Pride (and Prejudice)

A Pride flag near the Russian coat of arms during a protest outside the Russian Embassy in London, 16 March 2023. Krisztian Elek/SOPA Images/LightRocket via Getty Images

Russian authorities have banned nine groups that provide support to lesbian, gay, bisexual, and transgender (LGBT) people as “extremist,” Human Rights Watch said today. The apparent aim is to further suppress, stigmatize, and criminalize those who document abuses, share information, and provide legal, medical, and other assistance to Russia’s LGBT population.

Following the 2023 Russian Supreme Court decision to outlaw as “extremist” the “International LGBT Movement”—a legal and factual mischaracterization of a diverse, decentralized global human rights cause—the authorities have targeted numerous civil society organizations. Between March and May 2026, courts banned nine LGBT groups in seven Russian regions as “extremist,” namely Coming OutLGBT Resource CentreParni PlusMoscow Community Center for LGBT+ InitiativesIridaRussian LGBT NetworkKallisto movementT9 NSK, and Centre T. A lawsuit against Alliance of Straights and LGBT for Equality is pending.

“Russian authorities are intensifying their criminalization of those who provide critical support to the very LGBT people they have systematically persecuted,” said Hugh Williamson, Europe and Central Asia director at Human Rights Watch. “Authorities should vacate all court decisions and criminal convictions based on these spurious ‘extremism’ charges.”

On April 22, a court in Orel banned Parni Plus, an LGBT media outlet. The court based its decision largely on an “expert assessment” by the Nizhny Novgorod Academy of the Internal Affairs Ministry, effectively a law enforcement university. It found that Parni Plus “belittled Russian spiritual values and showed contempt for Russian President Vladimir Putin,” criticized Russian laws, and attempted to create “an alternative, anti-state hierarchy of values.” Parni Plus said the authorities were “trying to label the visibility, voice and experiences of the LGBTQ community as ‘extremism’” and said it would continue its work.

A similar report formed the basis for the Moscow city court ruling banning the Moscow Community Center for LGBT+ Initiatives on April 23. The center said it “cannot ignore the fact that queer people have not ceased to exist and require support.” The group also said it would continue its advocacy and providing psychological, legal, and other support.

Centre T called the May 4 decision by the Moscow city court to ban the organization “unfounded and repressive.” The group pledged to continue its work to provide support and information for transgender and nonbinary people.

On March 3, the Saint Petersburg city court banned Coming Out, a prominent LGBT support group, as “extremist.” The group said the authorities have been expanding the definition of extremism to criminalize “virtually any independent activity, any dissent, or any act of solidarity to isolate, intimidate, and silence those who speak about issues and support vulnerable people.” Coming Out said it would continue its work to resist the state’s efforts “to make LGBT+ people unseen and unheard.”

Russian LGBT Network, which the Saint Petersburg city court on April 27 also banned as “extremist,” said the court’s judgment had “nothing to do with justice,” and that its activities essentially consisted of supporting the LGBT community, documenting discrimination, protecting rights, and discussing the situation of queer people in Russia. It also said it would continue its work.

On April 7, the Sverdlovsk Region court outlawed the LGBT Resource Centre. The court said the center engaged in “propaganda” and that its activities contradicted Russia’s state policy. On April 29, the Yaroslavl Region court banned Kallisto as “extremist,” claiming the movement aimed to “reshape and effectively destroy Russia’s fundamental spiritual and moral values, in particular traditional family values.”

On May 19, a court in Novosibirsk used the same reasoning to ban T9 NSK, an initiative that supported transgender people and their friends and family. The group shut down its website and social media accounts. In May, the Saint Petersburg city court registered the Justice Ministry’s lawsuit to ban the Alliance of Straights and LGBT for Equality as “extremist.” The group said it would continue working to provide support, security, overcome isolation and censorship, and focus on education and outreach. This was the last known case to be tried, in closed proceedings.

Under article 282.2 of Russia’s criminal code, participation in organizations banned as “extremist” carries penalties of up to 6 years in prison, while leading such an organization carries up to 12 years. Donations to such organizations are punishable with up to 8 years in prison under article 282.3, and repeated displays of “extremist” symbols, such as the rainbow flag or banned organizations’ logos, up to 4 years under article 282.4.

On March 6, a court in Samara convicted Artyom Fokin, the leader of Irida, a local LGBT community organization, on charges of leading an “extremist” organization and repeated violation of the country’s repressive “foreign agents” legislation and fined him 450,000 rubles (US$6,000). A Samara court subsequently banned the group on April 24.

Human Rights Watch monitoring has found that at least nine people had been convicted on criminal charges based on the “extremist” designation of the “International LGBT Movement,” including for allegedly leading organizations supposedly belonging to this movement, sharing content, organizing drag shows, conducting activism, or supporting same-sex dating. At least 25 others are facing criminal charges.

In 2023, the United Nations high commissioner for human rights, Volker Türk, condemned the Russian Supreme Court’s “LGBT-extremism” ruling. Independent UN human rights experts warned that the designation enables arbitrary and abusive application of the law and jeopardizes a wide range of activities protected under international human rights law.

“The Russian government’s banning of LGBT rights organizations is absurd, harmful, and discriminatory,” Williamson said. “Rights-respecting governments should support Russian LGBT groups and activists, including by enabling them to continue their work from abroad.”

Source: “Russia: LGBT Rights Groups Further Criminalized,” Human Rights Watch, 28 May 2026


Evgeny Pisemsky, founder and editor of Parni Plus, at the 2024 Pride parade in Bristol. Photo: Evgeny Pisemsky/DW

It has been nearly three years since the nonexistent “International LGBT Movement” was declared an “extremist” organization by the Russian Supreme Court, per its 30 November 2023 ruling. The decision unleashed a crackdown resulting in over one hundred convictions on charges of “LGBT propaganda.” Russian police have detained people at clubs and private parties, and queers have been remanded in custody and fined several thousands of rubles. Numerous LGBTQ+ organizations have been targeted, and many of them have been declared “extremist” as well, although they provided medical and legal assistance, hosted cultural events, and reported on the queer community via social media. Deutsche Welle spoke with members of these organizations about how they continue to operate in Russia and render assistance to people despite all the obstacles.

“The greater the pressure has been, the more attention we’ve paid to the LGBT movement”

Parni Plus, which has been around for eighteen years, is the principal Russian-language queer news website, and it has been closely linked to Phoenix Plus, an NGO that was founded two years earlier. Phoenix Plus focused on raising awareness, promoting free testing, and supporting HIV-positive people. Phoenix Plus’s chair, the cisgender male Evgeny Pisemsky, had also worked as a volunteer at the public awareness center Info Plus. Since Info Plus provided little specific information for HIV-positive gays, the idea arose to launch the site Parni Plus.

“Originally, running the site was my hobby, but at one point I realized it was a great way of reaching a bigger audience,” Pisemky, who became the website’s editor-in-chief, told DW.

Parni Plus has transformed along with the changing political climate in Russia. After the Russian State Duma passed a law banning “promoting LGBT to minors,” the site started publishing articles about the LGBTQ+ movement’s fight for its rights.

“The greater the pressure has been, the more attention we’ve paid to the LGBT movement,” Pisemsky explained to DW.

