We Wouldn’t Mind If You Died of AIDS

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HIV Prevention Organization in Altai Territory Closes Due to Inability to Pay Court Fine
Takie Dela
December 4, 2018

Choice (Vybor), a non-profit HIV service organization, has been forced to close its office in Biysk, Altai Territory, due to its inability to pay a court-imposed fine, reports Kommersant. The NGO had been found guilty of refusing to acknowledge it was a “foreign agent.”

The Altai Territorial Court upheld the ruling of the Biysk City Court, which had fined Choice 150,000 rubles [approx. €2,000] for failing to recognize itself as a “foreign agent” and voluntarily place itself on the registry of “foreign agents.”

According to Maxim Olenichev, a lawyer from Attorneys for Equal Rights who represented Choice in court, on November 30, the organization was forced to close its office and cancel its HIV prevention programs in the region, including programs for intravenous drug users and other risk groups.

“HIV-service NGOS have access to ‘closed’ groups of people who are unwilling to turn to state institutions for help,” Olenichev said in an interview with reporters. “Attacking such NGOS reflects a policy of ‘traditional values,’ a policy focused on criminalizing the actions of people who do not comply with these values or ignore them. By using the law on ‘foreign agents’ to destroy NGOs, the state promotes the growth of HIV-infected people, although by joining forces with NGOs the state could halt the epidemic’s growth.”

The court ruled that several of Choice’s campaigns, during which the NGO handed out HIV express tests (41 people tested positive — TD), over 100,000 clean syringes, and 20,000 condoms for free, were “political” in nature. Choice employees noted they worked with the primary vulnerable groups as defined by the Russian state, using the same methods as specified in the official rules for HIV prevention. The court chose to ignore these arguments.

The court also agreed with the Russian Justice Ministry’s claim that Choice had received foreign funding in 2014 and 2016. Choice received 147,000 rubles from ESVERO, a non-profit partnership, and 272,000 rubles from the AIDS Healthcare Foundation.

Olenichev pointed out that ESVERO had been implementing a project of the Global Fund for Fighting AIDs, Tuberculosis and Malaria, which receives funding from the Russian government, in thirty-four Russian regions. The NGO was thus using grants to put the money back into the Russian economy. As for the AIDS Healthcare Foundation, which sponsored Choice with funding in rubles, Olenichev claimed there was no evidence in the case file that the organization was foreign. Nevertheless, the court refused to reverse the fine.

According to the latest data from the Russian Health Ministry, in 2017, 53.5% of new cases of HIV infection were caused by sexual intercourse, while 43.6% of new infections were caused by the use of intravenous drugs. According to official statistics, the number of HIV-infected people in Russia is 998,525. Eighty-one percent of them know they are infected.

The World Health Organization (WHO) has recognized Russia as leading Europe in new cases of HIV infections at 71.1 cases per every 100,000 people. The virus is primarily transmitted through heterosexual sex (59%) and intravenous drug use (30%). The Russian Health Ministry has called these figures “extremely inaccurate.”

In late October, the Saratov Regional Organization of Chronic Diabetes Sufferers announced its closure: a court had also fined it 300,000 rubles for violating the law on “foreign agents.” The expert employed by the prosecutor’s office to audit the organization concluded it had “shape[d] preconditions for discrediting the authorities” and “report[ed] about the region’s so-called sore points to [its] foreign partners.”

Thanks to Alexander Feldberg for the heads-up. Translated by the Russian Reader

The Injustice Ministry

rainbowWhile rainbows do occasionally appear in the skies above Russia, the Putin regime has pursued a consistent course of official homophobia and avoidance of the country’s out-of-control HIV epidemic. Photo by the Russian Reader

Russian Justice Ministry Proposes Tightening Oversight of Foreign HIV Prevention Programs
Mediazona
September 3, 2018

The Justice Ministry has drafted a law bill that would introduce a new procedure for running foreign programs in Russia for preventing the spread of HIV. The text of the draft law has been published for public discussion.

The ministry proposes introducing a mandatory notification procedure for all noncommercial organizations planning to combat HIV in Russia, but which receive foreign funding, whether from other countries, international organizations, foreign nationals, stateless persons, their representatives, and Russia legal entities and individuals receiving money and other property from these sources.

After receipt of such a notification, the Justice Ministry will have a month to review it. It will then either have to issue permission to operate in Russia or a substantiated rejection. If a noncommercial organization continues to work on preventing HIV after receiving a rejection notice, it will be abolished.

As the BBC has noted, four foundations preventing the spread of HIV in Russia have been registered as “foreign agents” by the Justice Ministry.

