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SAMARA, Russia, Aug. 22, 2003 - PSI/Russia uses peer educators and young volunteers to reach youth at risk for sexually-transmitted infections and HIV, united by the common goal of trying to slow down the fastest-growing rate of HIV infection in the world. On Tuesday afternoons PSI/Samara volunteers pour into the office laughing and talking together as they do each week, come rain, shine or, more likely, snow. They are predominantly 14- to 24-year-old students and their reasons for volunteering are as varied as their faces, but they all share the same desire to educate other youth on how to protect themselves against HIV and other STIs. Surveys conducted by PSI in many Russian cities and regions all yield the same alarming results — while 99% of youth have heard about HIV, and 80% consider HIV a problem for Russia, very few consider themselves at risk, believing HIV is a disease only for gay men and injecting drug users (IDUs). While this has been historically true in Russia, the past couple of years have shown a significant increase in sexual transmission, particularly among youth aged 15 to 25. The PSI/Samara program, funded by the U.S. Agency for International Development, has 25 active volunteers, eight of which have qualified as peer educators. Peer Education Coordinator Dr. Mikhail Volik gives new recruits individual attention and helps identify their motivations for joining, their expectations of PSI and their personal needs and resources. An experienced volunteer is then matched to the new recruit to provide guidance and support. Dr. Volik also invites volunteers' parents to the office to reassure them that their kids are in safe hands and are not promoting sex, but educating others in HIV prevention. "It is a good feeling to know that you personally, with your knowledge and engagement, can do something against the spread of HIV among your friends, in your school and in your town," says Jenny, a 22-year-old peer educator. Every Tuesday afternoon training is provided to the volunteers on many different themes relating to technical knowledge of HIV, methods of protection from HIV and other STIs (including abstinence, delayed sexual onset, partner reduction and condom use), HIV myths, stigma associated with HIV and psychological and communication skills (such as initiating conversations with youth at events and developing good listening skills). Each training session combines general and specific knowledge, communication skills and tools and games available for providing training to other youth. "I have become more communicative and self-confident since becoming a volunteer," says peer educator Anton, 17. Dasha, a medical student, says, "I can use my knowledge at university. Some of my teachers do not know so much about HIV/AIDS. They realized that they can ask me for more information." Not all the volunteers elect to become peer educators. To become a peer educator volunteers participate in 20-30 training sessions and, when they feel ready, take a computer-based test and verbal examination. UNAIDS has emphasized school-based HIV/AIDS education as an essential component of prevention interventions in low- and middle-income countries, and studies conducted in various countries have shown that peer education is one of the most effective ways to spread information about health. But in Russia there is a lack of sex education in schools. Often peer education is the first time youth have the opportunity to learn about sexual health and to ask questions of someone who understands the situation technically and emotionally. Getting access to schools can be challenging. In Samara it was difficult to conduct the first training sessions due to the anxiety of school board members that open talks about safer sex could be perceived as promoting promiscuity. To win public support, PSI began educating teachers, parents and local authorities, reassuring them that the ultimate goal is to protect their children from disease. PSI/Samara now receives numerous invitations from local authorities and educational institutions to provide peer education at schools, youth camps and universities. The PSI peer education strategy is to move away from one-off activities and move toward repeated sessions, which use structured, robust participatory approaches, to ensure young people internalize and personalize HIV/AIDS issues. In Samara, Dr. Volik does all he can to implement ongoing, long-term activities in schools, but resources and access can make it challenging. In the 12 months since the PSI peer education program was initiated, there has been a significant increase in the percentage of ongoing and repeat sessions, and as a result an increase in the effectiveness of such training. Dr. Volik's latest initiative to train volunteers from other youth programs to mount their own in-house peer education is also proving successful. "We can't cure AIDS, but we can easily prevent it. Let's do it together!" is the PSI/Samara motto. — Jenny Bluhm, Nicola Morgan, Dr. Mikhail Volik, PSI/Russia
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