At one time, the media project tried to “navigate” the legal obstacles while also publishing articles criticizing the authorities for ignoring HIV prevention. This resulted in numerous instances when the authorities blocked the website.

“Our lawyer and I would send off complaints to Roskomnadzor [the Russian media watchdog] along the lines of ‘Where did you find that?’ and they would unblock us every time,” said Pisemsky.

When Phoenix Plus was declared a “foreign agent,” in 2020, Pisemsky had to shut it down in order to safeguard Parni Plus. But its consciousness-raising and activism continued, as Pisemsky consistently helped people get online HIV consultations from anywhere in Russia. The covid-19 lockdowns and Russia’s subsequent full-scale invasion of Ukraine did not put a stop to the organization’s work either: its team was ready to assist anyone and everyone remotely.

The team made the decision to reject the “18+” warning label it had been obliged to post on the website. In June 2023, they wrote that information about sexuality and sexually transmitted diseases were particularly vital to children and adolescents.

“[W]e are sick and tired of turning our back on queer children and teenagers. They are the most vulnerable segment of our communities, which are in particular need of support nowadays. We are not only freeing them from the need to lie when accessing the site. We [also] plan to publish many more articles just for minors,” they wrote.

After the LGBTQ movement was declared “extremist” in Russia, the Parni Plus team was forced to flee the country.

“We became ‘foreign agents’ twice: first as Phoenix Plus, and then as Parni Plus. Practically all our reporters were also declared ‘foreign agents’, and we racked up over twenty fines, totaling two million rubles,” Pisemsky recounted.

He argues that remaining open matters most of all.

“The ‘extremist’ label makes you worry about family members, and the authorities have been trying to erase us, but we have been surviving against the odds. It is vital to LGBTQ+ people that [our] organizations remain visible,” said Pisemsky.

80% of transgender people in Russia want to leave

Centre T is an organization specializing in assistance to trans people. It emerged in 2020 from a therapy group run by Yan Dvorkin, who is non-binary, and his colleague.

“We didn’t plan on founding a special organization. We were just psychologists who did sessions for trans people. But we quickly realized that our clients had a huge number of unmet needs in different areas, and that there was nowhere in Moscow for them to turn. There was nowhere to refer people for medical care or for meeting people and relaxing,” Yan explained.

That was how Centre T came into being. Its first project was called “Plush Toy Cat”—monthly tea parties featuring board games and dancing. These events took place for several years and, according to Dvorkin, would draw as many as 150 people.

“People from the regions would even come to hang out with other transgender people. It was an unbelievably positive experience: the participants found friends, partners, and future roommates at the get-togethers.”

Centre T gradually expanded. Its staff began providing consultations on emigration and means of obtaining medical care. They engaged in public education and community building, opened a shelter in Moscow, and set up regional associations.

After Russia’s full-scale invasion of Ukraine, the Centre T team immediately sensed that negative changes were afoot in Russian society. According to Dvorkin, the active persecution of trans people in Russia kicked off precisely after February 2022, culminating in the 2023 law banning “sex change” (the correct term is “gender transition”).

“We worked with a medical board based at a clinic, and its physicians treated transgender people with respect. They issued diagnoses of ‘transsexualism’—a classification that enabled individuals to start redoing their identification papers and getting ready for surgeries. The passage of the law banning gender transition changed everything. We had fought against its adoption, and it was largely for this reason that our organization was designated a ‘foreign agent’ in 2023,” he said.

Dvorkin has no regrets that Centre T put up such a fierce fight. The team received many words of support in return.

Centre T staff members attended court hearings of cases involving LGBT individuals. Members of ultra-right gangs would occasionally attack them at the entrance to the courthouse.

Dvorkin described how the Centre T team coped with tough times.

“One time they attacked us with pepper spray and a child passing by got caught in the crossfire. His mother came to our defense and went with us to the police station. But our arguments about dangerous radicalization or the literal example of who was actually harming children fell on deaf ears in court. After losing such cases we would go to my place to ‘celebrate’ by eating a cake baked in advance and singing along to a guitar,” he recounted.

After the “LGBT movement” was ruled “extremist,” it became much harder for Centre T to operate, as many organizations voided their cooperation agreements with them, and they had to cancel in-person events. The situation in Russia changed drastically, and Centre T began moving its staff members abroad; many of them had been charged with violating the anti-LGBT “propaganda” law. Centre T also made the decision to close its Moscow shelter, which had attracted unwanted attention.

“This dude tried to kick down the door. We called the police. Our people saw through the window that he went outside, shook the policeman’s hand, and they went their separate ways,” recounted Dvorkin.

Currently, Centre T continues to operate online: it helps people access medical care and responds to crisis calls, providing support not only to trans people and their families but also to professionals at various levels. Centre T has also been providing more robust counseling on emigration matters.

“It has become clear that transgender people can no longer live a normal life in Russia. Eighty percent of transgender people in Russia want to leave and are looking for a way to do so,” concluded Dvorkin.

Although he sees Centre T’s new status as an “extremist organization” as dangerous, he has no plans to go into hiding.

“If I’m detained and extradited, then that’s life,” he said.

The MCC has gone underground

Unlike the majority of LGBTQ+ organizations, the Moscow Community Center for LGBT+ Initiatives (MCC) is still engaged in offline work in Russia and make it their emphasis. The MCC was formed in 2015 and conceived as a place where people could drop in, feel safe, and have a good time by reading books, drinking coffee, attending themed events, and meeting new eople. In 2019 it was transformed into a co-working café.

“We wanted casual passersby to be able to walk into our café, see the special ‘signs,’ and immediately realize they were in an LGBT space,” notes Olga Baranova, the MCC’s non-binary president.

Another of the MCC’s big projects is the queer festival OpenArt. Launched in 2017, it still takes place, under wraps, in Russia. Although it is hard to imagine now, the festival’s first edition was even guarded by police officers.

“An FSB officer arrived and asked what was going on. I told him to come in and have a look. He was afraid of possible riots and that skinheads would go after the festival attendees on the dark streets and beat them up. So we were assigned a police patrol. The provocateurs showed up at the doors, of course, but our guards kept everyone safe. No one inside noticed a thing,” Baranova recounts.

Despite the law against “gay propaganda” among children, the MCC managed to navigate the obstacles and and engage with a young audience: in 2022, for example, the festival was held in a two-story venue, with a 16+ area on the first floor. Nevertheless, it wasn’t without its challenges.

“Center ‘E’ officers [the Russian Interior Ministry’s anti-“extremism” police] came and talked with me. They asked me to shut everything down. Ultimately, though, the festival was a huge success,” Baranova recalls.

When the “International LGBT Movement” was declared “extremist” by the Russian authorities, the MCC went underground. The organization is now focused on emergency assistance, whether that means moving people abroad or getting them into a shelter.

“It’s important to remember that we cannot help everyone because we simply don’t have the resources,” Baranova points out. “If the police are pounding on your door, if you’re up against a tough situation in life, then you definitely should write to us and submit a request.”

Otherwise, the MCC continues to hold events on important topics, and their goal is to ensure that people do not end up being isolated.

“We see what are our beneficiaries need and every three to six months we change the focus of our meetings,” notes Baranova. “For example, right now many of them are looking for jobs.”

The community center wanders among various venues, and Baranova regrets the constant need to move from place to place. “In your own home you can put your favorite pillow on the bed and your favorite glass on the table. These are the things that create a sense of home, not bare walls,” she complains.

