Since 1990, Russia has experienced a dramatic increase in the number of abandoned children, associated with harsh socio-economic conditions, increases in drug and alcohol addiction and HIV infection. Approximately 20% of infants born to HIV-positive mothers are abandoned in Russia. To find out why, we conducted 266 qualitative interviews in 2004-05 in four Russian cities, including HIV-positive women who had abandoned their infants and others who had not, relatives of the women (mostly their mothers), HIV-negative women who had abandoned, and medical experts. Unintended pregnancy was cited as the most important factor influencing the decision to abandon. Other important determinants included lack of partner and family support, drug abuse, fear of birth defects or disabilities, negative attitudes of medical professionals, and marginalized socio-economic status. HIV infection was closely linked to many of these reasons. Important avenues for interventions among HIV-positive women emerged, including improved contraceptive information and provision, education of medical personnel and women on HIV prevention and treatment, enhancement of social support, and strengthening of fostering and adoption programmes for HIV-affected families.

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As part of an ongoing collaboration on the development of policies and strategies for the prevention of noncommunicable diseases (NCDs) between the Russian Center for Preventive Medicine (RCPM) and the Centers for Disease Control and Prevention (CDC), a needs assessment was conducted. One of the most important problems identified was the lack of local and national data on prevalence of behavioral risk factors. The surveillance system in place collected information only on facility-based treatment and health status, and only random and small-scale surveys of selected risk factors could be found (Tozhiev et al. 2000;Volkov et al. 1999). To begin to address this problem we developed and pilot tested a telephone-based behavioral risk factor survey (BRFSS) in Moscow. The Russian BRFSS was modeled after the US system which is coordinated by the CDC (BRFSS 2000). We also took advantage of experience in surveillance that existed in Russia through participation in the WHO Country-Wide Integrated Non-communicable Diseases Intervention program-CINDI (WHO 1996) and the Mega Country initiative (WHO 2003). The long-term goal is to establish a sustainable system for monitoring behavioral risk factors and use this data for decision making. Questionnaires used in surveys in Russia and other countries including the BRFSS (BRFSS 2000), CINDI (WHO 1996), and the International Physical Activity Questionnaire-IPAQ (IPAQ 2003) were reviewed and potential items identified. The final version of the questionnaire included 151 questions in the following modules: demographics, health status, health care quality, fruit and vegetable consumption, smoking habit, levels of physical activity, self-reported levels of blood pressure and blood cholesterol, alcohol consumption, diabetes and cardio-vascular diseases (CVDs) and women's health, and required approximately 10 -12 minutes per interview. A pre-test of 100 adults indicated that the questions were well understood and this group did not have difficulty in responding to them. A telephonebased survey was chosen because most households in Moscow have at least one telephone. From the 3 200 820 phone numbers on our list a pool of 3 031 numbers was randomly selected, 19.5 % of these were found to be ineligible, resulting in a total pool of 2 440. Interviews were conducted by the RCPM staff and by volunteers who were given two 3-hour training sessions. Interviews were conducted with the person in each household who answered the phone, and only adults aged 25 -64 years were eligible. Up to 10 telephone calls were made to a household at different times of the day. If those calls failed three more attempts were made one month later. About 50 % of the eventual participants were reached on the first attempt, and 90 % of interviews necessitated no more than four telephone calls. There were 1 693 interviews completed from the eligible pool of 2 440, a response rate of 69.4 %. 12 % (290) of the sample was impossible to reach, and 19 % (457) refused to be interviewed. The most common reasons for refusal w...

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