Approximately a million Russians are infected with HIV. In July, RBC reported a spike of infections in Moscow. The Russian Health Ministry responded to the report by claiming the situation was stable. It urged journalists to focus only on official statistics.

Translated by the Russian Reader

There Are No Condoms in Russia

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Developing a Moral Immunity to HIV
The Education and Science Ministry doesn’t want young people to talk about condoms
Anna Makeyeva and Valeriya Mishina
Kommersant
November 3, 2017

As Kommersant has learned, a scandal has erupted in the Education and Science Ministry over an online HIV prevention lesson for high school and university students. The people responsible for the internet project have refused to fulfill demands by officials to vet answers to users’ questions in advance, as well as their recommendations to “talk about morality in order to get away from slippery topics” and avoid such words as “condom.” It is still unclear how the lesson, scheduled for December 1, will be taught.

The Nationwide Internet HIV Prevention Lesson, timed to coincide with World AIDS Day on December 1, has been held by order of the Education and Science Ministry since 2015. On the eve of the lesson in 2016, Education and Science Minister Olga Vasilyeva noted that the issue of countering the spread of the HIV infection among children and adolescents, given the complicated epidemiological circumstances, had long been a focus of the Education and Science Ministry, and occupied a vital place in a set of measures for preserving and strengthening the health of children and young people.

“The use of such innovative methods as open internet lessons at preventive events in educational institutions will help us cope more effectively with the existing problem,” Izvestia quoted the ministry’s stated position in 2015.

On November 2, a working meeting in preparation for the upcoming internet lesson was chaired by Larisa Falkovskaya, deputy director of the department for state policy on children’s rights at the Education and Science Ministry.

“For the first time in my life, a meeting at the Education and Science Ministry ended in scandal because of my fault. I refused to write the answers for those taking part in the online HIV prevention lesson,” said Sergei Bulanov, who is in charge of organizing the online lesson and heads the Center for Modern Education Technologies, a group of non-profit organizations engaged in educational and related projects.

According to Bulanov, the officials at the meeting deemed use of the word “condom” “unacceptable,” and consequently the meeting was adjourned.

Project organizers suggested to officials they give up the practice of using prepared answers in the video lesson and discuss issues of prevention in a playful way, for example, by arranging a rap battle between student teams from two regions.

“But we were told to talk about morality in order to get away from slippery topics,” complained Bulanov, adding, “The topic is ratherly widely represented in the school curriculum, but currently the Education Ministry has adopted a surprising stance, based on substituting HIV prevention, which is mostly a matter of personal hygiene, with lessons in moral values.”

Besides, Bulanov argues it is incorrect to equate the risk of infection only with antisocial behavior.

“Thirty percent of HIV-infected women were infected by the only sexual partner they ever had. Can we reproach them for antisocial behavior? HIV-positive teenagers who have been infected from birth did not lead an antisocial lifestyle.”

Vadim Pokrovsky, head of the Federal AIDS Center, argues the view it is better not talk to children about sex currently prevails in Russia.

“It is one of the reasons HIV has spread so widely in Russia,” he said.

According to Pokrovsky, twenty percent of young women are already having sex by the age of fifteen. He added that in Germany, for example, sex education is an obligatory subject in schools. Last year, only 3,500 cases of infection were registered there, while over 100,000 cases of infection were registered in the Russian Federation.

“We see two fundamentally [different] approaches and two different outcomes,” Pokrovsky concluded.

The Education and Science Ministry declined to comment on the situation when approached by Kommersant. The Russian Federal Health Ministry learned about the conflict from Kommersant. The ministry said the online HIV prevention lesson was an undertaking of the Education and Science Ministry.

“They did not come to us with this or consult with us,” our sources at the Health Ministry said.

Sergei Bulanov assured Kommersant preparations for the open HIV prevention lesson for young people would be continued.

“We will keep on working, focusing more on recommendations from specialists at the Health Ministry and Rospotrebnadzor [the Russian federal consumer watchdog] than on the client [i.e., the Education and Science Ministry].

The internet lesson will take place on December 1, 2017.

Translated by the Russian Reader. Photo courtesy of Pravda.ru

Russian Government Refuses to Allocate 70 Billion Rubles to Combat HIV

Government Refuses to Allocate 70 Billion Rubles to Combat HIV
Polina Zvezdina
RBC
January 26, 2017

The Health Ministry has sent the government a plan for implementing the national strategy for preventing the human immunodeficiency virus (HIV) until 2020. RBC has a copy of the document, whose authenticity has been confirmed by a source close to the government, in its possession. The plan does not stipulate allocating additional funds for combating the infection. In the financial feasibility study appended to the draft plan, officials noted the agencies responsible for its implementation, as well as the regions, would have to finance the plan’s implementation.

