Andrey Rylkov Foundation
for Health and Social Justice
Русский

HIV: The Unknown Epidemic Gripping the Russian Federation

Text: Meg Zakar

In January 2016, it was reported that as many as 1.5 million Russians, 1 percent of the total population, were infected with HIV, and that number is expected to keep escalating (Osborn).  Those are just the reported cases.  Over half of the cases of HIV in Russia today are because of infected needles alone.  The Russian government has recognized that there is a problem, but due to economic difficulties (Weiss), as well as social stigmas associated with HIV, not much has been done to combat the epidemic that is raging across the Russian Federation.  For example, according to Patriarch Kirill, the head of the Russian Orthodox Church, the “establishment of family values, ideals of chastity and marital fidelity” are what can help stop the spread of the virus (MacFarquhar).  Chastity isn’t going to do much for a drug user who can’t even try to get clean because the Russian Federation doesn’t believe in use of opioid substitution therapy “OST;” since 1997 it has been deemed illegal by the government, and those who are caught can face up to 20 years in prison (Hoskins).  So what can really even be done then?  Can this health issue even be tackled?  And what happens if this is the start of a pandemic?

In looking at the Russian Federation’s overall health profile, everything on the surface appears to be somewhat ok.  Life expectancy at birth for men is 65, and for women, 76 years of age.  The total population last reported in 2015 was 143,457,000 people, and 74% of the total population lived in urban areas.  Supposedly 100% of births and causes-of-death are registered, yet what is very interesting is that in looking at the Millennium Development Goals for deaths due to HIV/AIDS (per 100,000 population), only 42.8 deaths are reported (WHO).  There are now 1.5 million+ people with HIV but only 43 deaths per 100,000 people?  Also, in looking at the statistical data on HIV…there isn’t any except for 1 piece from 2009 where 27-42% of people with an advanced HIV infection were given antiretroviral therapy coverage (WHO).  If you look at both the WHO World Health Statistics Report and the WHO Global Health Observatory Report, there is no data available for HIV testing centers.  There is also no data for people living with HIV (WHO).  There isn’t any data within the last decade.  The Russian Federal AIDS center’s page domain is now for sale (Hoskins), or there would have been stats available for viewing from 2014.  I was able to find some information on HIV in Russia by typing in the word for HIV “ВИЧ” in Russian and found the AIDS center in Perm a few weeks ago in which all data was broken down by all people with HIV and children, but unfortunately, that statistical resource data page has since been taken down (Aids Center Perm).  I also found Moscow’s AIDS center page, but they too have no statistical data on how many people currently have or are being treated for AIDS (AIDS MHz).  TASS, one of Russia’s major news reporting agencies, reports that the WHO and European Centre for Disease Prevention Control are providing incorrect information about HIV and that the epidemic isn’t as bad as they claim (TASS).  Those with HIV in Russia though I’m sure would disagree with TASS.

I first incorrectly assumed that many of the people who had been diagnosed with HIV in the Russian Federation were either drug addicts, or they became HIV positive as a result of unprotected intercourse (mainly in men), or were in prison doing drugs. Upon further research though, with information that was just released last week by the Russian Federal Aids Centre, “There are 80-100 cases of HIV infection among women a day.  This is no joke – a day.  They are mostly young women, aged from 25 to 35 years and they are the main new risk group” (Avert).  The key affected populations are people who inject drugs, prisoners, men who have sex with men, sex workers, and now people having heterosexual sex as well (Avert). So I was partially correct in my initial assumption, but was stunned to see the growing number of women infected with HIV daily.  Re-using needles, unprotected sex, and not enough educational information on how HIV is spread can all be linked to political, social, and economic factors.  Each of these factors have equally led to the dysfunction that can now be seen.  While there is now a supposed harm reduction service in place, only those who have money can really afford to either detox or afford the HIV cocktails.  There are also legal barriers setup by the government which invoke old social stigmas, in regards to both homosexuality and drug laws. Major funding gaps because of the government are also to blame for the continued rise of HIV in the Russian Federation (Avert).  The question is, which factor should be addressed first, in order to fight this growing issue?  I would like to argue that perhaps by addressing and trying to reduce the stigma that is associated with HIV in Russia, like was done in South Africa, the quality of life of everyone could be greatly improved, and government officials could be more likely to listen and decide to give more funding.  Not only are those with HIV stigmatized, but their family members are also stigmatized, which then in turn leads those family members to stigmatize their family infected (Pretorius).  But who should lead the fight against stigmatization?

There has been one man within the health sector of Russia who has been very outspoken about the HIV epidemic, regardless of the fact other healthcare professionals try and make him out to be crazy or an agent working against Russia.  Vadim Pokrovsky, who is the head of Russia’s federal AIDS center, was featured in an article by Reuters last year in which he warned of Russia’s “concentrated epidemic” becoming a full-fledged general epidemic, due to the general population now becoming infected.  He openly criticized the governmental budget of 40 billion roubles to help fight HIV, stating that that was 60 billion roubles too short (Osborn).  Because of his claims, Moscow wanted to launch an investigation, but had a Russian think tank, RISS, prepare the report.  The head of Moscow’s health care committee, Lyudmila Stebenkova, then let RISS present the findings, which determined Russians needing to be more moral, and condoms being the issue.  She said, “In the long run, it is not AIDS we must fight, but drugs and promiscuity”(Chernykh).  Pokrovsky still kept fighting, trying to argue for sex education in schools, clean needles, and methodone clinics.  Stebenkova dismissed his argument, saying that would only encourage more children to want to have sex.  Dr. Evgeny Brun, Russia’s chief narcologist, also dismissed the thought of using methodone, as “our professional joke is that methadone is similar to treating the vodka alcoholic with cognac” (Fowler).  The local Ministry of Health of Ekaterinburg released pertinent information in November 2016 on how HIV should be a top priority, but this news wasn’t even featured on television, Syria was instead (Chernova).  The Andrey Rylkov Foundation for Health and Social Justice, which is a small Russian NGO, has also begun speaking out about HIV and how the government lied to the people about giving more funding.  Their website is very informative about how they’re trying to fight the “foreign agent” stigma the Russian government has enacted about foreign entities.  They’re on the Russian government’s black list, and are accused of being foreign agents.  I’m surprised their page is still active (Rylkov Foundation).

If the Russian government does not allow for the Russian people to know the truth, if more funding isn’t given to the health sector, and if more people don’t overcome stigmatization, then this epidemic has the potential to become even more widespread.  Since there is no data available, I was unable to find if HIV is more concentrated to the urban areas of the country, or if it is running rampant throughout.  I sincerely hope that through grassroots efforts or from more healthcare professionals like Pokrovsky speaking out, that prevention and treatment for HIV within the Russian Federation can be attainable for those infected, or will be infected.

Note:  I wanted to share this screenshot from the website I mentioned where my source data had been deleted.  I ran into this problem over and over again while working on my paper.

Picture133



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