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Donald Postnov
Russian Federation

“A road of a thousand miles starts with a single step.”—Confucius

Donald Postnov (named after the American astronaut Donald “Deke” Slayton) is an obstetrician/gynecologist in Moscow, specializing in the prevention of mother-to-child HIV transmission (PMTCT), and the project coordinator for the Care and Support Program of AIDS Foundation East-West (AFEW). Moscow, capital of the Russian Federation (RF), is known as the “Third Rome.” Founded in 1147, Moscow lays on seven hills at the junction of the Moscow and Yauza Rivers. Today, Moscow is a rapidly changing city, becoming more Westernized as the former Soviet Republic continues to integrate itself with the world economy. Nevertheless, this ancient city still retains a certain unique Russian-ness.

What is the AIDS situation in your country?

With a population of 144 million, and an area 1.8 times that of the U.S., the RF is going through a period of immense transition since the collapse of the Soviet Union a decade ago. Presently, the RF is experiencing an uncontrolled HIV/AIDS epidemic. The number of registered HIV cases has increased from 1,071 at the end of 1995, to 258,127 as of December 2003. Many experts believe that there probably are more than one million people in the RF who are infected with HIV. The latest bulletin of the Russian Federal AIDS Centre predicts the number of people living with HIV/AIDS will rise to five million by the end of 2005.

How did you initially get involved with HIV/AIDS, and what motivated you to become an activist?

After I graduated from the Military Medical Academy and the Medical Post-Graduate Academy in St. Petersburg, I was invited to join the team of AIDS Foundation East-West (AFEW). I spent a year working in the HIV Prevention and Health Promotion in Prisons Program as a medical consultant. After this, since I was a gynecologist and AFEW was launching a new PMTCT program, I became its coordinator. I am an AIDS activist because as a doctor it is my mission to save lives; as a human being, I want to give hope to those who suffer. And as a future father, I want all HIV-positive women to be able to have healthy babies.

Most HIV infections in Russia have occurred among IV drug users, but HIV is now also affecting a greater segment of the general population through heterosexual transmission. Free HIV testing is available in medical establishments, as well as at “trust points,” where drug users and HIVers can receive support anonymously and without governmental tracking. Says Donald,“However, some of the pre- and post-test counseling is of variable quality, which is something our organization is working to improve.” The most pressing need right now in Russia is treatment. Even though treatment is free, there are many constraints for people living with HIV/AIDS. The most serious barrier is the lack of financing for treatment programs in the outlying regions. In addition, there are few self-help groups for HIV-positive patients. Donald stresses that the negative attitudes prevalent in the medical community and in the government must change toward HIV-positive drug users and sex workers.

What is the healthcare situation in your city?

Quite favorable in comparison with other regions of Russia. Healthcare is provided free-of-charge by the government to officially registered residents of the city.

Is there sufficient governmental support for AIDS programs?

The relationship between the government and NGOs working in the HIV/AIDS area in Russia is still in its early phase. There is, nevertheless, much potential for fruitful cooperation in the future.

Prevention campaigns, such as the AFEW PMTCT program, include the development and distribution of information materials, the development of relevant medical training for healthcare professionals, the implementation of peer counseling programs for women living with HIV/AIDS, and the development of clinical treatment protocols. The organization also aims to increase pregnant HIV-positive women’s responsibility for the future of their own children. AIDS prevention is usually taught in high schools, and sometimes additional “healthy lifestyle” classes are supplemented. A major problem is that a Russian federal law bars HIV-positive children from studying in the same schools as non-positive students.

What can we, as individuals, do to help during the AIDS crisis?

First, we should not attach blame to people living with HIV/AIDS because blame leads to stigma and discrimination. Second, we can each lead a healthy lifestyle, avoiding behavior that puts us at risk.

April 2004