From: fweir.ncade@rex.iasnet.ru

Date: Mon, 02 Jun 1997 15:10:21 (MSK)

For the Hindustan Times

From: Fred Weir in Moscow

MOSCOW (HT) -- Russia is facing an epidemic of sexually-transmitted diseases, particularly the deadly immuno-deficiency syndrome AIDS, for which its crumbling medical services and public education system are totally unprepared, experts warn.

"We are observing an exponential increase in people infected with the AIDS virus," says Mikhail Narkevich, head of the Russian Health Ministry's AIDS unit. "In the first five months of this year, the number doubled. We expect it to double again over the summer."

The USSR's first case of infection with HIV, the virus thought to cause AIDS, was registered in 1987. Six years ago, when the Soviet Union collapsed, the country had fewer than ten HIV carriers.

Russia currently has 4,200 officially registered cases of HIV infection and 290 people with the full-blown AIDS condition.

These numbers are small by comparison with many other countries, but experts say that's only because Russia had a late start on the epidemic.

"The Soviet Union was a closed society, and that to some extent insulated us from the epidemic that was sweeping the world," says Mr. Narkevich.

"But now intravenous drug use is sharply on the rise, and loose sexual habits are more widespread. These things are driving a catastrophic upsurge in AIDS and other diseases," he says.

Due to the breakdown of the Russian health system and the social stigma that still goes with reporting a sexually-transmitted disease, experts believe the numbers of registered HIV cases reflect as little as a tenth of the actual numbers of infected people.

"If the present rate of increase continues, we can expect 800,000 to a million HIV-infected Russians by the end of this decade," says Mr. Narkevich. "That in itself is a huge medical catastrophe, for which we are utterly unprepared."

The incidence of syphilis has increased by a staggering 40 times since 1989. Syphilis infection now stands at 177 per 100,000 people -- a rate that is more than 50 times higher than most European countries. Gonorrhea, trichomoniasis and chlamydia infections have shown similar patterns of explosive growth.

"We have noticed a direct link between syphilis and HIV infection," says Mr. Narkevich.

Public education about the health risks of unprotected sex is virtually non-existent. Russia's first attempt to introduce sex education classes for teenagers began only last year, with a modest pilot project in a handful of schools.

Until 1995 about 80 per cent of all new HIV cases in Russia were traced to sexual transmission. Experts point to the dramatic rise in prostitution since the end of the communist welfare system, with its guaranteed opportunities and job security for women.

They also warn that the post-Soviet social environment has fuelled an upsurge in popular cynicism, with accompanying patterns of sexual promiscuity and devil-may-care attitude to the consequences.

"The obvious causes that have led to this drastic rise in sexually-transmitted diseases is the fact that sex and pornography are widely advertised by the mass media," argues a recent article in Russia's main medical journal, Meditsinsky Kourier. "One of the consequences of the propaganda of sexual emancipation is the increasing number of pregnancies among teen-agers. As many as 95% of the pregnant women of the age from 18 to 20 have no permanent jobs, 70% are not married, and 50% have sex with chance partners."

Over the past two years, however, intravenous drug abuse has exploded in Russia and, with shared syringes, AIDS transmission has gone through the roof.

At the end of 1995 there were only 3 cases of HIV-positive drug addicts, says Mr. Narkevich. A year later there were almost 800. Health officials say that 70 per cent of new cases are now found among drug addicts.

Russia's estimated 600,000 intravenous drug abusers are the pipeline bringing the AIDS epidemic in full force to Russia. At the same time deteriorating public health institutions are less able than ever to cope.

"We seemed to be insulated for so long, and thought that maybe Russia was an exception to global trends," says Mr. Narkevich. "Now we are facing the flood with almost no defences."

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Johnson's Russia List

2 June 1997

djohnson@cdi.org