Additional financing of the plan was stipulated in a earlier draft, also examined by RBC. In the draft, the Health Ministry had indicated additional monies from the budget, 17.5 billion rubles per annum, would be required to meet the strategy’s targets. There were plans to spend 13.2 billion rubles of this money on treatment, 3.2 billion rubles on diagnosis, and 1.1 billion rubles on treatment oversight. This funding should have made it possible for all HIV patients currently registered at AIDS centers to undergo special treatment and increase to 35% the share of the population tested annually for HIV. In 2015, 19.3% of the population was tested for HIV, while 37.3% of infected patients were provided with medical treatment.

It was the Finance Ministry that did not approve allocating the 70 billion rubles, judging by a ministry review sent to the Health Ministry on December 22, 2016. First Deputy Finance Minister Tatyana Nesterenko did not support the additional allocation, because these funds were not included in the approved federal budget for 2017–2019. In the review, the Finance Ministry argued that budgetary allocations for new spending could be contemplated only at the beginning of the fiscal year and provided that the government had additional revenues.

The government will continue its discussion of the draft plan for HIV prevention, said Denis Godlevsky, an expert at the HIV Assistance Foundation. There is a chance the Health Ministry will succeed in obtaining the full funding, he said.

"Percentages of HIV infected people in Russia. The percentage of people infected nationwide is 0.72%." In the original article, this map is interactive by region.
Percentages of HIV infected people in Russia by region. The percentage of people under the age of 60 infected nationwide is 0.72%. In the original article (go to the link at the top of the page), this map is interactive by region. The figures for Crimea and Sebastopol reflect the percentage of infected residents among all age groups. Infographic courtesy of RBC

Testing 35% of the population annually for HIV and providing 100% treatment for all registered patients were goals the Health Ministry hoped to achieve only if it received the “requisite” financing, as outlined in the HIV prevention strategy adopted by the government. If this money is not provided, the ministry proposes focusing on a different set of figures. Under the current healthcare budget, the number of people undergoing testing would increase to only 24%, while 56% of infected patients would receive treatment.

The Health Ministry has not responded to RBC’s questions as to which set of targets the ministry would follow when implementing the strategy.

If government agencies would use the funds already available effectively and rationally, the situation would begin to change for the better anyway, said Alexei Lakhov, deputy director for public relations at E.V.A., a noncommercial partnership.

“And when the situation changes for the better, a financial feasibility study can be done requesting additional appropriations,” Lakhov suggested.

The HIV prevention strategy was approved on October 20, 2016. It contained no information about funding.

Translated by the Russian Reader

Onward and Upward (The HIV Epidemic in Russia)

"HIV Positive." Photo courtesy of Gazeta.ru and Shutterstock
“HIV Positive.” Photo courtesy of Gazeta.ru and Shutterstock

UN Identifies Russia as Epicenter of HIV Epidemic
Takie Dela
July 15, 2016

UNAIDS, the United Nations organization that deals with HIV prevention, has published a report that claims Russia has the largest HIV epidemic in the world, writes Gazeta.ru.

According to UNAIDS, Russia’s regions accounted for approximately 80% of new HIV cases last year. The countries of Eastern Europe and Central Asia accounted for another 15%.  The study says that, in terms of the speed with which the number of patients has been increasing, Russia has bypassed such countries as Mozambique, Kenya, Uganda, and Zimbabwe, although the numbers of people who are infected are twice as many as in these countries as in the Russian Federation.

According to the Federal AIDS Center, there are currently 824,000 HIV-infected people in Russia. Moreover, the proportion of new cases is 11% or 95,500 people. UNAIDS experts claim the deteriorating situation is due to the fact that Russia lost international support [sic] in the form of HIV programs and has failed to replace it with adequate preventive methods paid for by government funds.

According to data from the Ministry of Health, only 37% of patients under constant medical observation receive the medicines they need, that is, 28% of the total number of patients. On June 12, it came to light that Russia’s regions have begun receiving less money from the federal government for the purchase of drugs for HIV-infected patients. The funding cuts have ranged from 10% to 30%. Due to the fact that funding is insufficient, medicines are prescribed only to patients suffering critical levels of immunosuppression.

Another factor contributing to the spread of HIV in Russia is intravenous drug use. More than half of HIV-infected people were infected in this way.

