BTW, though there have been a lot of highly alarmist claims lately about a looming AIDS pandemic in the FSU, I think it's mostly part of a scare-tactic campaign. I think it will probably saturate the at-risk group (IV drug users; admittedly, there are a lot of them) and burn itself out. Russian culture just ain't that promiscuous.
Chris Doss The Russia Journal ---------------------------- San Francisco Chronicle July 30, 2002 AIDS crisis catches Russia off guard Ill-funded charity groups struggle to educate public Anna Badkhen, Chronicle Staff Writer
St. Petersburg -- Last of Three Parts .
"It must have been a prostitute," said Dmitri, reflecting upon how he became infected with the virus that causes AIDS. "Yeah, I'm pretty sure that's what it was."
But don't prostitutes want you to use condoms?
"Oh, they do," Dmitri said with a smirk. "But I don't. "
Leaning against a crumbling wall at Azaria, a support group for St. Petersburg drug users, Dmitri contemplated his life before he tested HIV- positive a year ago. A self-described former racketeer, Dmitri, who asked that his last name not be used, said he had always had money, good clothes and nice cars. He was an irresistible man, especially when it came to prostitutes, he said.
Had he known that unsafe sex could lead to getting HIV?
Dmitri's response was typical of thousands of Russians who carry the virus.
"I wasn't really thinking about it," he shrugged. "I never thought it could become my problem."
The virus that causes AIDS is spreading faster in Russia than anywhere in the world -- and the government's failure to educate the public about the fatal disease, say experts, bears much of the blame.
Even though the government's own health officials are warning of an unchecked epidemic, the Kremlin has allotted a meager $3 million for anti- retroviral AIDS drug treatments this year. That's about enough money to treat roughly 500 of the country's 201,000 registered HIV cases.
Prevention and education programs have been almost entirely neglected. The $2 million the government has earmarked for AIDS prevention works out to about 1 cent per person per year, 10 times less than the country needs in order for these programs to be effective, notes Vadim Pokrovsky, director of the Moscow- based Center for AIDS Prevention and Treatment.
Pokrovsky believes the Kremlin refuses to admit the scale of the problem because it doesn't want to frighten foreign investors away and its scarce financial resources are devoted to seemingly more immediate problems, such as the conflict in Chechnya and a military badly in need of repair. But he notes that the government has allocated nearly $2 billion for the celebration of St. Petersburg's 300th birthday next May.
"Apparently, the government doesn't take the problem of AIDS and AIDS prevention seriously," Pokrovsky remarked dryly.
Prevention programs also run into resistance from an unlikely source: health professionals, many of whom were educated under the Soviet public- health system, which viewed drug abuse -- a major contributor to Russia's HIV epidemic -- as purely a criminal offense. Some of them -- such as Alexei Mazus,
one of the most prominent AIDS physicians in Russia -- oppose needle exchange programs, which provide addicts with clean syringes and needles, and methadone treatment.
Methadone is illegal in Russia, and Mazus has publicly stated that needle exchange programs would simply lure young people into drug addiction.
In some Russian cities, such as St. Petersburg -- which has an estimated 70, 000 intravenous drug users and 17,000 registered cases of HIV -- charity- funded needle exchange programs operate despite the disapproval of AIDS officials like Mazus. But these programs reach a small fraction of Russia's endangered drug abusers, says Aza Gasmanova, St. Petersburg's top epidemiologist.
The same could be said for education. While recent polls show that 95 percent of Russians know how HIV can be transmitted -- unsafe sex, dirty needles, via blood and bodily fluids and during childbirth -- such lessons are not being applied.
"The problem is, people don't trust their own knowledge," said Alexander Goliusov, head of the HIV-AIDS prevention department at the Russian Health Ministry.
Attempts to introduce sex education courses in high schools have been thwarted by parents who fear such lectures would encourage teenagers to have sex, or by the conservative Russian Orthodox Church.
Private AIDS organizations barely make ends meet, said Nikolai Panchenko, chairman of the St. Petersburg Society for People with HIV-AIDS. His budget for 2001 was a meager $2,000. His workers -- all volunteers -- often have to seek donations in the street to keep the group afloat.
"On a good day, we can get 300 rubles (less than $10)," said the group's press secretary, Viktor Bakayev.
While rare state-funded television commercials show former intravenous drug users confessing that they became infected through dirty needles, AIDS experts say the TV spots fail to target people who do not use drugs, a fast-growing segment of the HIV-positive population.
"What we need is continuous, long-term campaign," Bakayev said.
Kostya, a 24-year-old heroin addict, was surprised when he learned that he had HIV last year.
"I did not know I was at risk," said Kostya, who made the discovery when he checked into a hospital to get treated for hepatitis A, B and C.
Kostya said he had not told anyone other than his mother about his HIV status, fearing that his friends would turn away from him.
"My mother took the news fairly well," Kostya said. "But she doesn't know what AIDS is. She thinks it's a disease that can be cured."
Russia's failure to implement a sustained prevention program has ominous implications for the future, said Pokrovsky.
"The government will become aware of the problem only when people who have HIV become a large part of our society," Panchenko said. "Unfortunately, it looks like that will only happen when there is an infected person in every Russian family."