Russia will create its own programs rather than borrow ideas from abroad to fight the biggest HIV epidemic in Eastern Europe, the country’s top epidemiologist, Gennady Onishchenko, told an AIDS conference Wednesday.
Health professionals at the third Eastern Europe and Central Asia AIDS Conference, which opened Wednesday in Moscow, cautioned that the problem was growing rapidly, largely because of illegal drug use, and the government needs to contribute more resources to prevention programs.
Russia has followed an abstinence-based strategy for curbing the spread of HIV, and Onishchenko indicated that it would continue to do so.
“Maybe methadone therapy can be implemented in some countries, but not in Russia,” Onishchenko told reporters.
HIV prevention workers in Western countries widely support methadone therapy, typically offered at clinics, as a treatment option for heroin users that reduces their vulnerability to HIV infection from contaminated needles.
Methadone has helped to halve the spread of HIV infections in many countries, Robin Gorna, executive director of the International AIDS Society, told the conference.
Russia is the world’s biggest consumer of heroin, according to the Federal Drug Control Service, and most new HIV cases are among drug users.
Onishchenko also criticized needle exchange programs, which are credited with lower infection rates in other countries, saying they promote narcotics sales and HIV transmission.
It is unclear how many people are infected with HIV in Russia. The United Nations puts the figure at 1.1 million of Russia’s 143 million population, while the government’s Federal AIDS Center has registered about 501,000 cases. Eighty percent of those diagnosed with HIV were between 15 and 30 when they registered with the health authorities, the AIDS center said.
UNAIDS regional director Denis Broun told The Moscow Times that he believed the number of HIV-infected people was closer to 900,000 and growing rapidly.
“The epidemic continues to grow. It hasn’t become steady and reversed,” Broun.
Since the Group of Eight summit in St. Petersburg in 2005, the government has boosted annual HIV spending by 33 times to 9.5 billion rubles ($325 million), but most of the funds are spent on treatment, Broun said.
While Russia has achieved success in treatment, preventive efforts need more support, Broun said.
“The relationship between the government and society is not trustful yet, but it’s needed for a successful HIV prevention,” Broun said. “We are worried that prevention programs are no longer a priority of Russian health care.”
Some other countries in the region, like Belarus, have managed to reverse the HIV problem by paying more attention to prevention programs, he said.
A grant from the Global Fund to Fight AIDS that supported HIV prevention programs ended in August, and the fund’s executive director, Michel Kazatchkine, said he hoped the government would keep the programs in place.
Onishchenko did not say whether the programs would be maintained.
The economic crisis, meanwhile, has put more people at risk of infection, Broun said.
“With the economic crisis, more people have become at risk of drug use,” he said.