HIV-Positive Prison Inmates in Russia Have Limited Access to Antiretroviral Treatment, Advocates Say

Prison inmates living with HIV/AIDS in Russia often lack access to proper antiretroviral treatment and medical care, some advocates said recently, the Moscow Times reports. Limited education among inmates about the disease, a shortage of doctors and bureaucratic barriers in obtaining medical release in the country are contributing to the problem, the Times reports. According to Alexander Kononets, head of the Federal Prison Service's health department, there are 42,000 inmates living with HIV/AIDS in Russian prisons and jails. Written consent is required for an HIV-positive inmate to receive treatment while incarcerated, according to the Times.

Federal Prison Service spokesperson Valery Zaitsev said inmates are screened for HIV/AIDS when they enter a detention facility and usually are screened again when they are transferred to prison. The tests usually are the first time the inmates are tested for the virus, Zaitsev said, adding that those who test HIV-positive subsequently "receive antiretroviral drugs and other appropriate treatment." However, Yelena Panasenko, who coordinates support groups for prisoners with HIV/AIDS in the country's Saratov region, said additional efforts are needed to help the inmates maintain treatment. "Prison doctors can offer treatment, but they will not persuade each inmate to undergo it," Panasenko said.

Tatyana Bakulina -- head of IMENA, a St. Petersburg-based nongovernmental organization that operates support programs for HIV-positive inmates -- added that the situation for inmates living with HIV/AIDS is exacerbated by high rates of tuberculosis and hepatitis C coinfection. Kononets said that there are 43,000 inmates with TB in Russia. "Sometimes a prisoner will come down with a severe fever for three days, and nobody will examine him or give him any medicine," Bakulina said.

Vadim Pokrovsky, head of the Federal AIDS Center, said that the situation concerning medical treatment for inmates "was pretty poor last year, but it is already getting better." According to Pokrovsky, inmates now receive treatment under a federal program instead of through regional governments. Experts also said that difficulties released prisoners face reintegrating into society can complicate treatment. About 230,000 convicts are released annually -- 90% of whom suffer from various diseases -- Kononets told the Public Chamber in October 2007.

Court Case
The Supreme Court on Tuesday rejected a request by Vasily Aleksanyan, a former executive of Russia's Yukos Oil Company, to be released from prison so he could be treated for HIV/AIDS, the Times reports. Aleksanyan, who is facing embezzlement and tax evasion charges, claims that he was intentionally denied treatment while in jail as punishment for not testifying against his bosses. Russian law says that any person diagnosed with serious illness should not be kept in pretrial detention. Prosecutors said that Aleksanyan refused treatment while in jail; however, his lawyer, Yelena Lvova, says Aleksanyan gave written consent for therapy in July 2007. Aleksanyan never received treatment and has not had a medical examination since Dec. 30, 2007, Lvova said. Aleksanyan was diagnosed with HIV a few months after his detention in April 2006 and "could die any day," another lawyer said (Osadchuk, Moscow Times, 1/24).