Translated by the Russian Reader

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Relevant excerpts from Prevention Gap Report (UNAIDS, 2016):

Page 174. The scale of prevention programmes for key populations was insufficient to curb the region’s surging epidemics. This was particularly true in the Russian Federation, home to the region’s largest HIV epidemic and largest population of people who inject drugs (1.5 million).

Page 178. On average, 82% of people on antiretroviral therapy have a suppressed viral load. The highest rate was in the Russian Federation (85.2% of people on antiretroviral therapy), followed by Ukraine (77.7% of people on antiretroviral therapy); the lowest rate was in Tajikistan (32%). Given that only 21% of people living with HIV were on treatment, however, the prevention effect of the suppressed viral load would have only a marginal effect on reduction in HIV incidence.

Page 178. Even the limited coverage by prevention programmes was under threat. The Global Fund has been the region’s largest donor for HIV prevention among key populations since 2004. As of July 2013, however, the Russian Federation was classified by the World Bank as a high-income country; 7 of the other 14 countries are classified as lower-middle-income countries. As a result, international support to HIV programmes in the region is decreasing, and new domestic funding for HIV prevention is not keeping pace as the priority of HIV programmes in many countries is to increase coverage of antiretroviral treatment. In the Russian Federation, 30 projects serving some 27,000 people who inject drugs were left without financial support after the Global Fund grant ended in 2014. Although remaining projects in 16 cities continued to provide essential HIV services to people who inject drugs in 2015, their scale is not sufficient to change the trajectory of the HIV epidemic in the Russian Federation.

Page 179.  In the Russian Federation a so-called “law on foreign agents” interrupted the work of community-based organizations that receive international funding to provide HIV prevention services to key population in the absence of domestic funding for these purposes.

Russia’s HIV Epidemic

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“Getting tested for HIV is easy! Find out your HIV status. Get peace of mind for yourself and loved ones.” Photo by the Russian Reader

The other day I saw this public service poster, promoting HIV awareness and encouraging commuters to get tested for HIV, on a train I was taking to the outskirts of the city. I was more than mildly surprised to see it, because AIDS and HIV had been semi-taboo subjects in Russia for a long while, despite the fact that both experts and public health officials had been acknowledging for the same long while that the country had huge numbers of HIV-infected people and those numbers were growing.

It was thus slightly comforting to see the following item in the news the other day. I guess this is what counts for progress in this country, which has increasingly been governed as if it were slightly to the left of ISIS.

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Russia’s HIV Situation ‘Epidemic’ — Rospotrebnadzor
The Moscow Times
November 30, 2015

According to Rospotrebnadzor, about 50 percent of HIV-positive Russians contracted the disease by using needle-injected drugs.  Photo: LizM/Pixabay

Russia’s HIV infection rates have become epidemic, spreading to citizens beyond at risk groups, the head of Rospotrebnadzor’s epidemiology supervision department in St. Petersburg, Irina Chkhindzheriya said, the Interfax news agency reported.

Russia’s HIV infection rates have become epidemic, spreading to citizens beyond at risk groups, the head of Rospotrebnadzor’s epidemiology supervision department in St. Petersburg, Irina Chkhindzheriya said, the Interfax news agency reported.

“We have to admit that the country’s soaring HIV rates can be described as epidemic. About 1 percent of Russians are HIV-positive … The epidemic has broken through traditional limits and is spreading to the general population,” Chkhindzheriya said, Interfax reported Monday.

According to Rospotrebnadzor, about 50 percent of HIV-positive Russians contracted the disease by using needle-injected drugs, and 42 percent — through heterosexual contact.

About 1 percent of pregnant Russian women are infected with HIV, giving birth to more than 600 congenitally infected infants every year, the report said.

“Statistics show that approximately 50 people per 100,000 of the population are HIV-positive, and the situation becomes much worse in the regions,” Chkhindzheriya said, Interfax reported.

At the start of the month, the total number of registered HIV-positive Russians numbered 986,657.

Editor’s Note.  The CIA World Factbook estimated the population of Russia as 142,423,773 in July 2015. 

Let’s (Not) Talk about Sex

sexikas-1
“Relaxation 24 hours,” Petrograd, December 2014. The city’s pavements, walls, and billboards are teeming with such offers of paid sex.

Every day more than 200 new cases of HIV are registered in Russia, and by the end of 2015 the number of HIV-positive Russians will exceed 1 million, according to news reports released on Monday, World AIDS Day.

Russia’s health and safety watchdog Rospotrebnadzor told Interfax that “860,000 HIV-positive people are currently registered in Russia, and every year this figure increases by 10 percent.”

