug Abuse, he is currently testing a "Rapid Policy Assessment and Response" intervention in three sites in Eastern Europe. He has served as a consultant on public health law with organizations ranging from the United Nations Development Programme and the American Psychological Association to the Institute of Medicine and the producers of the Oscar-winning film "Philadelphia." As an attorney and Board member of the American Civil Liberties Union of Pennsylvania, he has represented people with HIV facing discrimination from employers, service providers and the government. Burris is a graduate of Washington University in St. Louis and the Yale Law School.

Joanne Csete is the Director of the HIV/AIDS and Human Rights Program at Human Rights Watch. In this capacity, she has overseen the development of a body of research and an agenda of advocacy actions related to a range of human rights issues linked to HIV/AIDS, including several investigations in the former Soviet Union. She was previously chief of policy and programs in the regional office of UNICEF in Nairobi, working especially on HIV/AIDS, and before that senior advisor in the Programme Division of UNICEF's New York headquarters. She worked in Africa for about 10 years on public health and nutrition programs, mostly in Rwanda, Burundi, D.R. Congo and Kenya. She was on the faculties of Nutritional Sciences and International Development Studies at the University of Wisconsin - Madison from 1988 to 1993.

Vitaly Djuma is the chairman of the Russian Harm Reduction Network. Vitaly started working in the harm reduction field while it was widely introduced in Russia back in 1998, when he was the assistant and then manager of the training program of Medicins Sans Frontieres. This program has trained 200 health professionals in harm reduction approaches. In 2000, Vitaly joined the Open Society Institute (Soros Foundation) in Moscow as a program coordinator for the harm reduction initiative that supported 50 projects in Russia. In December 2003, Vitaly headed a newly established independent Russian Harm Reduction Network that unites 17 full member organizations and many other partners through out Russia. Vitaly also serves as policy adviser in Russia for the International Harm Reduction Development program (IHRD) of OSI-NY.

Jean-Paul C. Grund is a public health and drug policy researcher at the Center for Addiction Research (CVO), Utrecht, the Netherlands, and at DV8 Research, Training & Development, Rotterdam, the Netherlands. His specialties include qualitative and quantitative field studies of drug use, and its social, health and policy concomitants. His research interests include the international diffusion of drug use patterns and administration routes, and their public health aspects, as well as the spectrum from recreational to compulsive drug use patterns and their associations with social-economic, cultural, drug market and drug policy factors. At present, Dr. Grund is conducting a study of initiation into injecting drug use among vulnerable youth in Ukraine, together with the Ukrainian Institute for Social Research. He conducted studies of drug use and HIV risks in the Netherlands, the USA, Central and Eastern Europe, and evaluation studies of needle exchange in Russia and Eastern Europe. Dr. Grund was the founding Director of the International Harm Reduction Development program of the Open Society Institute, which fostered the development of practical harm reduction programs in Central Eastern Europe and Russia. He also was a Research Fellow in Residence at The Lindesmith Center, a New York based drug policy think tank. Dr. Grund holds an advanced degree in Clinical and Developmental Psychology from Utrecht University and received a Ph.D. in Social Science from the Medical and Health Sciences Faculty at Erasmus University in Rotterdam, The Netherlands. He is the author of numerous articles and two books on drug use culture, HIV, and their social-political determinants. His most recent book concerns drug use and HIV risks among the Roma population of Central and Eastern Europe.

Robert Heimer is Associate Professor of Epidemiology and Public Health and of Pharmacology at the Yale School of Medicine. He has been working on HIV prevention for drug users since 1990 when he began studies of the effectiveness of the New Haven syringe exchange program. In 1998, the scope of his work expanded from the U. S. to Russia at just the same moment that the epidemic of HIV, overwhelmingly associated with injection drug use, struck Russia and other countries of the former Soviet Union. This work, begun as an NIH/Fogarty-funded training program in HIV prevention science in St. Petersburg, has expanded to a large portfolio of research projects in St. Petersburg and beyond. Dr. Heimer is interested in the intersection of Russian drug preparation and injection practices with the implementation of harm reduction strategies. His recent efforts include participation in the first HIV incidence study of Russian drug users, in the evaluation of syringe exchange programs in Kazan and St. Petersburg, and in the virological assessment of the potential for HIV transmission through home-made preparations of heroin and methamphetamine.

