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The AIDS epidemic crisis in Russia
by Ebey Soman

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In a country with low population growth, and where 80% of the HIV infected population is between the ages of 15-30, Russia has a significant reason to worry about its future. Currently HIV patients comprise 1% of the Russian population and an infection rate that is 10 times faster than UK. However, fear and ignorance is prominent in Russia’s tragedy.

The HIV and AIDS epidemic in Russia and the Eastern European and Central Asian region is growing at an exponential rate. Many experts in the field say that the problem the countries in this region faces are far worse than Africa but it is widely ignored. It is also very important to note that in this region, 90% of the HIV & AIDS cases are reported in Ukraine and Russia. And in Russia alone, two thirds of this regions HIV cases are reported. In total, the 2007 estimates indicate that there are around 1.5 million people living with HIV, with close to 60,000-70,000 individuals dying from AIDS. The prevalence rate of HIV among the adult population in Russia and Ukraine has doubled between 2001 and 2007 while the rates in Africa and Southeastern Asia actually fell. As of 2008, it is estimated that there are close to 1 million HIV infected individuals living in Russia.

The first case of HIV was reported in the Soviet Union in the year of 1986, reportedly due to homosexual relationship between Soviet soldiers. Since homosexuality was forbidden, the matter was quickly covered up and HIV/AIDS did not receive the proper attention it needed. Rather, the issue was largely branded into a disease that only affects the gay population. Much like in the United States, HIV was treated as GRIDS (Gay Related Immune Deficiency) was treated in the early days of HIV in the US. Many individuals were tested for AIDS and HIV without their knowledge and those discovered faced extreme social discrimination. Thus many more infected individuals went unreported and the HIV/AIDS continued to grow.

The economic and political instability of the Soviet Union and the emerge of the young Russian Federation also played a key role in contributing to the problem. Unlike the western nations, Russia never really had a well developed health care sector. In fact, to this day (2009), Russia still does not have a decent health care system. Thus a HIV/AIDS awareness campaign was not a priority for the government and the health care sector had no resources or enough organization to even begin addressing the strong need for better reproductive health among the populace. During this period, the fall of Soviet Union led to harsh economic conditions in much of Eastern Europe and Russia. The rise of prostitution and the sex industry began to intensify the HIV epidemic. The sex workers are not educated about STDs or about HIV and many do not use any protection. To make matters worse, Russian were reported to have high rates of sexually transmitted diseases and the use of intravenous drugs began to multiply the risk factors.

Heroin drug users grew in Russia and the Eastern European and Central Asian countries after the fall of Soviet Union. With drug users came the risk of sharing needles which significantly raised the risk factors for transmitting HIV. In 2006, 60% of all reported HIV cases were attributed to injecting drug users and by 2007 that figure rose to 83% of the infected cases of HIV. These figures are mind-blowing considering that HIV infection in the sex workers are only 6% and 5% among the prisoners (officially). Russia has recognized this problem and has begun to combat HIV and in 2006, it actually showed a slight drop in HIV transmissions through drug use. Among children, Russia has a high transmission rate compared to Europe. This may be due to vertical transmission or HIV transmission from an infected mother to her child. While Russia is working to limit this issue, it still happens and it is still a growing problem. Another suspected cause for the continuing spread of HIV is through blood transfusions. Even though the western nations have close to eliminated this threat through safer precautions, blood testing and other safety mechanisms, Russia still has not implemented such measures in their health care system. This may be directly a result of the bad health care system in Russia – and many experts in the public health sector calls Russia a “public health disaster.”

The problems of Russia do not end there. Rather, the nightmare only continues. The people who have multiple sex partners in Russia are also seeing a rise of infection rates. The modern Russia is seeing a dramatic rise in nightclubs and other social gathering places where the young population likes to gather – and where the HIV transmission rates have skyrocketed. Heterosexual contacts and multiple partners have become a leading cause of new HIV infections in Russia. Among the female population, heterosexual contact has accounts for nearly two thirds of the infections each year and in 2007, 44% of the infected individuals were women. In the region, the leading cause of the infection among the female population has been sexual contact with a drug user. In men, the leading cause of HIV still remains to be homosexual relations, followed by injecting drug use and high risk heterosexual contact via multiple partners or another drug user.

In a country with low population growth, 80% of the HIV infected population is between the ages of 15-30. Thus Russia has a significant reason to worry about its future. Currently HIV patients comprise of 1% of the Russian population and an infection rate that is 10 times faster than UK. However, fear and ignorance is prominent in Russia. During the entire presidency of Putin, not a single press conference was dedicated to this growing issue threatening to spill over from the high-risk population into the general Russian populace. More recently, anti-aids groups working in Russia has come under fire from local Russian government institutions for promoting western ideals or promoting western companies. While their charges may not be true, the political view of seeing the anti aids campaign as a western effort will discourage people from taking this issue seriously or even listening to their awareness efforts.