Members of the Russian LGBTQ community are persecuted for their identity

Eighteen years ago, a small community center called Coming Out opened in St. Petersburg. Since then, it has grown into one of Russia’s leading LGBTQ+ rights organizations. Coming Out also provided free psychological counseling and ran in-person solidarity groups, but its primary activities were legal support and consultations.

Thanks to Coming Out, there is an archive of accounts of discrimination against queer people in Russia.

“Long before 2022, we gatherd accounts of discrimination against queer people by law enforcement, of workplace and domestic discrimination, and of discrimination at medical and educational institutions. We analyzed the messages transmitted by the state propaganda machine and corroborated the existence of worrying trends with the numbers. We annually presented the outcomes of our work to Russian and international officials,” Denis Oleinik, a cisgender man and Coming Out’s executive director, explained to DW.

Coming Out was designated a “foreign agent” by the Russian authorities in December 2021. A few months later, realizing they could no longer work in Russia because they could not guarantee their own safety, the organization’s staff gradually fled Russia and moved its entire operations online. When Coming Out was declared an “extremist” organization, in March 2026, all of its staff members were ready for this turn of events, according to Oleinik.

“Over the past four years, we’ve learned to do everything remotely, put together a secure volunteer system, and set up systems for gathering and storing information that are as anonymous as possible. It’s really important to us that the beneficiaries of our assistance are safe and that the help we provide doesn’t harm them. To date, there have been no cases of people being persecuted for receiving support or assistance,” he explained.

Oleinik wants anti-queer discrimination to disappear in the future, but Coming Out’s research paints a completely different picture.

“In 2025, members of Russia’s LGBTQ community were subjected to persecution and discrimination not only for things they said or wrote but also for their very identity. Thus, in 2025, posting personal photos featuring kissing, publishing a blog about the lives of a same-sex couple, and organizing meetings in one’s own home were classified as ‘propaganda’ and ‘extremism,'” its report says.

This means that Oleinik and his colleagues have their work cut out for them.

Source: Dima Yelagin, “How ‘the boys’ became a threat to Russia,” Deutsche Welle Russian Service, 16 June 2026. Translated by the Russian Reader


Kolya* says they would not dare to go to a state health-care facility for the therapy they are receiving for a mental health condition. The 19-year-old from a city in Russia’s far-east, who identifies as non-binary and gay, tells The Lancet they fear that information about their sexuality could be passed on to other state institutions and used against them in some way. “I wouldn’t have told the mental health specialist treating me about my sexuality if they weren’t a private doctor. I wouldn’t tell the municipal clinic, I wouldn’t want them to have that kind of information about me in case they passed it on somewhere”, they say.

Kolya chose a private clinic because, like many in the LGBTQ+ community, they perceive them to be less likely to divulge their gender identity or sexuality to others, and less likely to be discriminatory. Kolya’s distrust of the Russian health-care system, and their avoidance of it, is becoming increasingly common among the heavily marginalised LGBTQ+ community, according to one of the largest surveys of how LGBTQ+ people are living in Russia, released in May.

The survey of more than 6000 people in Russia by the Coming Out and Sphere Foundation organisations showed a significant rise in the number of LGBTQ+ people avoiding seeing a doctor for fear of discrimination or biased treatment last year, reaching 35%.

Many of the respondents who reported discrimination said they had faced inappropriate comments, jokes, or offensive remarks from medical professionals, as well as experiencing reproductive coercion. Others specifically mentioned issues that arose when seeking help from psychologists and psychotherapists. In such cases, respondents reported instances of outing and breaches of confidentiality, including the disclosure of information about sexuality or gender identity without their consent.

The report’s authors say LGBTQ+ people, and especially transgender people, are losing access to medical services due to this distrust. “In our latest survey we saw a 6 percentage point year-on-year rise in people avoiding seeing a doctor. Historically, annual increases for this indicator have been in the range of 1–2 percentage points. A 6-point rise represents a marked departure from that trend—that’s why it is significant”, Denis Oleinik, Executive Director of Coming Out, told The Lancet.

“If this rate of increase were to continue at the same pace annually, within 5 years a substantially larger proportion of LGBTQ+ people would be avoiding medical care, with serious consequences for both individual health outcomes and broader public health. The 6-point rise may not sound dramatic in isolation, but viewed against the historical baseline and the potential trajectory it represents a genuinely concerning shift”, he added.

Over the past decade, a series of repressive anti-LGBTQ+ laws have been passed in Russia, including bans on any public information or activities supporting LGBTQ+ rights or displaying non-heterosexual orientation, on same-sex marriage, and on transgender people officially or medically changing their gender. A 2023 ruling by the Supreme Court also banned the international LGBT movement, declaring it extremist, allowing people to be fined or prosecuted for anything that could be construed as promoting “non-traditional sexual relations”.

In previous years, authorities have used these tools to crack down on groups and activists taking action to support LGBTQ+ rights, but now they are increasingly being used against individuals, with prosecutions even for displaying or wearing rainbow-coloured materials. “The persecution has moved to people being targeted not for something they have done, but just for being LGBTQ+,” said Oleinik. This in turn has made many in the community concerned about going anywhere, including health-care facilities, where their gender identity or sexual orientation could be identified and possibly disclosed.

Vitaly Djuma, Executive Director at the Eurasian Coalition on Health, Rights, Gender and Sexual Diversity told The Lancet that, in many cases, an LGBTQ+ person with a particular complaint that could be linked to non-heterosexual sexual behaviour would “not give up that kind of intimate information unless they really trusted the doctor, especially if they thought it could lead to disclosure [of their sexual orientation]”. Instead, he said, they would be forced to go to a private clinic, if they could afford it, or risk seeking treatment within state health care. “They would have to just try and deny the complaint is any indication of their sexuality”, he added.

Groups providing harm reduction services in Russia say that LGBTQ+ people are accessing their services, which they can legally provide to other key populations, to resolve health issues. “The LGBTQ+ community is increasingly reaching out to us in a more discreet way, sometimes through third parties. People are afraid to disclose that they are LGBTQ+”, a worker at a non-governmental organisation in a major Russian city, speaking on condition of anonymity, told The Lancet.

The situation is especially difficult for transgender people, who, the survey shows, are more likely to face discrimination in health care, and more likely to avoid going to a doctor, than other members of the LGBTQ+ community. Oleinik said there were “few cases where doctors or clinics outright rejected providing services to someone just because they were gay or lesbian, but for trans people, it’s much worse”.

He added that there had also been cases of transgender people who, with medical changing of gender banned, turned to the black market to get the medicines they needed to transition, administered them unsupervised, and subsequently became ill.

Lucy Shtein of the North Caucasus SOS crisis group, which evacuates persecuted LGBTQ+ people from Russia, pointed out that following the ban, transgender people had become even more vulnerable as a group. “After the ban on gender transition, access to medical care became even more restricted for them”, she told The Lancet.

Furthermore, anti-LGBTQ+ legislation has forced groups which provided health services for members of the community, such as harm reduction, prevention of sexually transmitted infections, or psychosocial help, to either close down or leave the country, cutting off another line of access to health care for people who do not trust state medical services. Experts say it is difficult to determine what effect this avoidance of, and inability to access, health care, is having on health among the LGBTQ+ community in Russia.

