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Anna Żakowicz IAC 2014, Melbourne

Driving a community-based response to the HIV epidemic and increasing the testing and treatment uptake Lessons learned from a country experience in Estonia. Anna Żakowicz IAC 2014, Melbourne. HIV in Estonia. Total population of Estonia – 1 . 3 2 million

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Anna Żakowicz IAC 2014, Melbourne

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  1. Driving a community-based response to the HIV epidemic and increasing the testing and treatment uptakeLessons learned from a country experience in Estonia Anna Żakowicz IAC 2014, Melbourne

  2. HIV in Estonia Total population of Estonia – 1.32 million Total HIV cases in Estonia – 8,702(UNAIDS country progress report 2014) Patients on ART in Estonia - 2,691(idem) Situation in Narva Narva is the third largest city in Estonia - 64,667 residents. Registered HIV cases in Narva – 2,056 (3,13 % of total Narva population) Registered HIV+ patients in Narva Hospital – 981 634 on ART (Tartu University, December 2013)

  3. Narva: With 3,13 % the highest HIV rate in the European Union 25% of all PLHIV in Estonia live in Narva; >50% of all PLHIV live in the county of Idu-Virumaa, of which Narva is the largest city High drug burden: highest rate of PWID of Estonia (national prevalence of PWID 15-49 yrs: 0,9% ) About 53,800 inhabitants belong to the Russian minority in Estonia (93%) Sharp decline in population, continuously rising unemployment One infectious diseases specialist in a part time position Stigma in healthcare settings: Stigma Index 2012 points out barriers to access testing and treatment

  4. Tartu University, 2014

  5. Estonian network of people living with HIV testing programme: Outreach testing Rapid INSTI tests In collaboration with National Institute for Health Development 2013: 10,722 people got tested nationally with seroprevalence of 3.25%, 78% linked to care 2014: 5 602 people got tested with seroprevalence of 4%, >80% linked to care National prevalence: 0.65% National prevalence among adult population: 1.2%

  6. Linda Clinic: a community based response to a gap in HIV-care in Narva Joint initiative of AHF and Estonian network of people living with HIV (EHPV) Medical license received in March 2013, opening in June 2013 Client centered approach Psychosocial support services, including counseling and treatment adherence for PWID and their families Linda Clinic testing programme June 2013 – YTD: 1,942 tests, 46 first time positives: linked to care in the Linda Clinic

  7. Linda Clinic: a community based response to a gap in HIV-care in Narva Before..(2011) After…(2013)

  8. Funding and governance Linda Clinic is operated by the Linda HIV Foundation, founded in 2012, consisting of EHPV and AHF representatives EHPV provides staff for psycho-social services (EHPV provides this service at national level) Clinic management: Linda Clinic director, AHF Europe testing and linkage manager, AHF Europe medical director, AHF EU Project Coordinator Patients’ advisory group

  9. Patient statistics: Current client uptake: 113 patients 56 on ART 58% PWID 41% accessing services through EHPV testing programme 59% through 2 clinics in the region

  10. No ARVs for Linda Clinic Estonian Ministry of Social Affairs is blocking access to ARVs for the Linda Clinic, despite previous agreements Our patients receive their drugs through Narva hospital We are fighting the decision of the MoSA since October 2013 in several ways:

  11. Petition site: more than 3,000 sign-ons since October 2013 WWW.CHANGEAIDSEU.ORG

  12. Silent protests in front of MoSA: October 2013 and February 2014

  13. Court case: In November 2013 the Linda HIV Foundation filed an appeal against the decision not to provide ARVs to the Clinic. The case was won; MoSA has to review its decision. Right now, MoSA appealed to the decision.

  14. Press conference in Tallinn, October 2013

  15. Treatment is Life campaign: animation video May 2013

  16. International support: UNAIDS deputy director Luiz Loures: - Linda Clinic as a best practice in community based testing and treatment in the context of Treatment 2015 - letter to Estonian MoSA to express his wish that the Ministry reconsiders its decision WHO mission to Estonia 12-16 May 2014: - mission report will be presented to MoSA and made public in September 2014

  17. Support us By signing the petition at changeaidseu.org Thank you! Anna Żakowicz – Europe Advocacy and Partnerships Director Nina Schat – EU Advocacy and Marketing Manager

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