Kevin Irwin is a Public Health Sociologist, a Research Associate at the Yale School of Public Health and the Center for Interdisciplinary Research on AIDS (CIRA). His work focuses on disease prevention and health improvement for drug users and sex workers in the US, Russia and India. This work spans both clinical and field settings; from investigating the impact of AIDS-related stigma and discrimination in hospitals, to assessing provider and consumer satisfaction with office-based buprenorphine treatment, to evaluation of syringe exchange programs, and to ethnographic research with injection drug users. In Russia this work has been centered on understanding the relationships between homemade drug manufacturing and risk for HIV in several cities, as well as the evaluation of secondary syringe exchange in Kazan. As an outgrowth of this work he is also actively involved in developing capacities and resources for the ethical conduct of research with drug users.

Kaveh Khoshnood is an infectious disease epidemiologist and his primary research interests are the epidemiology, prevention and control of HIV and Tuberculosis among drug users, prisoners and other at risk populations in the United States and in resource-poor countries. Professor Khoshnood mentors researchers from China, India, Russia, and South Africa in HIV/AIDS and Tuberculosis related research. Professor Khoshnood's other interests are the examination of the links between health and human rights and the ethical dilemmas in research involving vulnerable populations.

Zita Lazzarini teaches health law and bioethics at the University of Connecticut Health Center and the Harvard School of Public Health and directs the Division of Medical Humanities at University of Connecticut Health Center. The mission of the Division of in Medical Humanities is to advance knowledge about the medical humanities, health law, and ethics through teaching research and service in the community. She is currently developing projects and methods to evaluate the impact of laws and policies on health and behavior using a social epidemiology framework. Ms. Lazzarini has co-authored Human Rights and Public Health in the AIDS Pandemic, published by Oxford University Press in 1997. Her work has appeared in Journal of the American Medical Association (JAMA), the American Journal of Public Health (AJPH), the Columbia Law Review, Emory Law Review, the Journal of Law, Medicine, and Ethics, the Journal of Public Health Management and Practice, AIDS Law and Policy, Health and Human Rights, and other medical and legal journals. She is a member of Institutional Review Board (Human Subjects Research Committee) at the University of Connecticut Health Center (UCHC), Chair of the clinical ethics committee at UCHC, and a member of the clinical ethics committees at Hartford Hospital. She serves as a Special Consultant for the Center for Law and the Public's Health, at Johns Hopkins University, the Georgetown-Johns Hopkins Program on Law and Public Health and for the Centers for Disease Control and Prevention. She has worked with the World Health Organization on projects involving HIV-related legislation, employment policies, and human rights. Ms. Lazzarini's areas of recent research include public health law, privacy and confidentiality, human subjects regulations, HIV prevention among pregnant women, and injection drug users, and health and human rights. She does local and statewide work on bioethics and HIV prevention.

Anna Moshkova is a Program Officer with the International Harm Reduction Development program (IHRD) of the Open Society Institute, where she has worked since 1998. Her responsibilities include overseeing IHRD's programs in Russia, Ukraine, Georgia, and Belarus, managing drug substitution therapy services and advocacy, and IHRD programs aimed at HIV prevention among street youth. Born in Ukraine and raised in Russia, Anna holds a master's degree in Art History, and is currently pursuing a dual MA in international affairs and nonprofit management.