Data for some common health indicators in the community, such as numbers of HIV/AIDS cases and other sexually transmitted infections, as well as depression and other mental health conditions, are not always available or lack relevant detail. Although there are official figures for the number of people currently living with HIV and new infections, specific data on epidemiological trends among key populations is either not publicly available or, according to experts, not reliable.

Routes of transmission—according to some reports most new infections are now transmitted through heterosexual contact—are determined through self-reporting, while historical data have shown the proportion of overall HIV testing carried out among key populations is decreasing year on year.

This makes it very difficult to get an accurate picture of the epidemiological situation for the disease among the community, which could indicate potential wider consequences of individuals avoiding health care.

“Data for transmission routes is unreliable with the use of self-reporting and a large amount of unidentified transmissions. The HIV epidemic is absolutely still ongoing among men who have sex with men and other members of the LGBTQ+ community, especially in big cities where the practice of chemsex is burgeoning”, Djuma said.

Oleinik added that systematic research on LGBTQ+ people has become essentially impossible as researchers, non-governmental organisations, and public health professionals cannot gather such data without risking being associated with extremist activity. “If anything does exist in official sources, it tends to appear exclusively in negative framing—for example, linking same-sex behaviour to HIV transmission in ways that stigmatize the community rather than support it. Such studies or statistics cannot be trusted as objective public health data”, he said.

Additionally, apart from physical health, there are serious concerns of a deterioration of mental wellbeing among the community, with studies having previously established links between discrimination and mental health among LGBTQ+ people.

There are no specific data available on mental health in the community— statistics for relevant indicators, such as suicide, are not up to date—but there is some anecdotal evidence of worsening mental health in the general population, and all those who spoke to The Lancet said mental health among the community was inevitably being impacted by the government’s repressive legislation and an increasing normalisation of homophobic discourse among politicians and society.

Kolya says that “aggressive government anti-LGBTQ+ narratives” were one of the key reasons they were in psychotherapy and taking anti-depressants. “It’s stressful as hell sometimes. Every queer person I know feels that same stress [caused by these narratives]”.

Groups working with LGBTQ+ people in Russia said they had seen a rise in demand for their mental health services. “We have received significantly more requests for psychological support, especially from young LGBTQ+ people. Many have become more willing to seek support, are less afraid of psychotherapy, and are more open to working with psychologists and psychiatrists. This is likely connected both to the deterioration of mental health due to repression and to a broader understanding of the importance of mental health in general”, said Shtein.

“The number of people who come to us seeking psychological support is higher than last year and it’s growing every month”, added Oleinik. “The number of people thinking about suicide or who [harmed] themselves is also growing every year”, he said.

Kolya, and others who spoke to The Lancet, said that suicidal ideation and attempts were common among the community, again especially among transgender people. However, Oleinik said that despite the grim situation facing the community, groups like his would continue to help LGBTQ+ people access health care. “Our role in the current situation is increasingly important. We understand that people in the community need us—a lot of organisations have closed, stopped offering some programmes, but we can still reach the community. It might look like there is little hope at the moment, but we won’t stop”, he said.

Source: Ed Holt, “LGBTQ+ Russians increasingly avoiding doctors,” The Lancet, 25 June 2026


Olga Baranova

A magistrate in Moscow has been delivered a complaint of “LGBT propaganda” (as defined by Article 6.21.3 of the Russian Federal Code of Administrative Offenses) filed against Olga Baranova, program director of the Moscow Community Center for LGBT+ Initiatives. Apparently, this is her first fine—coming after the MCC was designated an “extremist” organization.

The hearing will take place on July 8, according to the court’s website. The court has not disclosed which agency drafted the report. Cases involving “LGBT propaganda” can be launched by various agencies: the Interior Ministry, the Prosecutor’s Office, or Roskomnadzor. However, in politically motivated cases, the instigator is most often Center “E”—the Interior Ministry’s department for “combating extremism.”

In late April, a court ruled in favor of the Justice Ministry and designated the MCC an “extremist” organization. It is one of ten LGBT groups that were given this designation in 2026. The Center is currently appealing the decision, so it is not yet listed in the registry of extremist organizations.

Source: “MCC director Olga Baranova gets her first ‘propaganda’ citation,” Parni Plus, 27 June 2026. Translated by the Russian Reader


Alexander Klimov, art director of the Orenburg bar Pose. Source: Social media/Moscow Times

A court in the Orenburg region on Monday handed down prison sentences to a bar owner and two of his employees in Russia’s first criminal case targeting people accused of belonging to what authorities call the “International LGBT Movement.”

The trio was arrested on LGBTQ+ “extremism” charges in March 2024, representing the first instance of criminal charges being pressed in connection with the Russian Supreme Court’s designation of the non-existent “LGBT movement” as “extremist” the year before.

Bar owner Vyacheslav Khasanov received a seven-year sentence, according to Ostorozhno Novosti. Manager Diana Kamilyanova was sentenced to six years and three months, while art director Alexander Klimov received two years and three months.

All three were accused of organizing events that demonstrated “affiliation with individuals of unconventional sexual orientation under the guise of running a nightlife venue.” According to the exiled news outlet Mediazona, the bar hosted drag shows.

The trio denied the charges during the court proceedings, which were held behind closed doors.

While the case represents the first instance of criminal charges being brought under the LGBTQ+ “extremism” designation, Russia’s first actual prison sentence under the ban was issued separately in January 2025 in the Kemerovo region.

The Orenburg court said Monday that its verdict has not yet taken effect and remains subject to appeal.

In addition to the prison terms, the court seized 1 million rubles ($12,800) in revenue from Khasanov. It also barred all three defendants from working in the entertainment and hospitality industries for two to three years following their release.

Source: “Orenburg Court Jails 3 Bar Employees for LGBTQ+ ‘Extremism,’” Moscow Times, 29 June 2026

HIV on the Rise Again in Russia

The number of new cases of HIV infection in Russia has been growing again. In 2022, 63,150 people were diagnosed with HIV, while a year earlier this figure was 61,098 people, according to the Russian Health Ministry. During the pandemic, fewer cases of HIV infection were detected in Russia due to reduced testing coverage and lockdowns.

The HIV detection rate in Russia increased by eight percent per 100,000 people in a year. There was an even bigger jump in particular regions. Compared with 2021, this figure almost doubled in the Belgorod Region. It increased by 76% in the Kaluga Region, by 66% in Yakutia, and by 60% in Ingushetia and the Altai Republic.

HIV infection rates in Russia per 100,000 people between 2004 and 2022, according to the Russian Health Ministry.

However, the Health Ministry’s data encompasses only people who have registered as outpatients at AIDS centers. They do not reflect those who have tested positive for HIV, but were not registered. The number of such people is as high as twenty percent of all confirmed cases of infection, estimates Vadim Pokrovsky, head of the Epidemiology and AIDS Prevention Research Department at Rospotrebnadzor’s Central Epidemiology Research Institute. Nor does this figure include foreign nationals and anonymous positive tests.

In 2021, 1,138,000 people with a confirmed diagnosis of HIV diagnosis resided in Russia. In 2022, another 60,000 people were diagnosed with HIV. To these groups we need to add around 300,000 people (according to Pokrovsky’s estimates) who have HIV but don’t know it because they haven’t been tested. Thus, the number of HIV-positive people in Russia is one and a half million, which is one percent of the country’s population.

