A Plague Ignored

As of March 1997, there were 3,327 officially  reported cases of HIV-infection in Russia, but many specialists estimate that the actual number of infections is closer to 10,000. These numbers are compounded by the fact that most health experts, including the Russian Ministry of Health, are predicting between 800,000-1 million HIV-infected Russians by the year 2000. 

Gennady Roshchupkin was 19 years old when he found out he was HIV+. In 1988, the Moscow student paid a visit to his local polyclinic, complaining he was feeling poorly and suffering from an undefined, general exhaustion. In response, the clinic’s doctors subjected him to a battery of tests for sexually transmitted diseases (STDs). One of these was a test for the HIV antibody. Like all Soviet citizens at the time, Gena was tested without his consent or knowledge.

It is more than likely that, even if the clinic had bothered to ask for Gena’s permission, he wouldn’t have given it, as all he knew of the disease was government-sponsored propaganda  about Russi-ans’ political and moral immunity. As described by James Riordan, in his study, Sex and Russian Society, the Soviets originally treated HIV/AIDS as “a Western problem, with overtones of retribution for bourgeois depravity, and accusations against the CIA for unleashing the virus through an experiment gone wrong.”

Therefore, Gena knew virtually nothing about the reality of HIV/AIDS: its transmission, symptoms and manifestations. A young gay man living in the capital of the Soviet Union, seven years after the disease had become front-page news in the West, Gena was as innocent as the rest of his country, believing that the illness respected ideological boundaries.

His doctor broke the news to him. “Well, Gena, the good news is that you don’t have syphilis. The bad news is...you’re HIV+.”  And the doctor sent him on his way. Without counseling, without treatment and without any concrete knowledge of what exactly it meant to be HIV+ in the Soviet Union.

Because, at the time, the Soviets were bent on disregarding the ramifications of the disease – a waiting time bomb – to themselves and their morality. Caught up in the chaotic currents of Gorbachev’s political reforms, the USSR was “not ready socially, ideologically, or economically for a serious prevention campaign, “ said Shona Schonning, 26, resource manager for AIDS infoshare. “Homosexuality was illegal,” she said. “Issues related to reproductive health were not considered appropriate themes for public discussion, and the country was reeling from the instability of perestroika.”

But while the government stagnated, the Russian people were moving on: sexual liberation, drug use and all types of revolutionary personal experimentation were de rigeur, creating an environment ripe for impending social disaster. Occupied with official problems, the government turned a blind eye to society’s crumbling morality.

But had the Soviets been aware of what was afoot in the counterculture, they could have predicted Belarus’, for example, current HIV outbreak (8,000 new cases in the past two years). Belarus’ case is of particular interest to Russia, since not only do the two countries share a ‘transparent’ border, thus allowing citizens to travel without restrictions, but the two countries’ leaders are also working towards political unification.

Many Belarusan drug addicts favored a type of heroin which needed to be mixed with protein before injected. When they could get them, they used eggs. But more often they sampled their own blood. Bored by their non-existent future prospects, the twenty-something offspring of Soviet factory settlements poisoned themselves with their drugs and dirty needles. They passed on the disease to their husbands and wives, children, lovers and customers.

This is illustrated in towns like the  Belarusan Svetlogorsk (pop. 70,000) where 1,000 people have contracted an indigenous strain of the HIV virus since June 1996. Town officials say that the virus may infect 90% of the town’s 3-4,000 addicts within two years. So far, all the local health leaders have managed to do is round up drug users, their friends and anyone who looks  like a potential drug user and bus them en masse to local clinics for forcible testing. Once tested, there is little hope or help. Victims are left to languish.

Many Belarusan health authorities estimate that there are other potential victims who remain untested, which could mean that, within three years there might be a second wave of AIDS victims who caught the disease sexually from addicts. And yet, the situation in Belarus is not as grave as in the Ukraine. The Russian Scientific-Methodological Center recently revealed that there are 11,800 HIV-infected persons in the Ukraine, primarily intravenous drug users, a staggering number for a country that size.

