HIV/AIDS, Russia’s Other Pandemic, Expanding to Sub-Saharan African Levels

Paul Goble

            Staunton, Oct. 14 – So much attention has been devoted to the coronavirus pandemic that many Russians have forgotten that they face another pandemic as well, that of HIV/AIDS and that this epidemic now involves more than a million of them, with the rate of infections in some regions rivalling that of the poorest countries of the Caribbean and sub-Saharan Africa.

            According to Novaya Gazeta investigative journalist Antonina Asanova, Russia today now suffers from HIV cases ten times more often than do people in the European Union and in parts of the Urals and Siberia, that figure is 20 or even 35 times the EU rate (novayagazeta.ru/articles/2021/10/14/seks-bez-prosveta).

            Officially, more than 1.1 million Russians are listed as HIV infected, something that costs the economy for their treatment some 225.5 billion rubles (three billion US dollars) a year, with the government focusing almost exclusively on treatment rather than prevention, an approach that ensures the unregistered will continue to spread this disease.

            The spread of HIV can be described as “a quiet epidemic.” The first wave in the 1990s was largely limited to those who used drugs; but now almost two-thirds of new cases come from sexual contact heterosexual as well as homosexual. And the second wave now is dominated not only by that method of transmission but involves older people.

            “The largest number of new cases are not in the two capitals but in the Urals and Siberia,” Asanova reports. Kemerovo, Irkutsk and Perm are especially hit, and in the first two, “almost every 50^th resident” – that is, two percent of the population would test positive for HIV if they were all being tested.

            “Such a level of the spread of the virus should logically be compared not with Europe but with the small and poor countries of Africa or the Caribbean Sea,” she continues. “The share of HIV positive cases in the Kuzbass is comparable to that in Gambia, Haiti and Belize. And this without any exaggeration is a catastrophe.”

            Most Russians still think of HIV/AIDS as “a disease of marginals” like drug users, prisoners and youths from poor families. “But in the last five years, HIV has ceased to be an illness linked to drug use. Now, more often than that, the virus is spread via ordinary undefended sexual contact,” with 65 percent of new cases last year coming that way.

            Only 55 percent of all Russian cases are getting anti-retroviral therapies, and that means that nearly half are still in a position to spread the disease, a pattern that makes the future grim indeed. Moreover, HIV is increasingly a disease of middle-aged and older people rather than the young.

            But what is especially worrisome, experts say, is that the stigma of having HIV is still so great in Russia that many who should be tested are avoiding doing so, another guarantee that this pandemic too will only get worse in Russia.