The epidemic Russia doesnt want to talk about

This article is part of Telescope: The New AIDS Epidemic, a deep-dive investigation into the modern face of a disease that transformed the world.

MOSCOW — In 1986, the year before Russia would register its first official case of HIV, a Soviet health official named Vladimir Trofimov spoke on state television about the troubling new infection that was making international headlines. “This is a Western disease,” he said. “But there is no base here for the spread of this disease, since in Russia there is no drug addiction and no prostitution.”

Today, theres little denying that AIDS is also a Russian disease. More than 340,000 Russians have died of AIDS, two-thirds of them in the past decade. In 2018 alone, the last year for which precise figures are available, AIDS took the lives of 37,000 people across Russia, with the rate of new infections rising by between 10 percent and 15 percent a year, according to the World Health Organization.

And while Trofimov was also wrong about drug addiction and prostitution in Russia, traditional at-risk groups no longer account for the majority of new infections.

Although needle-sharing among drug addicts was one of the main reasons the disease spread so quickly, most HIV transmissions in Russia — 57 percent — are now a result of heterosexual sex. Drug use is responsible for 40 percent, while gay sex accounts for around 3 percent, according to Russias Federal Research Center for AIDS Prevention and Control in Moscow.

Russia has resisted calls to introduce sexual education in schools and has cracked down on NGOs attempting to stem the tide of new infections.

“There is no such thing now as a group of risk — there is only risky behavior,” said Maria Godlevskaya, a project coordinator at the St. Petersburg-based EVA organization, which helps women living with HIV. “This can concern anyone from athletes to ballerinas to priests.”

Godlevskaya, who has been HIV positive for over 20 years, says low levels of testing in the past was one of the reasons why the epidemic grew so quickly in Russia.

“This lack of testing means married couples are now infecting each other, because one of them didnt know that the other had been HIV positive for years,” she said. Many women, she added, only find out they are HIV positive during pregnancy, when they are screened for the disease. Even rural pensioners are increasingly at risk, doctors say.

The number of people living with HIV in Russia now exceeds 1 million, according to official statistics. Most experts say the true figure is likely to be at least 1.5 million — around 1 percent of the total population of 146 million — because many people are unaware of their HIV positive status. In five Russian cities in Siberia and the Ural region — Chelyabinsk, Irkutsk, Samara, Tolyatti and Yekaterinburg — more than 1.5 percent of the population is HIV positive.

Although Vladimir Putin has never described HIV as a “Western disease,” he has shown a remarkable reluctance to discuss the countrys HIV epidemic. Beyond a few brief comments, the Russian president has not spoken at any length about HIV since 2006, when he called for urgent action to tackle the virus. Yet in the intervening years, Russia has resisted calls to introduce sexual education in schools and has cracked down on NGOs attempting to stem the tide of new infections.

Traditionalism

Critics say Russias reluctance to adopt tried and tested means of reducing new HIV infections is a result of the ultra-conservative government policies that have been promoted by the powerful Russian Orthodox Church since Putin returned to the presidency for a third term in 2012.

In 2013, Pavel Astakhov, at the time Russias top official for childrens rights, said that the novels of Russian authors such as Leo Tolstoy contain everything a child needs to know about love and sex. Astakhov quit his post in 2016, but attitudes have been slow in changing. In 2017, plans to hold online lessons about HIV/AIDS for Russian students were scrapped after the education ministry insisted on avoiding “delicate topics” and the use of the word “condom.”

“Instead of sex education, the government says young people should adhere to the slogan the main weapon against HIV is love and fidelity,” Iskander Yasaveyev, a sociologist at the Higher School of Economics in St. Petersburg, wrote in an article published recently by Novaya Gazeta, an opposition newspaper.

“Putin, through his silence and traditionalism, bears a significant part of the responsibility for the HIV epidemic in Russia,” he added.

Russias drug policies are also an obstacle toward reducing new infections, say HIV activists. Methadone, which international researchers say can lower the risk of passing on the virus by reducing intravenous drug use, is banned in Russia and anyone supplying it faces up to 20 years in prison.

The consequences of Russias methadone ban were illustrated starkly after the Kremlins seizure of Crimea from Ukraine, where the drug is prescribed to people battling heroin addictions.

According to the United Nations, around 800 former heroin addicts were cut off from methadone-based replacement therapy after Russia annexed the Black Sea peninsula in 2014. Around 100 died of suicide, overdoses or complications related to HIV and tuberculosis over the next year, the U.N. says. Russia denied the deaths were related to the methadone ban.

Foreign agents

Nongovernmental organizations that work with drug users have also come under attack in Russia. The Andrey Rylkov Foundation, which has around 25 members, is the sole source of free, clean needles and condoms for addicts in Moscow, a city of more than 12 million people.

In 2016, the Russian government placed the foundation on a list of so-called foreign agents because it receives overseas funding. In April, the organization was forced to limit access to its website after Vasiliy Piskarev, the head of the Russian parliaments security committee, accused it of promoting drug use following a report by an opposition website about its efforts to help addicts during Moscows coronavirus lockdown.

“The government believes that any work carried out in accordance with the WHOs international recommendations is work aimed at introducing a corrupting Western influence on Russian youth,” said Anya Sarang, the foundations director.

Vadim Pokrovsky, head of Russias federal AIDS center | Vasily Maximov/AFP via Getty Images

Vadim Pokrovsky, the outspoken head of the Federal Research Center for AIDS Prevention and Control in Moscow, has also frequently blamed social conservatism and the influence of religious groups for the rise in new HIV infections.

“Conservative sentiments prevail,” Pokrovsky said recently. “The rules of conduct must be consistent with Christian traditions, which some believe will of themselves reduce the spread of HIV infections.”

Pokrovsky cited Germany as an example of how to Read More – Source

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