Unaware of what was to come, the general public wallowed in their once-unimaginable freedom. Voices from the Soviet government, like that of Nikolai Burgasov, onetime USSR Deputy Health Minister, compounded the increasing danger by boasting that, since homosexuality was illegal in the USSR, America’s disease could never become a problem here.

In 1987, the first documented case of an HIV+ Soviet citizen destroyed the myth of invulnerability. A soldier who had been infected abroad with the HIV virus was found to have transmitted the disease to 15 other Soviet soldiers with whom he had homosexual relations. This revelation was followed in 1987 by the appalling news that 279 children had been infected in state hospitals through contaminated equipment and reused syringes. This sparked, noted Schonning, of AIDS infoshare, “a discriminatory, fear-based mass media... which often led to... persecution of people with HIV/AIDS.”

Today, more than ten years later, due to an exploding rate of infection (785% in 1996), the Russian Government is only just beginning to come to grips with what most AIDS experts agree is an epidemic in embryo. But, lacking the necessary funds and resources, will the government be able to stop the tide?  In 1995, the Health Ministry received only 49% of the funds budgeted for national AIDS education. The current HIV/AIDS situation in Russia, while bleak is not necessarily without hope, it could be remedied, but faced with Russia’s numerous social and economic problems, the government has a tendency to put AIDS on the back burner.

But time is running out. 1996 saw an unprecedented growth in new cases in Russia (1496 reported). By November ‘96, the number of cases for that year alone were almost the same as the combined number of cases for the preceding nine years.

Child and adult prostitution, sexual emancipation , a lack of AIDS education and, most seriously, the growing rise of HIV-infection among IV drug users is taking its toll. The Russian Scientific-Methodological Center estimates that there are ten new cases of HIV infection daily. Last year, 213 Russians died from AIDS-related causes; 80 of these were children.

These numbers are no surprise when one considers that, minimizing the productiveness of education and the ability to prevent further infections, the Russian government is still mainly concerned with, “contact-tracing.” To that end, the Russians have established an ineffectual network of 82 AIDS centers throughout the country for the purposes of testing and isolating all those who test HIV+, as well as their family and sexual partners.

The corollary to this theory points a finger at foreigners as the source of infections, forcing them to get tested for the virus before they may enter the country. (Interestingly enough, Russians may play a hand in the spread of STDs in Europe, as a recent UK study has named Russia as the source of syphilis in Britain.) Treatment and support is still given short shrift.

This situation is in no way alleviated by the fact that many Russians have a justified fear and distrust of the medical system, which keeps them from getting tested anyway. As Julie Stachowiak, executive director of AIDS infoshare, said,“these fears are valid, as once someone tests positive, they may be refused treatment on the basis of their condition... be subjected to tests without their consent, unknowingly be given experimental treatments of medication, be told they have a chronic condition and turned away with no further information, undergo a medical procedure without proper sanitary conditions or anesthesia, or have information about their condition made public.” It is also true that once someone has been labeled a carrier of the HIV virus, he or she can be held criminally responsible for putting other citizens in danger.

The few persons who do get tested are often financially cut off from the West’s new wonder drugs – usually only available at exorbitant, black market prices. Most HIV-infected persons are limited to domestically-produced AZT, which can also prove problematic to obtain. Many clinics, in an attempt to lower costs, have taken to denying patients drugs for several weeks at a time. Said AIDS patient Gennady Roshchupkin, “If I had $5,000, I could have Crixivan [a new AIDS drug] tomorrow. But I have no money.”

Realizing the urgent need for outside help, international, not-for-profit organizations do what they can. MSF Holland, for example, has opened medical centers in each of Moscow’s railway stations where one may, for free, get a variety of types of medical assistance, including a test for the HIV virus. Earlier this year, the Russian AIDS group Vozvraschenye (Return), in partnership with the French Medecins Du Monde, brought an old Soviet bus which they divided into three sections: peer counseling, treatment and testing, and needle exchanges. They parked the  bus in some of St.Petersburg’s shadiest areas, offering confidential HIV testing, impartial treatment, emotional support and AIDS education. However, eight weeks after they started, with already 3000 people helped, they were inexplicably put out of business by the St. Petersburg OMON.