2.6% of pregnant women in the Irkutsk Region are HIV positive.

At the Congress on Infectious Diseases, Pokrovsky said that almost a third of Russia’s regions are undergoing the generalized (third) stage of the HIV epidemic. He explained that there are three stages of the epidemic. The first (initial) stage involves isolated cases. The second (concentrated) stage occurs when more than five percent of any high-risk subpopulation is infected (for example, prison inmates, drug addicts, or sex workers, while the third (generalized) stage occurs when more than one percent of pregnant women are infected with HIV.

According to Pokrovsky, nine Russian regions are in the first stage of the epidemic, while forty-eight are in the concentrated stage, and twenty-seven are in the generalized stage. In the Irkutsk Region, 2.6% of pregnant women have been diagnosed with HIV, he noted. Ten percent of Russian prison inmates are infected with HIV, and four percent of Russian men over the age of forty have HIV, adds Pokrovsky.

In 2022, regions of Siberia and the Urals — Krasnoyarsk and Perm Territories, Orenburg, Kemerovo, Irkutsk, Tomsk, Chelyabinsk, Novosibirsk, Kurgan and Sverdlovsk regions — remained the leaders in the rate of HIV spread, as in previous years.

“Regions of Siberia and the Urals are leaders in the rate of HIV spread. Number of new HIV infections per 100,000 people.
Click on the region or start typing its name in the search box to see specific figures.”
This map is interactive in the original article, as published on the Important Stories website.

And yet, flying in the face of its own data, which showed an increase in cases, in March of this year the Health Ministry reported a reduction in the number of new cases of HIV infection in 2022.

According to the UN strategy for eradicating HIV, a country should seek to hit the “90–90–90” treatment target if they want to beat the epidemic. This means that ninety percent of people with HIV should know their status, ninety percent of people who know they are HIV positive should receive sustained treatment, and ninety percent of patients undergoing treatment should have an undetectable (i.e., very low) viral load. When this is the case, an HIV-positive person undergoing antiretroviral therapy cannot transmit the virus to another person.

Antiretroviral (ARV) treatment is the principal means of combating HIV. Every person living with the immunodeficiency virus should receive this therapy. But that is not the case now.

In 2021, 82% of people who had regular medical check-ups and 56% of all those living with a confirmed diagnosis of HIV infection received ARV treatment, according to Rospotrebnadzor’s AIDS Prevention and Monitoring Center. An undetectable viral load was attained by eighty percent of those receiving ARV treatment.

The rest — more than half a million people with a confirmed diagnosis — do not receive treatment. Their viral load remains detectable, so they risk spreading the infection.

By law, Russian citizens should receive ARV treatment for free. However, the Health Ministry procures less medicine than HIV-positive people need, and has not increased the treatment budget despite the fact that the number of patients has been growing every year. Every day, the project “Interruptions.ru” fields messages from patients complaining about the unavailability of treatment.

49% of Russians registered as HIV positive are covered by drugs purchased by the state.

In 2021, Russia procured only 391,000 annual doses, according to the International Treatment Preparedness Coalition. This covers approximately 49% of the number of people who receive follow-up care, and 34.4% of all people registered as HIV-positive. Therapy coverage was thus fifteen percent lower in 2021 than in 2020.

The drugs procurement budget for 2023–2025 must be increased by at least fifteen billion rubles annually in order to provide all patients with the necessary treatment. However, the Finance Ministry is willing to allocate 31.7 billion rubles for drugs procurement annually during the period 2023–2025 — that is, it does not plan to increase spending.

And yet, according to one estimate, Russia spent ten trillion rubles on the war over the past year. This same amount of money could provide all Russians in need of it with ARV treatment for 270 years in a row.

The Health Ministry procures drugs for ARV treatment on the federal level, while the regions must purchase the drugs they lack themselves, an activist who helps people with HIV explained to Important Stories on condition of anonymity.

According to her, AIDS centers in the regions submit applications to the Health Ministry for the amount of drugs they need. But the Health Ministry buys less than requested — for example, AIDS centers might apply for ten thousand doses, but the Health Ministry buys them only seven thousand. The regions have to find the money to make up for the shortfall in drugs.

“We must increase the number of patients in treatment and increase coverage,” our source told us. “At the moment, it is unclear what to do without additional allocations of money for purchasing medicines.”

If the Russian authorities spent ten trillion rubles on medicines, rather than on the war in Ukraine, they could provide HIV-infected Russians with the treatment they need for 270 years in a row.

The regions are not required to buy additional medicines, nor do all of them do it. Consequently, patients find themselves in unequal conditions: in richer regions, they receive the appropriate treatment, while in poorer regions they do not. Moreover, spending on drugs does not depend on how bad the HIV epidemic is in a particular region. This can be seen by looking at procurements of the drug Dolutegravir. According to our source, it is a well-researched and rather expensive drug that is suitable for many patients. But the Health Ministry has been reducing its purchases of the drug, while the country’s richest regions — the Tyumen Region, Moscow, St. Petersburg, and the Khanty-Mansi Autonomous District — spent the most of their own funds on it in 2022.

More than half of Russia’s regions did not purchase additional Dolutegravir for their patients at all, including, for example, the Sverdlovsk Region, where almost three thousand new patients were registered in 2022.

More than 77% of the money spent on Dolutegravir was spent by regions where only 23% of new HIV patients live.

Cutting-edge HIV treatment is available mainly to residents of rich regions

More than 77% of the public funds spent on procuring the drug Dolutegravir in 2022 were allocated by regions where only 23% of new cases live

A table showing how much Russia’s regions spent, in rubles and as a percentage of nationwide spending, on the ARV drug Dolutegravir in 2022, versus new cases of HIV infection last year, both in sheer numbers and as a percentage of the national total. The list includes Tyumen Region (at the top), Moscow, St. Petersburg, Khanty-Mansi Autonomous District, Chelyabinsk Region, Irkutsk Region, Tula Region, Novosibirsk Region, Yamalo-Nenets Autonomous District, Murmansk Region, and “all other regions.”

In 2022, Kommersant wrote about the reduction of purchases of expensive drugs for which there are no less-expensive substitutes. In 2021, such drugs accounted for 67% of the total volume of ARV treatment purchases, while in 2022, this figure was 55%. Cheaper drugs are being purchased to replace them.

Reducing the choice of drugs available makes it more difficult for patients to choose a treatment that suits them without causing side effects. It happens that only one drug out of four is suitable for a person, but the region where they live does not supply it.

Pokrovsky notes that the 63,000 new cases in 2022 is a high rate of infection. In reality, there are even more HIV-positive people in Russia, since the country’s most vulnerable groups are less likely to be tested.

“In part, the large number of new cases is due to the fact that we do test a large portion of the population: more than forty million tests were done in 2022. (But we must take into account the fact that, for example, pregnant women and donors are tested several times a year.) On the other hand, people who are particularly vulnerable to HIV infection — drug users and men who have sex with other men — are not tested enough,” Pokrovsky says.

68% of new HIV infections in Russia were the result of heterosexual sexual contact,
so sex education is needed to combat the epidemic.

Pokrovsky argues that to effectively combat the epidemic, the Russian government should promote sex education and fund social advertising campaigns.