As of 2007, many of the promises and campaigns by the Russian government has ended up in utter failure, with AIDS/HIV prevention services in Russia simply nonexistent and the focus on the government insufficient on the issue. The social stigma HIV and AIDS patients are faced with have not helped in the campaign to bring these people their needed care and many cases go unreported. The stigma also keeps infected people away from any government run clinics or efforts to provide them with antiretroviral. Even within the poor health care system, the medical professionals do not have the knowledge or the training to deal with the problem. Many simply do not know the facts about the disease and others simply fear the disease. The misconception among the medical community has led to resistance in treating drug users for HIV or taking a serious effort to curb the infection rates. The education system in Russia is also not geared towards tackling this problem. Many schools do not teach children about drugs, sexually transmitted diseases, HIV/AIDS and sexual education in general. Rather many children are ignorant about this problem and thus the rising number of then becoming HIV infected by the age of 15 when they are becoming sexually active.

Despite the rapid spread of HIV among the population, the Russian government has not placed the issue as a priority and has not taken any determined effort to combat it. Nevertheless, some measures were taken in order to try and curb the rate of infection. Russia recognized the problem among the drug users and have opened up needle exchange clinics where drug users can trade in their used needles and get new ones to use. The intent of this program was to limit needle sharing and thus reduce the risk for HIV transmission. However the program is not as successful as it was envisioned due to the lack of access the drug users have to such clinics. The demand for drugs and drug use in Russia is much higher than what these clinics can keep up with so they have not had the desired impact on the infection rates. Yet in 2007, the Russian government actually reduced funding to these clinics rather than increasing funding and making these centers much more accessible to the high risk population. The funding for HIV programs were allocated to treatment rather than focusing on prevention – yet another public health disaster by the government. Currently, the bulk of any effective aids prevention programs are carried out by various non-governmental organizations (NGOs) such as Global Efforts Against AIDS in Russia (GLOBUS) and the Harm Reduction Network.

The Russian government has also begun to import Anti-Retroviral drugs (ARTs) from foreign companies to provide treatment to the infected patients. However, these drugs are highly expensive and unlike countries like India where these drugs are made by the government really cheap, Russian government has no such generic manufacturing program. And some of the imported ARTs have difficulty reaching the patient population due to inefficient bureaucracy and strict customs checks in the country. The current fear is that without a proper treatment course, patients taking any ARTs will develop resistant strains of HIV which may then spread to the main population. Then any efforts to treat the diseases may decrease radically and infected people will simply become the lost cause.

The Russian government really needs to take a step back and reassess its situation. The government should listen to the NGOs and set HIV treatment and prevention as its priority. Rather than simply throwing more money at the problem, Russia should begin to focus on prevention and networking all the efforts of the NGOs and the government together. Russia will need to begin a tough HIV/AIDS awareness programs in public aimed at reducing the social stigma and discrimination the patients feel. At the same time, the awareness programs should also be educational so people know the modes of transmission and can take safer precautions. The government should seriously invest in providing the children with proper education in safe sex, abstinence, abstaining from multiple sexual relationships, staying away from drug use and how to treat STDs. Russia will need to reeducate its health care professionals in how to treat HIV/AIDS patients and begin to invest more in the public health sector. Rather than wasting money in trying to treat the problem, the government should invest in preventing the spread and reducing the prevalence rate among the adult population.

Russia should also take serious steps towards getting the various organizations to work together in the ways it can contribute in reducing the problem. The Russian Orthodox church and various religious organizations have a large influence in the society and thus should be allowed to participate with the government in promoting safe sexual behaviors. The church’s message of abstinence and marital faithfulness will actually be a beneficial message in the fight against reducing high risk behaviors for HIV. The sex workers in Russia should also be screened and tested for HIV and they will need to be educated in using safe sex methods. Those found to be HIV positive should not be allowed to continue their work, rather be provided with the long term care they will need. There are many orphans due to this disease and those kids will need to be kept off the streets so they do not become drug users, sexually active with the high risk populace or be susceptible to the host of other dangers. So they need to be provided with orphanages and government programs targeted to keep them in school and get them educated about their health. The government will also need to take a more proactive step in combating the illicit sex trade trafficking of women and children and the transportation of opium from Afghanistan into Russia for heroin. More needle exchange centers, AIDS centers and a more transparent and informational awareness efforts needs to be launched in Russia.

With a dwindling population and an out of control HIV infection rate in Russia, the future looks bleak. Estimates place Russia on the forefront of the battle against HIV and in a worse position than Africa. Largely ignored by the media and the government, HIV has become the rapidly spreading epidemic in Russia, especially among the youth who are supposed to be future of the country. In a country where low birth rate is set to contribute to a large demographic problem as the present generation age, every young person is a valuable asset to the country. And each new HIV infection is robbing the country of its more important resource and its future. Thus the government must make a renewed and re-determined effort to curb HIV in Russia before the bleak future becomes the reality, before the vast Russian Federation becomes a vast uninhabited desolation.

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ABOUT THE AUTHOR:

Ebey P. Soman is a student at Saint John's University and is deeply interested in writing about current events, philosophical, religious and social topics of interest. He is currently a published author in Triond, Helium and various other websites. Ebey is also an active member of organizations such as Peniel Revival Ministries Inc, Amnesty International, ONE Campaign and Save Darfur. A simple Google search can bring further information about this author and his many eclectic articles. See his personal page for his background and a list of his articles.

BIBLIOGRAPHY/SOURCES USED:

(see the article for source information)