In much of the world, rates of HIV infection are falling. In Russia, they’re going through the roof.
Claudia Williams, narrating:
Hi, I’m Claudia and this is the Sensemaker.
One story every day to make sense of the world.
The global effort to fight HIV is one of the biggest good news stories of the last decade.
After years of public health campaigns, policy-making and drug research the number of people getting infected with HIV around the world is in decline – fewer people are dying too.
But there are some places where the rate of new HIV cases is climbing – one of them is Russia.
Today I’m asking: what’s behind Russia’s HIV epidemic?
[In Russian]Yury Dud, YouTube
Last year, Yury Dud, a YouTube vlogger, did something that, if you are from Russia, is pretty remarkable. He started talking about HIV in his country.
In fact, he made an entire documentary about it.
And it was an incredible thing to do, because in Russia, no one really talks about the disease. There’s a lot of fear and stigma around it.
Here’s an HIV positive man – who’s also an HIV activist – talking about people’s perceptions of the disease in Russia:
“The extreme stigma against HIV positive people in Russia stems from fear. Many still think HIV can be transmitted by breathing the same air that HIV positive people should be rounded up denounced.”DW News
Yury Dud wanted to get rid of that stigma, because ignorance about HIV is killing people in his country.
So he did everything he could to spread the word. He gave his audience the facts about how HIV spreads – and how they can stop it.
He interviewed people living with HIV about their experiences. He showed that, with the right drugs and treatments, HIV positive people can live normal healthy lives – without any risk of transmitting the infection.
But Yury Dud wanted to show how urgent the problem was too.
So he started with the statistics.
[In Russian]Yury Dud, YouTube
He’s talking about them there.
And the big stat he mentions is this one: there are more than a million people living with HIV in Russia.
And that number is climbing every year at an alarming rate.
Earlier this autumn, a Russian government agency released data showing that 60,000 new cases of HIV infection were recorded last year – that’s compared to 25,000 cases across the whole of the European Union.
When you average it out across the population, the rate of new HIV infections in Russia is ten times higher than in the EU.
And recent analysis of the government’s data by Novaya Gazeta, a Russian newspaper – data which was also covered by The Times in the UK – found that in some parts of the Urals and Siberia, the rate of HIV infection is even higher – 20 and 35 times higher than in Europe.
It’s a real public health emergency, because not only are cases rising, deaths are too.
In 2018 alone, 37,000 people in Russia died of AIDS-related illnesses. That’s not something that happens often here in the UK anymore, because our healthcare system tries to diagnose and treat people with HIV long before the disease can progress to AIDS.
Remember, HIV is a disease that’s treatable and preventable – we know how to stop it spreading.
So why is the situation in Russia so bad?
That’s one of the questions Yury Dud was asking in his documentary.
And he identified a number of issues.
The first is that there’s a lot of illegal drug use in Russia.
Millions of people inject opioid drugs – and a lot of them are sharing needles.
“Injection drugs use has been the main driver of Russia’s epidemic. In some cities today a staggering 30 per cent of people who inject drugs are also HIV positive.”
The government doesn’t do a lot to help drug users, what people really need are needle exchanges: programmes that help drug users to get clean needles.
But organisations like that are targeted by the government – it says that they are promoting drug abuse.
Next, there’s a big problem with sex education.
The Russian Orthodox Church is a powerful force in Russian politics and society – and it’s very conservative.
The church is an important ally of Russia’s president, Vladimir Putin – and he doesn’t want to get on the wrong side of them.
So instead of teaching people about safe sex and HIV prevention, the government promotes “family values”.
The result? Thousands of people are getting infected with HIV through unprotected sex.
The last big issue is treatment.
Only around a third of Russia’s HIV positive people have access to the antiretroviral drugs they need.
If you take those drugs every day, they keep the disease at bay – and stop HIV positive people from infecting other people.
But in Russia there are massive shortages of those drugs:
“Russia’s national budget covers the treatment of only 300,000 HIV positive Russians, nowhere near the estimated 1 million who need care.”PBS News
And there’s no programme offering preventative drugs like PrEP, which helps stop people at high risk of HIV from getting infected in the first place.
But really, all of this comes back around to that problem of stigma that Yury Dud talked about in his documentary.
One of the reasons HIV is so stigmatised is because the groups at greatest risk of the disease – drug users, gay people and sex workers – are groups that are already marginalised and persecuted in Russia’s deeply conservative society.
Vladimir Putin’s government is partly to blame here.
President Putin promotes conservative attitudes – Russian nationalism and “traditional Russian values” are both big parts of his political message.
So doing the things that would help prevent HIV – teaching people about safe sex, treating drug users with dignity, and supporting vulnerable, marginalised groups – aren’t things that fit with his government’s conservative political stance.
Stigma around HIV drives how the government treats the disease.
And in turn, the government is driving the stigma.
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