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Vol. 3, No. 11 Winter 2007 2008 IN THIS ISSUE: Snapshot Knowledge Hub activities to date, in numbers Knowledge Hub Calendar Find out about training workshops and other upcoming events Knowledge Hub in Review Learn about recent activities HIV/AIDS Resources Links to useful information, evidence-based research, and more Snapshot These statistics reflect the Regional Knowledge Hub s activities from its inception in March 2004 through February 2008 Knowledge Hub courses held: 164 Healthcare professionals trained: 3999 o Ukraine: 1651 o Russia: 1900 o Azerbaijan: 29 o Estonia: 29 o Kazakhstan: 60 o Tajikistan: 24 o Uzbekistan: 68 o Moldova: 62 o Belarus: 121 o Kyrgyzstan: 55 Ukrainian physicians who have earned nationally recognized advanced professional certification in adult/adolescent or pediatric AIDS treatment through the Knowledge Hub: 146 Knowledge Hub Calendar The following trainings are scheduled to take place at the Knowledge Hub or affiliated centers March - May 2008 UKRAINE March 17 21, 2008 Advanced Antiretroviral Therapy (ART) in Children, Kyiv The participants, 10 multidisciplinary care teams, who had completed two series of ART trainings in November 2007 (Initiation of Pediatric Antiretroviral Therapy) and in January 2008 (Pediatric ART Onsite Mentoring) will take part in the Advanced Pediatric ART course. The trainings, organized with financial support from the International HIV/AIDS Alliance in Ukraine under the Global Fund Round 1 program, aimes to increase the participants level of knowledge and clinical skills on pediatric ART. After successful completion of the series of pediatric ART courses, 10 pediatricians will receive national certificates issued by the National Medical Academy of Post-graduate Education. Knowledge Hub Newswire Vol.3 No.11 (Winter 2007 2008) p.1

March 24 28, 2008 Advanced Antiretroviral Therapy (ART) in Adults, Kyiv This updated advanced training course on adult ART and opportunistic infections will be conducted for 38 participants. It is expected that improved knowledge on management of ART, its side effects, interactions with other therapies, treatment of major opportunistic infections will enable caregivers to provide professional assistance to HIV-infected patients who need ART. Training will be conducted within Round 1 Global Fund program in Ukraine. After successful completion of the series of pediatric ART courses, 10 physicians will receive national certificates issued by the National Medical Academy of Post-graduate Education. May 12 16, 2008 TB/HIV Co-infection Training, Kyiv Doctors from Oblast AIDS Centers and their colleagues from Oblast TB dispensaries are invited to participate in this course. The objective of the training is not only to provide trainees with essential information on Coordination of HIV-infection and TB control measures at the regional level; peculiarities of TB treatment in HIV positive patients etc., but also to strengthen cooperation between the two medical facilities. It is expected that this training will promote better revealing of HIV-associated tuberculosis and timely treatment of HIV positive patients with co-infection and help to decrease HIV-related stigma and discrimination at TB dispensaries. Training will be conducted within Round 1 Global Fund program in Ukraine. BELARUS April 14 18, 2008 PMTCT and ART Training Course, Minsk This course will provide participants with the knowledge on core elements of PMTCT based on WHO latest protocols and national standards as well as management of pregnant women on ART and newborns whose HIV status is not confirmed. Topics will include ART and PMTCT, specifics of neonatal care to children born to HIV-positive mothers or mothers with unknown status, PMTCT for women addicted to drugs, ART regimens for women and children, PMTCT program monitoring. The training course, funded by WHO will be facilitated by Ukrainian faculty. RUSSIA March 11 14, 2008 Working meeting on Palliative Care in HIV/AIDS, St. Petersburg The first meeting of proposed AIDS Training and Education Centers will take place in St. Petersburg. The purpose of the meeting is to discuss the Palliative Care in HIV/AIDS course curriculum and materials developed by AIHA with representatives of medical educational institutions hosts of ATECs, including Moscow State Medical Dentistry University, Irkutsk Medical University, Irkutsk Institute of Postgraduate Studies, Orenburg Medical Academy, St. Petersburg MAPO and Volgograd State Medical Academy. Two international experts - Dr. Marianne Matzo and Dr. Jeff Stoneberg - will participate in a four-day working meeting. The training is supported by Bratislava/ Strategic Health Partnerships Initiative (SHPI) program. March 17 21, 2008 (TBC) Initiation of ART for adults, St.Petersburg As part of AIHA s workplan to support scale up of ARV services in the city of St. Petersburg, AIHA will conduct a training for 20 infectious disease specialists in St. Petersburg city district policlinics, utilizing the course on Initiation of ART in adults originally developed by AIHA and piloted through the St. Petersburg ATEC. This five-day course will be held at the AIDS Center with faculty from the MAPS and AIDS Center. The training is held within Training, Care and Support (TCS) program. Knowledge Hub Newswire Vol.3 No.11 (Winter 2007 2008) p.2