In a speech to the State Duma on Monday, Anna Popova, head of Russia’s health and consumer watchdog Rospotrebnadzor, said that 75 percent of males who became infected with the virus this year had become HIV-positive by taking drugs. This leads to severe damage to the country’s economy, as these men are usually in their most productive years, she said.

Vadim Pokrovsky, head of the Federal AIDS Center, said that contrary to popular belief in Russia, only 1.1 percent of cases are registered among gay men. The rest are “heterosexuals who lead normal sex lives,” he was quoted as saying by Interfax.

Many regions do not have enough money to provide sufficient medication for HIV-positive people, Pokrovsky said.

“The number of HIV-positive people is growing very quickly. In three years it has increased by 200,000, while the amount of money allocated from the budget to deal with the problem has not changed,” he was quoted as saying by Interfax.

Russia has come under international criticism for its policy on HIV, such as prohibiting opiate-replacement therapy using drugs such as methadone. The practice has been shown to reduce needle sharing among drug addicts, thus reducing the HIV infection rate. The government has also been reluctant to embrace needle-exchange programs, another weapon proven to be effective in combatting the disease.

Critics also argue that more preventative measures need to be taken, starting with increased sex education in schools.

—Ivan Nechepurenko, “Number of Russians With HIV to Reach 1 Million by 2016,” The Moscow Times, December 1, 2014

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You don’t need sex education when you have Russian literary giants Leo Tolstoy and Fyodor Dostoevsky to enlighten you on the murky realities of the bedroom.

This, at least, appears to be the view of Russia’s children’s rights ombudsman Pavel Astakhov, who said on Monday that the country would not introduce sex education in schools because it contradicts Russia’s moral norms and traditions.

“I am often asked: When will you have sex education? I say: Never,” Astakhov snapped at a meeting with Russian parents, Interfax news agency reported.

Astakhov’s statement followed his complaint about an upcoming meeting with his European counterparts in Brussels next week.

The ombudsman said his European colleagues have branded him an “ideological opponent and enemy” because of his uncompromising drive to prevent children from learning about sex.

But he would still cooperate with fellow ombudsmen, said Astakhov, a former celebrity lawyer known for advocating a ban on U.S. adoptions of Russian children.

Astakhov gave his own recipe for teaching teenagers about sex last year, when he said Russian literature offered a goldmine of information on the subject.

“Children need to read more, it has everything on love and relationship of the sexes,” Astakhov told Rossia-24 television.

The staples of the literary curriculum in Russian schools, such as Dostoevsky and Tolstoy, are notably short on advice on contraception or how to deal with budding homosexuality or other non-heterosexual orientations.

A good thing, according to Astakhov, who said “school should raise children to be chaste and understand family values.”

“Russian Children Need More Tolstoy — Not Sex Ed, Official Says,” The Moscow Times, December 1, 2014

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Offers like this from “Lora,” “Eva” and other brothels and prostitution rings are pasted everywhere in the city, including on this billboard for a Christmastime theatrical production for children.

[…]

While Russia may be more notorious for its homegrown cheap sex labor, these days inbound sexual traffic in fact far exceeds the exports, thanks to Russia’s previously stable economy, which ensures a steady demand for prostitutes, experts said.

The country is now at once a destination, origin and transit country for sex slaves — part of a 1-million-strong slave force that exists in Russia, according to a recent report released ahead of the International Day for the Abolition of Slavery on Dec. 2.

But the government and the legislature both ignore the problem for fear that it would damage Russia’s reputation, even though sex trafficking exists everywhere, said activist Boris Panteleyev.

“Admitting the existence of slavery, in the eyes of officials, would harm our prestige,” said Panteleyev, head of the Man & Law NGO and a former prosecutor who has been combatting human trafficking since the 1990s.

As a result, sex slaves in Russia struggle even if freed, and have to rely on NGOs, clerics or police generosity in the absence of state rehab and protection programs.

“Russian criminal legislation is insufficient, and existing laws say nothing about help for victims,” said Yelena Timofeyeva of the SafeHouse charity.

[…]

Russia ranked as the country with the sixth-biggest slave population in the world — 1 million people — in a fresh annual report by the Australia-based Walk Free Foundation released last week.

The report put the total number of slaves among 167 countries of the world at 35 million. India was the runaway leader with 14 million slaves, while Mauritania had the highest percentage of slave population (4 percent).

[…]

—Alexey Eremenko, “Sex Slavery Thrives in Russia Out of Public View,” The Moscow Times, December 1, 2014