“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
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.