Accessibility of ART in St. Petersburg and Orenburg City, Russia
This study investigated the barriers preventing people with HIV/AIDS from accessing specialized medical care, specifically ART, and developed recommendations to increase ART availability and treatment adherence in HIV-positive, hard-to-reach patient groups in St. Petersburg and Orenburg. Structured interviews were held with 551 PLWHA—including injection drug users, commercial sex workers, and PLWHA in self-registered groups—as well as with focus groups and subject experts. Drug abuse, alcohol abuse, and individual experience (e.g., experiencing pain) were the most influential factors associated with accepting/not accepting ART. The study’s recommendations are targeted toward four audiences—the general population, the medical and social care system for PLWHA, the closest social contacts of PLWHA, and individual PLWHA— and vary by city, largely due to variances in trust in different media between the two cities.