By Andrew Cho
Our Center’s director Dr. Beyrer and assistant scientist Dr. Wirtz recently co-authored a paper that analyzed the HIV epidemic within the Russian Federation, outlining Russia’s current status as having the largest number of HIV-1 infected citizens of all the countries in Europe. In this study, they highlighted the lack of attention given to Russia’s epidemic by the current scientific literature. The inattention is tied to the lack of international cooperation from Russia’s current administration — and the resulting limited availability of data. Dr. Beyrer and Dr. Wirtz’s study used data that is currently available on Russian policies at the federal and province levels. More specifically, they studied HIV how widespread HIV is in Russia (prevalence rates) and the risk of contracting HIV (incidence rates), prevention programs, and the impacts of current Russian policies on the current epidemic.
They found that the “most common risk for HIV infection across Russia was exposure through sharing of injecting equipment among people who inject drugs (PWID).” According to the data available to the study, PWID accounted for 48.8% of new diagnoses of any risk group, heterosexual sex accounted for 48.7%, and homosexual acts accounted for 1.5% of the new diagnoses.
Now, how valid are these statistics? Given the Russia’s stigmatization (and outright criminalization) of homosexuality and their current laws that ban “sharing of information related to homosexuality,” the study pointed out that the data they pulled from Russian sources are most likely under-reporting same-sex behavior and its contribution to the current HIV epidemic. From the violent persecution of gay men in Chechnya to the passing of the Russian “gay propaganda law,” Russia has consistently relegated individuals identifying with the LGBTQ community to an ostracized status of second-class citizens — and now, these individuals are facing a public health crisis.
Currently, HIV/AIDS is in the top 10 causes of premature death in the Russian Federation with a 35% increase in mortality from 2005. One of the most concerning aspects of this current epidemic is that harm reduction programs and appropriate awareness and prevention programs are unavailable and often illegal in Russia. Needle exchange programs, evidence-based drug treatment for opioid dependence (such as methadone), pre-exposure prophylaxis (PreP), intervention programs, and sex education resources are unavailable or lacking for Russian citizens. Tackling this public health crisis is burdened not only by its sheer size as an epidemic but also the current political climate that stigmatize the LGBTQ community. As a result of Russia’s socially conservative environment, populations at risk are actively discouraged from seeking appropriate treatment they need out of fear of being “outed,” out of fear of persecution, of torture, of death. The current HIV epidemic is, without a doubt, a public health crisis. For the international public health community, it is a challenge that is constantly exasperated by social and legal barriers that come with Russia’s current administration.