“Nowadays, the biggest chunk of funding, over 30 billion rubles [per year], is spent on procuring drugs,” he says. “Treatment is supported by the pharmaceutical companies, so that is where the bulk of the funds are allocated. But there are no market-based solutions to prevention. In this case, you can only count on public funds. Very little is allocated for prevention, literally 500 million rubles [per year], and this amount does not grow from year to year. Most of it is spent on appeals to get tested, rather than on teaching people how not to get infected with HIV. Sex education is now practically prohibited [in Russia].”

Russia was among the top five countries in terms of new HIV case numbers in 2021. According to UNAIDS (the United Nations HIV/AIDS program), Russia accounted for 3.9% of the one and a half million new cases of infection in the world. Russia was bested, in 2021, only by South Africa (14% of all new cases), Mozambique (6.5%), Nigeria (4.9%), and India (4.2%). The Russian Foreign Ministry dubbed the news a “dirty information campaign” on the part of the West. Instead of receiving support, many Russian NGOs campaigning for HIV prevention and patient care have been labeled “foreign agents” by the Russian authorities.

Contrary to the stereotype that drug addicts are the most infected segment of the populace, heterosexual sexual contact is now the primary mode of HIV transmission in Russia, accounting for 68% of new cases.

You can take an HIV test free of charge and anonymously at AIDS centers in all regions of the country.

Source: “Every third region of Russia is experiencing a third-stage HIV epidemic. But the authorities refuse to recognize the growth of infections and purchase the medicines needed. Cutting-edge drugs are available to patients only in the wealthiest regions,” Important Stories (IStories), 13 April 2023. Translated by the Russian Reader


In Russian prisons, they said they were deprived of effective treatments for their H.I.V. On the battlefield in Ukraine, they were offered hope, with the promise of anti-viral medications if they agreed to fight.

It was a recruiting pitch that worked for many Russian prisoners.

About 20 percent of recruits in Russian prisoner units are H.I.V. positive, Ukrainian authorities estimate based on infection rates in captured soldiers. Serving on the front lines seemed less risky than staying in prison, the detainees said in interviews with The New York Times.

“Conditions were very harsh” in Russian prison, said Timur, 37, an H.I.V.-positive Russian soldier interviewed at a detention site in the city of Dnipro in central Ukraine, and identified only by a first name, worried that he would face retaliation if he returned to Russia in a prisoner swap.

After he was sentenced to 10 years for drug dealing, the doctors in the Russian prison changed the anti-viral medication he had been taking to control H.I.V. to types he feared were not effective, Timur said.

He said he did not think he could survive a decade in Russian prison with H.I.V. In December, he agreed to serve six months in the Wagner mercenary group in exchange for a pardon and supplies of anti-viral medications.

“I understood I would have a quick death or a slow death,” he said of choosing between poor H.I.V. treatment in prison and participating in assaults in Russia’s war in Ukraine. “I chose a quick death.”

[…]

Source: Andrew E. Kramer, ‘”A Quick Death or a Slow Death’: Prisoners Choose War to Get Lifesaving Drugs,” New York Times, 21 April 2023

“Snarling Dogs and Monkeys Chasing Each Other Through the Streets”

Leader of World Proletariat with Female Gate Attendant Reflected in Security Mirror, SUV, and New Year’s Tree. December 18, 2016, 11 Lomanaya Street, St. Petersburg

Monument to V.I. Lenin

Vladimir Ilyich Ulyanov (pseudonym – Lenin) (1870-1924) was a Russian and Soviet world-class politician and statesman, revolutionary, founder of the Russian Social Democratic Workers Party (Bolsheviks), and one of the organizers and leaders of the 1917 October Revolution in Russia. The monument was erected on the 87th anniversary of Lenin’s birth on the premises of the former Proletarian Victory shoe factory. Unveiled on April 22 , 1957. Cast from a model by the sculptor P.I. Bondarenko.

Source: 2gis.ru. Photo and translation by the Russian Reader

• • • • •

In Petrograd, “cryptic” messages like this one (spray painted on the fence of the now-defunct Krupskaya Confectionery Factory) are giving the sex ads stenciled everywhere on the pavements and walls a stiff run for their money. Basically, if you want to get whacked out of your mind on “bath salts” and then have sex with a prostitute, this town is the place for you. And it visually reminds you of that fact a thousand times a day, every which way you look. But don’t dream of holding a spontaneous political protest: then the law will come down hard on you. But gnarly, highly addictive drugs and prostitution (amidst an HIV epidemic) it can live with. ||| TRR, December 18, 2015
An important public service message from the kleptocratic post-fascist hybrid regime: Make your family strong, not your liquor! “In Russia, 16% of families break up due to alcoholism.” Uff da! ||| TRR, December 18, 2015

Post-Soviet “ethnic diversity” gone bad. Four “folk singers” from god knows what republic or “little people of the north” lip-synching a folk song at the New Year’s bazaar on Pioneer Square in Petrograd. ||| TRR, December 18, 2015

Vladislav Inozemtsev: The Foreign Agent in the Kremlin

lakhta wreck

The Foreign Agent in the Kremlin
Vladislav Inozemtsev
The Insider
December 31, 2019

One of the crucial events of the past year was passage of the law on labeling Russian nationals as “foreign agents.” Although the law emphasizes that such “agents” should disseminate information from foreign media outlets and receive financial remuneration from abroad, the notion of “foreign agent” has a quite definite meaning for most Russians: someone who works on behalf of a foreign government to the detriment of their own country.

However, if you think hard about the new law and its implementation (the Justice Ministry has been charged with designating individuals foreign agents, but citizens and NGOs will probably also be able to take the initiative), the first thing that comes to mind is the man who signed it so showily into law on December 2—Vladimir Putin, president of the Russian Federation, who took office exactly twenty years ago today, albeit as acting president.

When Putin moved into the Kremlin, Russia was successfully emerging from an economic crisis triggered by a sharp drop in oil prices in the late 1990s and the ruble crisis of 1998. These two events largely brought to a close the aftermath of the Soviet Union’s collapse and the transition from a planned economy to a market economy. Welcoming the new president, people believed him when he said, “The country’s future, the quality of the Russian economy in the twenty-first century, depends primarily on progress in those industries based on high technology and hi-tech products,” while the world took him at face value when he claimed, “Today we must declare once and for all that the Cold War is over. We abandon our stereotypes and ambitions, and henceforth we will jointly ensure the safety of the European population and the world as a whole.” It seemed that the coming decades should be extremely successful ones for Russia, and the country would inevitably takes its rightful place in the world economy and politics. However, events unfolded following a different scenario, and nearly all the trends that we can now ascertain as well-established suggest that if a CIA officer had taken charge of his country’s recently defeated enemy he would have done less damage to it than Putin has done.

First, Russia in the early noughties had very low labor costs: according to Rosstat, the average salary was $78 a month in 2000. Given that energy prices in Russia were then seven to ten times lower than in Europe, it was self-evident the country should decide to undertake large-scale industrialization by attracting foreign investors. The Central European countries, which in the late nineties and early noughties became successful industrial powers by attracting European capital (we can recall what happened with Škoda’s factories) were an example of the strategy’s wisdom.

