Officials Struggle to Cope with ‘Explosion’ of AIDS Cases in Siberia

As the AIDS epidemic continues to "explode" in Siberia, authorities struggle with how to curb HIV infections, the Boston Globe reports. Between 1999 and 2001, 8,000 people living in Irkutsk, Russia, tested positive for HIV -- a "staggering" 11,000% increase over the 37 infections that were reported before Jan. 1, 1999. And this figure may underestimate the epidemic, with most infections occurring among young drug users, few of whom volunteer for testing. An estimated one-quarter to one-third of the city's youth, ages 15 to 25, use drugs. In addition, Russian youth "rarely" use condoms, and "experimenting with multiple sex partners is increasingly common." Across Russia, Irkutsk ranks only behind Moscow and its suburbs in HIV infections. Those working to combat the outbreak in Irkutsk are "struggling," as Dr. Yulia Rakina, one of 36 physicians responsible for testing HIV incidence in the region, explained, "We don't have the proper resources. The authorities don't appear to have realized that the scale of the problem has changed dramatically." Leaders have continued to focus efforts on treatment, rather than prevention of HIV, a "longstanding policy" in the country. Ludmilla Kitova, head of Irkutsk's regional health committee, said, "Our program is purely medical. We are ready to work with international organizations in this sphere but we would need a great deal of money (from them)." But UNAIDS officials said that Irkutsk has "rebuffed" funding for prevention programs. U.N. Program Coordinator Tatyana Shoumilina said, "A lot of money is going down the drain. Money is there, which they are spending on testing. They have to rethink how to reallocate resources to prevention." Shoumilina recommended that the city focus its efforts on "counseling young people [about] how to avoid STDs and HIV infections, providing addicts with clean needles and distributing free condoms." Rakina emphasized that attitudes need to change at the national level, asking that the nation's decisionmakers "overcome their hostility toward the segment of society that most needs help -- young drug addicts -- and be willing to spend scarce resources working with them (Meyer, Boston Globe, 2/25).