Robert Power is Reader in Social & Health Sciences Research at the Royal Free & University College Medical School, University College London. He previously worked at Birkbeck College and Imperial College, University of London. He is currently involved in research and development programs in Russia and China to prevent HIV transmission among injecting drug users. He has conducted rapid assessment and monitoring of injecting drug use in South East Asia (Vietnam), Eastern Europe (Czech Republic, Croatia, Russia) and Northern Africa (Egypt). He has carried out many consultancies for the United Nations and World Health Organisation, advising on HIV risk reduction in several countries. In addition, he is currently carrying out research on the patterns of sexual behavior among adolescents in rural Zimbabwe and, in Britain, is developing peer education interventions targeting socially excluded groups, such as the homeless. Other research interests include service delivery and screening for tuberculosis, ethnography, and the psycho-social implications of anti-retroviral treatments for HIV positive patients. For several years he was the British representative on the United States' National Institute of Health Community Epidemiology Work Group, where he reported on drug and health trends.

From 1998 Anya Sarang worked for Medecins Sans Frontieres - Holland in Moscow, developing and supporting emerging harm reduction projects in Russia through the training program and networking. From 2001 to 2003 Anya worked for AIDS Foundation East-West (AFEW), which continued the HIV prevention program of MSF and from 2003 worked independently. In 2000, she was elected as a representative of the Russian sub-region to the Steering Committee of the Central and Eastern European Network and in 2003 elected as the Network Coordinator for the term 2003-2006. She is an Honorary Research Associate of the Centre for Research on Drugs and Health Behaviour based at Imperial College, London and is currently involved in IC-based research programme "Knowledge for action in HIV/AIDS in the Russian Federation. She is also a founding member of the Russian Harm Reduction Network.

Anna (Ani) Shakarishvili began her career at CDC in 1994 as an Epidemic Intelligence Service (EIS) officer with the Division of STD and HIV Prevention in the National Center for HIV, STD and TB Prevention working on the issues related to STDs, HIV and reproductive health in the United States and internationally. Following the EIS program, she joined the Division of Adolescent and School Health in the CDC's National Center for Chronic Disease Prevention and Health Promotion where she got engaged in school health, and health education and promotion related projects within the Binational US-Russia Health Committee's work in Russia. In 1997 Dr. Shakarishvili she initiated and since then has been overseeing STD/HIV activities, including operations and behavioral research, surveillance and prevention, in the Russian Federation out of CDC within the framework of the US-Russia Intergovernmental Health Committee. She serves as a focal point for Russia, Central Asia and other countries of the former Soviet Union within the Global AIDS Program at CDC, and is deeply involved in STD/HIV programs, research, and policies related to most at risk populations and other groups in that part of the World.
Dr. Shakarishvili has served as a consultant to international agencies including the World Health Organization, Open Health Institute, and UNAIDS. She is a Board member of the AIDS Foundation East-West (AFEW), and serves on numerous expert panels dedicated to the prevention and control of HIV/STDs in Eastern Europe and Central Asia.
Dr. Shakarishvili authored a book ("Contraceptive Technology - Russian Edition", Atlanta, GA, USA 1994) and articles on STDs and HIV infection related issues in Russia. She has received awards from the US Secretary of Health and Human Services and CDC for her contributions in the US-Russia Binational Health Committee's work in Russia and international projects.

Anton M. Somlai is Associate Professor of Psychiatry and Behavioral Medicine, Associate Director of the Center for AIDS Intervention Research (CAIR), and Director of CAIR's Intervention and Dissemination Core. Before joining CAIR's faculty in 1993, Somlai was Director of Prevention Services at a large midwestern AIDS service organization where he led the development and implementation of Milwaukee's first comprehensive needle exchange program. Somlai's domestic research has focused on HIV prevention interventions with hard-to-reach at-risk populations. Somlai has investigated strategies to transfer research-based HIV prevention interventions to front-line AIDS prevention community organizations. Somlai has traveled to Russia over 20 times and plays a leadership role in the NIMH Collaborative HIV/STD Prevention Trial, a 5-country Cooperative Agreement study that is evaluating the effectiveness of community-level primary prevention interventions.

Urban Weber joined the Global Fund to Fight AIDS, Tuberculosis and Malaria in early 2003. Serving as team leader for Eastern Europe and Central Asia, he is responsible for grant negotiations and the oversight of grant implementation in this region. He lived in Russia for three years, working with UNAIDS and Medecins sans Frontieres in the area of HIV prevention among drug users.