March 24 27, 2008 PMTCT training workshop, Orenburg Oblast Advanced PMTCT trainings based on the adapted version of the Generic PMTCT Curriculum will be provided to 7-10 health care workers who are PMTCT providers from Orsk, Novotroitsk and Gai by Russian instructors trained as trainers in PMTCT curriculum, including representatives from the Orenburg State Medical Academy. The training will be organized within Training, Care and Support (TCS) program. March 24 27, 2008 Primary Care and Tolerance Building Workshop, Orenburg This training for primary care providers will be offered to general practitioners (GPs) from district polyclinics in Central Orenburg region. Topics will include epidemiological and clinical information on HIV, patient communication skills, identification of common OIs, attitudes toward PLWHA, stigma and discrimination issues, and infection control. Faculty from Orenburg Medical Academy, Oblast AIDS center and the Narcology dispensary will co-teach the course. The training will be held within Treatment, Care and Support (TCS) program. April, 2008 (TBD) Primary Care and Tolerance-Building Workshop in Togliatti Second three days training for Community GPs will be conducted by local experts on VCT, epidemiology and infection disease. The purpose of the training is to educate community physicians about epidemiological situation on HIV in Togliatti, prepare them to work with HIV-infected patients and follow up with patients on ARV treatment. Community physicians supported Togliatti AIDS Center and Municipal Policlinics efforts to provide treatment and care for PLWH. This activity is funded by Global Development Alliance/AIDS Healthcare Foundation (GDA/AHF). April 8, 10, 11, 2008 (TBC) Primary Care and Tolerance-Building Workshop, St. Petersburg This is the third 3-day training on HIV in St.Petersburg. It will be provided to 22 social workers of Nevskiy district. Topics will include epidemiological and clinical information on HIV, client communication skills, attitudes toward PLWHA, stigma and discrimination issues. The training will be held within Treatment, Care and Support (TCS) program. April 7 11, 2008 (TBC) Pediatric ART training, Ust Izhora Introductory Pediatric ART for HIV care teams from St. Peterburg, Orenburg, Togliatti and Saratov to be conducted at the Republican Infectious Disease Hospital (Ust Uzhora Clinical Center for Children and Women with HIV). The course will be taught by a multi-disciplinary team of Russian faculty utilizing an international standard curricula adapted for Russia. The lectures and clinical sessions within this course are based on WHO recommendations on ART for European Region and will focus on team approach in HIV/AIDS care and treatment for children. The training will be held within Treatment, Care and Support (TCS) program. May 19 23, 2008 (TBD) On-Site Mentoring and HIV/TB Co-infection clinical training, Togliatti Two international faculties will conduct mentoring sessions and HIV/TB clinical training for AIDS center staff and for infectionists/nurses from Togliatti Municipal policlinics. Experts will also participate in the clinical cases discussion during Pulmonology Committee meeting. The activity is supported by Global Development Alliance/AIDS Healthcare Foundation (GDA/AHF). Knowledge Hub Newswire Vol.3 No.11 (Winter 2007 2008) p.3

May 26 30, 2008 On-Site Mentoring, Saratov Two international faculties will conduct mentoring sessions for Saratov Oblast infectionists and Saratov Oblast AIDS center staff. The mentoring will be organized under Global Development Alliance/AIDS Healthcare Foundation (GDA/AHF) support. Knowledge Hub in Review TRAININGS: These events were hosted by the Knowledge Hub or affiliated centers from December 2007 to February 2008 UKRAINE December 17 20, 2007 Mentoring on Adult Antiretroviral Therapy (ART), Kyiv and Donetsk As a follow-up to the course Initiation of ART in Adults the trainees participated in the clinical training during on-site mentoring. Under supervision of the experienced faculty they examined patients and discussed management of ART at Kyiv and Donetsk AIDS Centers. The attention was focused at indications for ART, management of side effects, treatment failure and treatment of the opportunistic infections. The course was conducted within Round 1 Global Fund program in Ukraine. January 28 31, 2008 Mentoring on Pediatric ART, Kyiv and Kharkiv The second course on ART for HIV care givers (pediatricians, nurses and social workers), which was focusing on on-site mentoring was held at Okhmatdyt clinic in Kyiv and at Kharkiv Oblast AIDS Center. The participants examined children who needed ART and those who were already on ART. Apart from management of ART issues they discussed adherence, counseling of mothers, feeding, vaccinations, treatment of other opportunistic