Hope as Russia moves to tackle an epidemic in waiting

By Dan Shea Nov 29, 2006, 12:43 GMT

Moscow - Marina, 25, fits the hip image of the 'New Russia', sporting angular glasses and abstract art-inspired shirts.

What you don't see is that she's HIV-positive.

'My life is pretty much normal,' Marina, who asked that her last name not be printed, said in the Moscow office where she works for an NGO that promotes AIDS awareness.

   Marina has a university degree. She is heterosexual and has never used drugs. And according to health officials, she emblemizes the 'second wave' of HIV infections in Russia that US experts have feared could lead to 14.5 million infections in the country of 143 million.

   In the 10 years since the incidence of HIV began to soar in the Soviet successor state, the disease has ravaged the ranks of Russia's 2 million estimated intravenous drug users.

   With the disease now entering the larger population as infected drug users spread HIV among the heterosexual community, the Kremlin has finally stepped into the fray. It made AIDS one of the themes of Russia's G8 presidency and last month nearly tripled state funding designated for AIDS programmes in 2007.

   'We will not let that outbreak happen,' Gennady Onishchenko, Russia's chief doctor and head of the country's federal consumer protection and health agency, told Deutsche Presse-Agentur dpa.

   For the first time since AIDS appeared, Onishchenko said, political will has in recent months appeared at the highest governmental levels. In Russia, that means the president.

   President Vladimir Putin has redoubled state efforts to beat back AIDS. In November, the Kremlin pledged 289 million dollars toward AIDS prevention in 2007, and Putin has vowed to supply 15,000 HIV-positive citizens with antiretroviral drugs by year's end.

   Given those measures and screenings of 20 million Russians, the country's top doctor said he hoped AIDS would become a 'banal infection' like syphilis.

   Representatives of nongovernmental organizations have also spoken well of the government's recent attention.

Valeria Sokolova of Transatlantic Partners Against AIDS (TPAA) called it a 'positive factor.'

As more and more people are infected through heterosexual sex, politicians are finally talking openly about AIDS in an attempt to slow an outbreak whose future, Sokolova said, was impossible to predict.

   Officially, 360,000 Russians are registered HIV-positive, the largest number in Europe. The United Nations says 1.6 million people could be infected, with two-thirds of all people having never been tested.

   With minimal interference from the Kremlin, AIDS flourished in the first years of the millennium. Over 59,000 new cases were registered in 2000, compared with the 30,000 that had been recorded since the country's first infection, a Soviet military translator in 1987.

   About 20,000 have tested positive this year, with government awareness programmes finally kicking in.

   Despite its atheist bent, the Soviet Union and then Russia, a morally conservative state where the Orthodox Church has great weight, allowed stigma against HIV-positive Russians to fester.

Onishchenko and other officials have taken up the AIDS fight by advocating family values sometimes more vocally than condom use.

Marina, the HIV-positive Muscovite, was infected seven years ago. Her boyfriend was a former drug user. A few months into their relationship, he tested positive. Marina, who said they had had unprotected sex, went to a clinic for a blood test.

'After I heard the result, my first thought was suicide. All I knew was that Freddy Mercury had died of AIDS,' she said, referring to the singer from the pop group Queen.

Marina added her parents don't - and won't - know of her disease.

She lives with a new, HIV-negative boyfriend, who knows her status, and his parents, who do not. 'I'm a good girl,' Marina said, and it would be unfathomable for them that she could have HIV.

Despite the residual stigma, she says conditions in Moscow are fine for someone with HIV.

There is a special hospital for people with HIV, accessible T-cell tests, free antiretrovirals if she needs them, and a large, supportive community of HIV-positive Muscovites.

Many in Moscow say the situation is worse in provincial cities. Demonstrators in the capital picketed Tuesday against delays in drug deliveries to regional cities.

Alexander Muravets, director of the US-based Population Services International office in the Volga River city of Samara, told dpa however that Samara's clinics were stocked with antiretrovirals.

Muravets said HIV had begun this year to enter the heterosexual community in the city of 1.3 million, with women comprising 50 per cent of new cases. Funding from the government and NGOs, he said, had arrived just in time to confront the second wave.

Onishchenko, the health agency chief, said he was an optimist.

'The beginning of the realization of these programmes is one of the most humanitarian steps of our society,' he added.