However, despite what Russian authorities said at the time, preventing foreign capital from entering strategic industrial sectors became policy. Almost immediately after Putin came to power, the government began renationalizing assets that had been privatized in the nineties: instead of raising taxes on companies owned by Russian oligarchs, the regime commenced buying them out, constantly ratcheting up the price, culminating with Rosneft’s purchase of TNK-BP for $61 billion in 2013. In fact, taxes raised from the competitive sectors of the economy and redistributed through the budget went to buy assets in the extractive sector and were invested in rather dubious projects. Consequently, by the early teens, the share of raw materials (mineral products, ore, and metals) in Russian exports had reached 79–80%, as opposed to 50.4% of Soviet exports in 1989. Finally, in recent years, Russia has begun “diversifying” its raw materials exports by reaching out to China, effectively becoming an “energy appendage” not only of Europe but also of the whole world.

Second, as the economy became ever more dependent on extractive industries, Russia under Putin began to deindustrialize rapidly, resulting in a sharp decline in the demand for skilled workers, who could have been employed to develop the country on new foundations. According to various estimates, 16,000 to 30,000 industrial enterprises, which had employed over 13 million people in the late-Soviet period, were closed between 2000 and 2018. As of 2017, 9.9 million people were employed in Russian processing industries, as opposed to 21.7 million people in the RSFSR in 1989, although there was no significant increase in labor productivity. We can concede, of course, that a good many of these enterprises were not competitive, but most of them were never put up for auctions in which foreign investors were allowed to bid, the Russian government did not provide potential investors guarantees on investments in technically modernizing enterprises, and so on. Essentially, the government adopted a consistent policy of simplifying the industrial infrastructure, increasing dependency on imports, and most significantly, downgrading whole cities that had previously been important industrial centers. It would be no exaggeration to say that the bulk of Soviet industrial enterprises was destroyed not in the “accursed nineties,” but in the noughties and the early teens.

Third, the process went hand in glove with a demonstrative lack of attention to infrastructural problems and managing Russia’s vast expanses. About 700 airports were closed between 2000 and 2010, domestic passenger traffic dropped below international passenger traffic, and so many roads fell into disrepair and collapse that since 2012 city streets have been counted as roads in order to buff up the statistics. Infrastructure projects have been concentrated either in Moscow (e.g., the Moscow Ring Road, the Central Ring Road, expansion of the Moscow subway) or on the country’s borders as a kind of exercise in “flag waving” (e.g., Petersburg and environs, Sochi, Chechnya, the Crimean Bridge, the reconstruction of Vladivostok and Russky Island).

Consequently, rural settlements have begun dying out massively in most regions of the country: since 2000, around 30,000 villages in Russia have disappeared, and nearly 10,000 of them have eight or fewer residents. The number of residents in cities with populations ranging from 50,000 of 200,000 people has decreased: population reductions have been recorded in 70% of these cities, while the population has dropped by a quarter in more than 200 such cities. There has been a massive exodus of people from the Russian Far East.  Even the solution of longstanding problems that were handled for better or worse in the nineties has been abandoned, including disposing solid wastes, minimizing harmful emissions, and storing hazardous industrial waste. Russian infrastructure is close to collapse: depreciation of the power grids exceeds 70%, while 75% of the heating network is obsolete. Only 52.8% of local roads meet Russia’s poor standards. All attempts to remedy the situation are propaganda tricks more than anything, and yet budget funds for infrastructure are allocated regularly, just as taxes are collected from the populace.

Fourth, despite formal achievements, such as increasing life expectancy and reducing per capita alcohol consumption, the nation’s physical and mental health is verging on the disastrous. From 2000 to 2016, the number of HIV-infected Russians increased almost twelve times, reaching 1.06 million people, meaning that the threshold for an epidemic has been crossed. Spending on health care has remained extremely low. It is usually measured as a percentage of GDP, but a comparison of absolute figures is much more telling: in 2019, the government and insurance companies allocated only 23,200 rubles or €330 for every Russian, which was 14.2 times less than in Germany, and 29 times less than in the US, not counting out-of-pocket expenses.

Despite the huge influx of immigrants and migrant workers during Putin’s rule, the population of Russia (without Crimea) decreased by 2.7 million people from 2000 to 2019. Drug addiction has been spreading rapidly, becoming one of the leading causes of death among relatively young people in small towns. And yet the authorities see none of these things as a problem, limiting access to high-quality foreign medicines and accessible medical care (the number of hospitals has been halved since 2000, while the number of clinics has decreased by 40%), all the while believing the HIV crisis can be solved by promoting moral lifestyles. There is little doubt that Russia’s population should began dying off at a furious pace now that the reserves of economic growth have been exhausted.

Fifth, the formation of a bureaucratic oligarchy, able to appropriate at will what the authorities see less as “public property” and more as “budget flows,” has generated enormous corruption and blatantly inefficient public spending. A sizeable increase in spending on the space program—from 9.4 billion rubles in 2000 to 260 billion rubles in 2019—producced a drop in the number of successful launches from 34 to 22. Despite promises in 2006 to build almost 60 new nuclear power units, only 12 units have been brought online over the last twenty years. Programs for growing the military-industrial complex have not been consistently implemented: production of new weapons has been minuscule, amounting to only ten to twenty percent of Soviet-era production. The country’s only aircraft carrier has for the second time suffered combat-like damage during an “upgrade,” while its only 4.5-generation fighter has just crashed during a test flight.

The latest challenges posed to Russia by the development of information technology around the world have elicited no response whatsoever from the regime. On the contrary, the bureaucrats and siloviki have consistently acted to discourage researchers and innovators. The dominance of the siloviki in most government decision-making, their utter lack of oversight, and unprecedented incompetence have meant that much of the money that could be used effectively in the military sector and open up new frontiers for Russia has been simply been embezzled.

Sixth, Putin’s rule has been marked by the impressive “gifts” he has made to countries which the Kremlin has often identified as potential enemies. Around $780 billion was spirited from Russia between 2009 and 2019, whereas less than $120 billion was taken out of the country during the entirety of the nineties. The most important cause of this outflow was a law, passed in 2001, establishing a nine-percent tax on dividends paid to “foreign investors” or, rather, the offshore companies registered as owners of Russian assets. (The subsequent abolition of this measure in 2015 has changed little.) Much of this money was invested in passive sources of income in the west or spent on the luxurious lifestyles of Russian billionaires, thus supporting local economies in other countries.

Even more “generous,” however, was Putin’s gift to west in the form of the four million Russian citizens who have left Russia during his presidency: mainly young and middle-aged, well-educated, willing to take risks and engage in business, they now control assets outside the country that are comparable to the Russian Federation’s GDP. This wealth has been generated from scratch by talented people the Russian regime regarded as dead weight. The destruction of human capital is the biggest blow Putin has dealt to Russia, and it is no wonder western analysts argue Russia will need a hundred years at best to bridge the emerging gap.

Seventh, we cannot ignore the holy of holies: national security. We have already touched on the military sector in passing. It is a realm in which technological progress has largely boiled down to showing cartoons to members of the Russian Federal Assembly: space launches are still carried out using Soviet Proton rockets, designed in the sixties; the last of the Tu-22M strategic bombers rolled off the line in 1993; the Su-57 is based on groundwork done while designing the Su-47 during the late eighties;  and the advanced Angara (S-200) missile was developed as part of the Soviet Albatross program from 1987 to 1991. Things are no better in the secret services: agents sent on secret missions set off Geiger counters, like Lugovoy and Kovtun, blow their cover wherever they can, like Mishkin and Chepiga, or get caught in the act, as was the case with Krasikov.