Unfortunately, the OMON’s reaction seems representative of the Russian government which is willing to acknowledge the seriousness of the HIV/AIDS situation in Russia, but ultimately hesitant to act. Thus, as the government continues to hem and haw, other countries, aware of the potential danger, have stepped into the fray.

For example, Dr. Zednek Jezek of the Joint United Nations Programme On HIV/AIDS is devoted to fighting HIV/AIDS in all channels of society through education, prevention and support. To that end, his group is creating street-side counseling programs, training seminars for health workers, needle exchange programs, free and confidential testing sites, literature and assistance systems for IV drug  users, including help for those who wish to become drug free. But in their good work, even an organization like UNAIDS can find itself wading in illegality. According to Dr. Jezek,, in the Russian Federation is it illegal for anyone to buy syringes without a prescription. While this seems an ostensibly intelligent action-the better to observe and limit the activities of drug addicts- in fact, it has led to more HIV-infections among Russian drug addicts who are forced to keep on reusing dirty needles, which they are unable to trade in or even clean properly. In certain cities, the only way for users to get “clean  needles” is to buy them off gypsies, who simply collect old and dirty needles before selling them right back. Therefore, every time Dr.Jezek and his colleagues attempt to help drug users get cleaned up, they step to the side of the law.

AIDS infoshare, another such group, is more of a AIDS information clearing-house than social liberator. With 11 other men and women, 27 year-old Gennady Roshchupkin distributes AIDS-related information, creates regional workshops and computer networks and defends violated human rights.

This is necessary because even though article Five of the Russian Federal Law, On the Prevention of the Spread of the HIV Virus, guarantees all rights and freedoms for HIV-infected citizens, Yeltsin’s government, in an ironic twist of fate, seems to be observing the Soviet gambit of granting all rights on paper and none in practice.

Amy Gallo, 22, of AIDS infoshare told of the homosexual director of a Rostov medical college, who died at home of AIDS-related complications in 1994. Though his family tried to keep the reasons for his death a secret, correctly fearing reprisals in the nature of coercion and intimidation, Rostov’s official sanitary committee found out what had happened and expressed their outrage by refusing to come for the body. Instead, with the complicity of the local government, they went through the college’s records looking for the names of all male students who may have had any sort of contact with the deceased. Each of these men then received an official letter from the government stating that their name was on a list of men who may have had homosexual relations with an individual who had recently died from AIDS. They were ordered to immediately report for HIV testing.

Such is the government’s ‘authoritative’ response to the AIDS crisis: an omniscient ability to mangle its citizens’ personal and professional lives.

For years, while the West was submerged in the numerous casualties of the early battles against AIDS, the Soviet Union was isolated in a preserving bell jar. During those years, had the government been willing, the Soviets could have prepared themselves for the eventual onslaught. An onslaught which could have been effectively diverted with a steady diet of prevention, education and care. Using Western techniques and knowledge acquired at the cost of many lives, the Soviet Union could have emerged from the plague relatively unscathed.

Instead, in today’s Russia, even such high-risk groups as gay men have failed to become radicalized. Chance, one of Moscow’s hippest gay night clubs, offers explicit gay porn videos and drag shows, but aside from a boastful pink triangle on one wall, there is nothing to remind young homosexual men that, without protection and foresight, each sexual encounter could be potentially fatal.

Perhaps these high risk individuals find comfort in Russia’s relatively low numbers, since 10,000 infections is a low number compared to the losses sustained in many Western countries. Yet, it is also true that these numbers are only the tip of the iceberg. If the Russian medical system continues to discourage testing, to underfund and deny treatment and to ostracize infected persons, the disastrous projections of 800,000 to a million persons infected with HIV by the year 2000 may become a reality.

Today, the United States is finally starting to see a sustained fall in deaths from AIDS. But in Russia the nightmare is only beginning. As Vadim Pokrovsky, director of the Russian AIDS Center said, “this disease is more serious and dangerous to our society than all the criminal activity that gets so much press.”