Facing the challenges of Russia’s AIDS epidemic

Stigma and discrimination, one of the major challenges being addressed in Russia, are standing in the way in the fight against Russia’s HIV and AIDS epidemic, one of the fastest growing in the world, according to a new report published today.

“Knowledge for Action on HIV/AIDS in the Russian Federation”, published by the Department for International Development and carried out in partnership with the Russian Government and NGOs, showed a large increase in the numbers of injecting drug users and in sexually transmitted diseases over the last generation.

The report set out how the HIV situation has worsened due to a number of challenges, including the stigma and discrimination associated with vulnerable groups such as injecting drug users and sex workers, hampering efforts in prevention and care.

It detailed the extent of the increasing problems in Russia, including:

– more than 300,000 HIV/AIDS cases, an increase of 300% since 1995;
– an 80-fold increase in the amount of syphilis cases registered between 1988 to 1998; and
– up to 3 million people, or 2 per cent of the population, have become injecting drug users.

According to the study, that investigated the behavioural, economic and political aspects of the disease in Russia, the HIV epidemic is concentrated in the new drug using population and among sex workers, where there is an increasing overlap. The increase in injecting drug users has in part been put down to the increase in drug trafficking, including an estimated 50 per cent of Afghanistan’s opium crop, passing through Russia on its way to Europe.

Injecting drug users and sex workers are marginalised within Russian society, making it politically difficult for the Government to fund treatment and prevention services in the face of competing demands. And widely accepted methods of treating drug addiction and reducing risk of HIV infection, including providing clean needles and condoms and drug substitution, are seen as endorsing drug use.

This situation has further been made worse by poverty, unemployment and weakened health services since the political reforms of the 1990s. The health care system is in transition and requires continued strengthening and modernisation to deliver the multi-faced campaign against HIV and AIDS.

The Russian Government, in response to the growing epidemic, has committed $120 million for HIV treatment for this year, an increase of twenty times current funding levels, and the Global Fund to fight AIDS, TB and malaria has pledged $209 million over the next five years. The Government is also committed to increasing the number of people with access to anti-retrovirals from 3,500 last year to 10,000 by the end of 2006 and up to 35,000 by 2007.

Gareth Thomas, Minister for International Development, said:

“This is a vital and timely report revealing the challenges that both the Government and people of Russia face, to overcome public attitudes and modernise Russia’s health system, if they are going successfully to fight the growing problem of HIV and AIDS.

“It is a further reminder of the worldwide need to stop discrimination by providing support to marginalised groups such as men who have sex with men, sex workers and injecting drug users.”

The report makes a number of recommendations to improve the handling of HIV treatment on a national level including:

– leadership on a national level for the response to HIV and AIDS epidemic;
– better co-ordination of the funding resources available, from international donors and NGOs;
– debate on sex education and HIV with education authorities and other key stakeholders to improve understanding of and attitudes towards the risks of infection;
– reform of drug treatment services; and
– engagement with business and the private sector to improve HIV control.

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