infections etc. The course was conducted within Round 1 Global Fund program in Ukraine. CENTRAL ASIA February 11 15, 2008, Tashkent, Uzbekistan Basic Regional ToT Course on ART Treatment This Training of trainers (TOT) course was especially developed for Central Asia region and targeted at multidisciplinary teams (MTDs) providing care and treatmen for HIV-patients. There were 24 trainees from four Central Asia countries which were equally represented: Uzbekistan, Kazakhstan, Kyrgyzstan, Tajikistan. The course was implemented within the Contract between the Regional Project Management Unit of the Central Asia AIDS Control Project (CAAP) and American International Health Alliance (AIHA) and conducted by leading American and Ukrainian faculty. KAZAKHSTAN January 21 25, 2008 Pediatric ART Training - Ust Izhora, Russia 21 Kazakh Pediatric ART care providers from Southern Kazakhstan participated in the Introduction to pediatric ART training in Ust-Izhora. The course included theory and practice of pediatric ART Knowledge Hub Newswire Vol.3 No.11 (Winter 2007 2008) p.4

management, initial diagnosis, dosages, ART side effects, monitoring of ART, treatment of most common diseases in children with HIV, growth and development, adherence issues. RUSSIA December 3 5, 2007 Primary Care and Tolerance-Building Workshop, Togliatti Total 19 participants (nurses and physicians) from Togliatti city polyclinics and clinical hospitals participated in this training. This activity was funded by Global Development Alliance/AIDS Healthcare Foundation (GDA/AHF). December 10 12, 2007 Primary Care and Tolerance-Building Workshop, St. Petersburg Second of the two 3-day workshops for district-based primary care providers was conducted for 20 social workers from Admiralteisky district social service centers of St. Petersburg. Topics included epidemiological and clinical information on HIV, client communication skills, attitudes toward PLWHA, stigma and discrimination issues. The workshop was organized in the framework of Training Care and Support (TCS) program. February 4 8, 2008 Primary Care and Tolerance Building Workshop, Orenburg This training for primary care providers was offered to 26 general practitioners from district polyclinics in Central Orenburg region. Topics included epidemiological and clinical information on HIV, patient communication skills, identification of common OIs, attitudes toward PLWHA, stigma and discrimination issues, and infection control. Faculty from Orenburg Medical Academy, Oblast AIDS center and the Narcology dispensary co-taught the course. The workshop was organized in the framework of Training Care and Support (TCS) program. February 12 16, 2008 PMTCT training workshop, Novotroitsk and Gai, Orenburg Oblast PMTCT training based on the adapted Generic PMTCT Curriculum was provided to health and social care workers who were PMTCT providers from Novotroitsk and Gai by Russian instructors trained as trainers in PMTCT curriculum, including representatives from the Orenburg State Medical Academy. The workshop was organized in the framework of Training Care and Support (TCS) program. MEETINGS: CENTRAL ASIA January 22 24, 2008, Tashkent, Uzbekistan Regional Curricula Review Meeting Total 38 people including the representatives of Ministry of Health of Uzbekistan, leaders of basic establishment Regional Training Center in Uzbekistan, leading specialist on PLWH Treatment, Care and Support and training issues from all beneficiary Central Asia countries (Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan), NGO representatives, representative from International organizations (WHO, GFATM, AFEW, UNICEF, UNIFEM, CAPACITY, CARHAP) together with Knowledge Hub experts and CAAP representatives took part in the meeting to review the technical content of training programs and modules for the CAR Regional Training Center on PLWH treatment, care and support. The development of CAR Regional Training Center on PLWH treatment, care and support is funded by Central Asia AIDS Control Project (CAAP). Knowledge Hub Newswire Vol.3 No.11 (Winter 2007 2008) p.5

UKRAINE February 18, 2008, Kyiv NIS Editorial Committee meeting The Review committee of the HIV thought leaders in Eurasia met in Kyiv in February to finalize the development of the Introduction to the Russian translation of the book Clinical Aspects of HIV Infection, 2007 by J Bartlett, G. Gallant. The purpose of the Introduction is to provide a context for use of the latest HIV/AIDS care and treatment information within the resource and services related environment in the Newly Independent States (NIS). The observations and comments of the NIS Editorial Committee members will help to ensure relevancy and the cultural competency of the book. The NIS Editorial Committee represents the leading specialists on HIV/AIDS care and treatment form Georgia, Kazakhstan, Russia and Ukraine. They participated in the development of introductions to the Russian versions of 2003 and 2005 editions of the book. This book focuses on care and treatment of HIV-infected and is recommended to physicians and other healthcare