San Francisco Chronicle Series Examines Russia’s AIDS Epidemic

The San Francisco Chronicle this week in a three-part series examined the HIV/AIDS epidemic in Russia. Summaries of the articles appear below:

• " Russia on Brink of AIDS Explosion; Ignorance and Inaction Threaten Catastrophe": The Chronicle examines how Russian residents -- not only public officials -- appear to be "in denial" about the country's HIV/AIDS crisis. According to official government statistics, 201,000 Russians have HIV infection. However, UNAIDS estimates that 700,000 Russians are HIV-positive, and Vadim Pokrovsky, head of the Russian Center for AIDS Prevention and Treatment, said that as many as 1.4 million people could have the virus. He estimated that if the current infection rate remains steady, Russia could have more than five million HIV cases by 2007. Despite the numbers, the government spends only $5 million annually on HIV/AIDS treatment, compared to the $65 million Pokrovsky said is needed. However, the Chronicle reports that it is "not only the government that is guilty of inaction," but the majority of Russians. The apathy is in part due to the fact that the majority of the country's HIV cases are related to injection drug use, a habit "most Russians despise, fear or just don't care about," the Chronicle reports. Unsafe-sex practices are also contributing to the spread of the disease and other sexually transmitted diseases, according to the Chronicle. Pokrovsky said that heterosexually transmitted cases of HIV rose from 2% in 2000 to 4% in 2001 and have since "soared," accounting for 15% of newly reported HIV cases in the first six months of this year (Badkhen, San Francisco Chronicle, 7/28).
• "Little Help in Russia for AIDS Sufferers; Fear, Ignorance Lead to Limited Patient Care": The article examines how most HIV-positive Russians, particularly children, receive little to no treatment because of a lack of funds and ignorance and discrimination among health care workers. The Russian government spends $45 per year per HIV-positive person, and most health care officials and workers are "poorly trained" about the disease. Many health care providers and orphanages refuse to take care of children with HIV out of fear of the disease. Such discrimination is the result of "long-standing prejudice rather than simple misinformation," the Chronicle reports, noting that despite HIV/AIDS awareness campaigns, most Russians treat people with the disease as "social outcasts." As a result, many people with HIV are denied entry into schools, are fired from jobs or turned down for health services. The discrimination is "seldom blatant and usually comes under the guise of other complaints, so it is rarely appealed," the Chronicle reports (Badkhen, San Francisco Chronicle, 7/29).
• "AIDS Crisis Catches Russia Off Guard; Ill-Funded Charity Groups Struggle to Educate Public": The rapid spread of HIV in Russia can be attributed in part to the government's "failure to educate the public" about the disease and an overall lack of funding for HIV/AIDS prevention efforts, the Chronicle reports. The government has set aside about $2 million -- or one cent per person -- this year for HIV/AIDS prevention efforts. However, Pokrovsky estimated that about $20 million per year is needed to mount a successful HIV/AIDS awareness campaign. Pokrovsky said he thinks that the government does not spend more on HIV/AIDS because it is afraid that admitting the scope of the epidemic will scare away foreign investors and because it does not want to detract from other "seemingly more immediate problems," such as the fighting in Chechnya. Some not-for-profit groups have tried to fill in the gaps, but funding is scarce. In addition, many HIV/AIDS prevention efforts have met resistance from health care workers. In the beginning of Russia's epidemic, HIV was transmitted mainly through injection drug use, and many doctors trained under the Soviet system still view drug addiction as a criminal matter and oppose needle-exchange programs and methadone treatment. HIV/AIDS education programs in schools also face opposition from the "conservative" Russian Orthodox Church and parents who fear that sex education would encourage teenagers to have sex (Badkhen, San Francisco Chronicle, 7/30).