Olga I. Borodkina ,St. Petersburg (Russia)
According to official data on 30.06.2009 494 074 HIV-infected people have been registered in Russia, including 4165 children. In St.Petersburg 40822 people with HIV, including 168 children, have been registered on the same date. St. Petersburg belongs to a group of Russian regions with a very high level of prevalence of HIV-infections that means that there are more than 300 HIV-infected persons among a population of 100 thousand. In the last years in Russia as well as in many other countries the epidemic of HIV was stabilized, but the growth of a cumulative number of registered HIV-infected persons continued which is connected first of all with the increasing life expectancy of people living with HIV as a result of modern antiretroviral therapy. In this situation the question of quality of life of people living with HIV becomes more and more important and the problem of developing an effective system of social help for this target group becomes one of the priorities of social policy.
It is necessary to recognize that now both academic community and practical workers in the field of social work pay attention to the problems of social work from HIV-infected clients; however in this area there is still a set of unresolved problems and questions, including the development of a public system of social services for families involved in the HIV epidemic. The marked problems were in the focus of the scientific-practical conference «Development of system of social services in the field of HIV prevention» which took place in St.-Petersburg on the 12th of November.
The conference also was the final action of the project “S krasnoi stroki” (“Since new line”) on the creation and development of the system of social and psychological support of the families with HIV problems. The project has been realized by the non-profit organization «Social services of Bethany», the governmental organization “Center of social support for families and children in the Krasnogvardejsky district of St. Petersburg” with the participation of the committee of social policy of St. Petersburg with support from USAID and IREX (USA).
At the conference the different issues connected with HIV prevention and social work in this sphere were discussed. Olga Borodkinа (St. Petersburg State University) explained in her presentation that social work with people living with HIV has to be a part of social prevention, which should be realized on individual, community and social policy levels. Individual-focused preventive strategies are directed on correction, regulation of the attitudes, life purposes and actions of the client in a direction of social norms and standards dominating in the society. Socio-political prevention is directed on the formation of structures which could help to involve the individuals in constructive, independent interaction with and within their social environment. The research data demonstrate strong paternalistic expectations among HIV-infected people. People with HIV need help to get an allowance, to get a place for a child in kindergartens, to organize the summer holiday for the children and etc. They also demonstrate the requirements for specialized services, i.e. connected with HIV status: psychological support, legal consultations, help to find and get job. Besides, people living with HIV are not informed enough about social programs addressed to people with HIV. But the new models of social work with people with HIV should not only correspond to these expectations, but also take in account the key tendencies of the development in contemporary social work that connect the strengthening of individual responsibility including the responsibility of individuals for decision-making concerning risks.
The presentation by Julia Ivashkina, head of the department of the Regional Center “Family”, who presented results of the project “S krasnoi stroki” (“Since new line”), which she supervised, showed that in this project 26 families have got social support. A technique of efficiency evaluation of social support for families with problems connected with HIV was developed and approved. As a result of the project a book with a collection of scientific and practical materials under the title «Practice of social work with the families impacted by a HIV-infection» was prepared and published. The book was also presented in details by J. Ivashkina at the conference.
The important part of the conference were the round tables. The first round table dealt with the organizational and legal aspects of activities of social services, organizations on social support to the families having HIV-connected problems. The following aspects were considered: standards of social services provided to the population of St.-Petersburg, problems of confidentiality of information about clients with HIV-infection, measures of social support for HIV-positive junior clients. According to experts the following forms of social work are necessary to develop: groups of support and mutual aid, motivational work, formation of treatment compliance and case management.
During the discussion on the second round table the problems of interdepartmental, interdisciplinary, intersectoral interaction in the sphere of social work with the families impacted by a HIV-infection were considered. The participants emphasized the complexity in interaction between public health and social work services particularly concerning HIV-positive pregnant women and women with children. To the city administration the committee of public health offered to develop standards and rules for the regulation of this sphere and to provide the special training of employees of public health organizations concerning social services, organizations working with HIV positive clients.
The main conclusion of the discussion on the third round table «Problems of professional competence of social workers in the field of HIV prevention» was connected with the necessity to develop a new interdisciplinary program on social work with HIV infected people involving academic staff and managers of social agencies on the base of best Russian, American and European practice.
The dissemination of the results of the project “S krasnoi stroki” as well as the adapted models of case work with HIV-infected clients should lead to the new directions of practical social work and social prevention of HIV/AIDS.
Olga Borodkina is Associate Professor at the Faculty of Sociology of the St. Petersburg State University.