workers. The book with the reviews will be published first quarter of 2008. http://www.eurasiahealth.org/eng/health/resources/82168 For more information on this section please visit www.aidsknowledhehub.org > What the Knowledge Hub does > Trainings, or follow the link: www.aidsknowledgehub.org/en/trainings/. HIV/AIDS Resources Primary funding for EAKN is provided by the U.S. Agency for International Development (USAID) Useful links to HIV/AIDS-related information and evidence-based research The EurasiaHealth AIDS Knowledge Network (EAKN) is a special initiative to identify key resources related to the care and treatment of HIV/AIDS and adapt and translate them for use by health professionals in the former Soviet Union and Eastern Europe. The EAKN Library consists of a core set of textbooks and guidelines that have been developed by the world's leading experts on HIV/AIDS. As these materials are updated in English, EAKN updates the Russian-language versions maintained on its Web site. In addition to the core set of key documents, the EAKN Library includes a variety of HIV/AIDS information resources, including patient education materials, articles, and abstracts. Among the most recently added or updated documents are: The curricula in Russian Palliative Care for People with HIV/AIDS: A Curriculum and Teaching Resource for Medical Educators has been posted online. This curriculum is designed to provide the materials which medical educators need to deliver effective training sessions on a number of palliative care topics. http://www.eurasiahealth.org/aids/health/resources/82702/ Twelve article reviews, prepared by the Internet project MedMir.com, which is aimed to provide Russian speaking medical professionals with timely, comprehensive and relevant clinical information in the form of the Russian language summaries of clinical study reports published in the top world medical journals! Review: Maintaining Antiretroviral Therapy Reduces the Risk of AIDS-Defining Events in Patients with Uncontrolled Viral Replication and Profound Immunodeficiency http://www.eurasiahealth.org/eng/aids/health/resources/99607! Review: Risk of extensive virological failure to the three original antiretroviral drug classes over long-term follow-up from the start of therapy in patients with HIV infection: an observational Knowledge Hub Newswire Vol.3 No.11 (Winter 2007 2008) p.6

cohort study http://www.eurasiahealth.org/eng/aids/health/resources/99606! Review: Lopinavir-ritonavir monotherapy versus lopinavir-ritonavir and two nucleosides for maintenance therapy of HIV http://www.eurasiahealth.org/eng/aids/health/resources/99605! Review: Metabolic Effects of a Growth Hormone Releasing Factor in Patients with HIV http://www.eurasiahealth.org/eng/aids/health/resources/99604! Review: Association between Exposure to Nevirapine and Reduced Liver Fibrosis Progression in Patients with HIV and Hepatitis C Virus Coinfection http://www.eurasiahealth.org/eng/aids/health/resources/99603! Review: Primary Varicella and Herpes Zoster Among HIV-Infected Children From 1989 to 2006 http://www.eurasiahealth.org/eng/aids/health/resources/99602! Review: Low Rates of Antiretroviral Therapy among HIV Infected Patients with Chronic Kidney Disease http://www.eurasiahealth.org/eng/aids/health/resources/99577! Review: HIV seroprevalence in street youth, St Petersburg, Russia http://www.eurasiahealth.org/eng/aids/health/resources/99576! Review: Metabolic Syndrome, Cardiovascular Disease and Type 2 Diabetes Mellitus after Initiation of Antiretroviral Therapy in HIV Infection http://www.eurasiahealth.org/eng/aids/health/resources/99575! Review: Herpes Simplex Virus (HSV) Suppression with Valacyclovir Reduces Rectal and Blood Plasma HIV-1 Levels in HIV-1/HSV-2 Seropositive Men: A Randomized, Double-Blind, Placebo- Controlled Crossover Trial http://www.eurasiahealth.org/eng/aids/health/resources/99574! Review: Single-dose tenofovir and emtricitabine for reduction of viral resistance to nonnucleoside reverse transcriptase inhibitor drugs in women given intrapartum nevirapine for perinatal HIV prevention: an open-label randomised trial http://www.eurasiahealth.org/eng/aids/health/resources/99573! Review: Risk factors for in utero or intrapartum mother-to-child transmission of human immunodeficiency virus type 1 in Thailand http://www.eurasiahealth.org/eng/aids/health/resources/99572 The EAKN Library is continuing to translate various publications, reviews of the latest articles from the leading peer-reviewed magazines, and recent abstracts from medical conferences. AIHA plans to begin translation of the book HIV Medicine 2007, by B. S. Kamps in March 2008. This comprehensive book is recommended for practicing healthcare workers from various specialties and for instructors at medical institutions of higher learning and advanced training faculties, as well as for all those providing health care to people living with HIV/AIDS. Currently AIHA has online the 2005 version of this book. http://www.eurasiahealth.org/eng/health/resources/82169/ Knowledge Hub Newswire Vol.3 No.11 (Winter 2007 2008) p.7