The elementary inability to carry out their work in secret is the height of unprofessionalism: a handful of journalists can dig up nearly all the dirt on Russian agents, using information freely available on the internet. The same applies, among many other things, to the downing of Malaysia Airlines Flight 17 over the Donbass and the regime’s use of unprofessional, incompetent mercenaries from various private military companies.

Finally, eighth, President Putin’s foreign policy deserves special attention. Over the past ten years or so, the Kremlin’s own efforts have led to the creation of a buffer zone of neighboring countries that fear or hate Russia. If something like this could be expected from the Baltic states, which sought for decades to restore the independence they lost in 1940, no one could have imagined twenty years ago that Russia would make Georgia and Ukraine its worst enemies. However, our country’s principal “patriot”—whose daily bedtime reading seemingly consists of the works of Zbigniew Brzezinski, who once argued that Russia’s “imperial backbone” would be broken only when it lost Ukraine once and for all—has consistently sought to make Kiev recognize Moscow as its principal existential threat.

Similar sentiments have emerged in Minsk, where the authorities and populace of the country that suffered the greatest losses in the Great Patriotic War for the sake of the Soviet Union’s common victory have been nearly unanimous in their opposition to further rapprochement with Russia. We won’t even mention Russia’s damaged relations with the US and the EU: at the behest of Moscow, which is immeasurably weaker than the collective west, a new cold war has been launched that the Kremlin has no chance of winning but that could lead Russia to the same collapse suffered by the Soviet Union during the previous cold war. Meanwhile, Moscow’s hollow propaganda and its theatrical micro-militarism have been a genuine godsend to western military chiefs, who have been securing nearly unlimited defense budgets, just like the designers of advanced technology, who have been developing new weapons and gadgets in leaps and bounds.

I will not catalogue the current president’s other achievements—from destroying the Russian education system and nourishing a cult of power in society, thus generating a crisis of the family, to undermining Russian federalism and nurturing an unchecked power center in Chechnya. I will only emphasize once again that not just any foreign agent, after spending decades infiltrating the highest echelons of power in an enemy country, would be able to inflict such damage. I don’t consider Putin a foreign agent in the literal sense of the word, of course, but if it is now comme il faut in Russia to identify those who are working, allegedly, for hostile powers and thus inflicting damage on their own country, it is impossible to ignore what Putin has done over the past twenty years.

The current head of the Russian state should have a place of honor on the list of “foreign agents,” just as “Party card number one” was always reserved for Lenin in bygone days. And the west should be advised not to seek to undermine Putin’s regime but, on the contrary, do its utmost to extend his term in the Kremlin, simply because as long as Russia is so inefficient, backward, and profligate it poses no threat to the rest of the world, however much the strategists at the Pentagon try and convince the top brass otherwise.

Photo and translation by the Russian Reader

We Wouldn’t Mind If You Died of AIDS and Hepatitis C

aids flagRussia has an HIV epidemic. According to the Federal Aids Prevention Center, approximately a million Russians are infected. A third of them also have hepatitis C. At best, only hundreds of these patients receive state-of-the-art treatment. Image by Yaroslava Chingayev, special to Vedomosti

Officials Want to Replace Current Hepatitis C Treatment with Outmoded Therapy
Industry and Trade Ministry Supplied Money for Manufacture of Drugs
Irina Sinitsyna and Olga Sukhoveiko
Vedomosti
December 13, 2018

The Russian Health Ministry plans to significantly reduce procurements of the most effective treatment for viral hepatitis C, combined interferon-free treatment, thus reducing the availability of the drugs for patients infected with HIV in combination with hepatitis B and hepatitis C. Instead, the ministry has proposed putting these patients on interferon therapy. Maria Onufriyeva, director of Community of People Living with HIV, an interregional grassroots organization, has written about the matter to Health Minister Veronika Svkortsova. Ms. Onufriyeva has also sent a letter to Valery Alexeyev, director of the Honest Procurements Project at the Russian People’s Front (ONF). Vedomosti has seen copies of the letters. Ms. Onufriyeva confirmed she sent them. A spokesperson for Mr. Alexeyev said he received the letter. The Health Ministry has not responded to her query.

In November, Minister Skvortsova said that over 714,000 Russians were infected with HIV. According to the Federal Aids Prevention Center, whose figures Ms. Onufriyeva cites, there are 978,443 Russians infected with HIV. A third of them also have hepatitis C.

In late October, the Health Ministry published the final list and amounts of drugs it would be procuring in 2019 and providing to HIV patients, including HIV patients who also have hepatitis B and hepatitis C, writes Ms. Onufriyeva. (Vedomosti has seen a copy of this list.) In particular, the Health Ministry wants to reduce procument of dasabuvir by 750%, meaning one hundred patients would have access to the drug, while this year 748 people could count of getting it, according to the Community’s calculations.

In monetary terms, this would mean a drop in expenditures on the drug from 431.6 million rubles [approx. 5.7 million euros] to 57.9 million rubles [767, 754 euros].

The Health Ministry plans to switch to narlaprevir, intended for the treatment of hepatitis C in combination with other antiviral drugs. In 2018, as the Community has discovered, and as is borne out by information accessed on the federal procurements website, narlaprevir was not purchased by the Russian governmennt. In 2019, the Health Ministry could spend 139 million rubles [approx. 1.8 million euros] on procuring the drug in order to treat 430 people, the Community argues.

Dasabuvir is the most up-to-date antiviral drug. According to the Community, it can cure 98% of hepatitis C patients in twelve weeks.

This figure was confirmed by Vadim Pokrovsky, director of the Federal AIDS Prevention Center.

In Russia, HIV patients who also have hepatitis C have been treated with dasabuvir in combination with ombitasvir/paritaprevir/ritonavir, manufactured under the brand name Viekira Pak by the American company AbbVie. Dasabuvir was placed on the official Russian list of vital and essential drugs for this year. Two years ago, Alexey Repik’s R-Pharm and AbbVie agreed to partly localize manufacture of the drug at R-Pharm’s plant in Kostroma. As R-Pharm reported then, the deal covered repackaging of the drug and quality control. According to AbbVie, Viekira Pak is distributed in Russia by R-Pharm and Euroservice.

Ms. Onufriyeva writes that interferon therapy is much less effective in treating chronic hepatitis C patients with HIV. The treatment significantly reduces quality of life, since it requires weekly injections.

Mr. Pokrovsky explained the difference. Interferon treatment has almost no effect on the virus itself. It stimulates the body’s immune response, but it has numerous side effects, from impotence to mental disturbances. The treatment lasts a year.

Due to the length of the treatment, Ms. Onufriyeva said, it was between 52% and 133% more expensive than interferon-free treatment.

Tableted by R-Pharma, narlaprevir has to be taken together with ritonavir, pegylated (long-acting) interferon, and ribavirin, as indicated in the instructions.

In 2012, R-Pharma acquired a license for the production and sale of narlaprevir from Merck & Co. It tried to refine the drug with support from a federal targeted program administered by the Russian Industry and Trade Ministry. Trade publication Vademecum wrote that R-Pharm invested 700 million rubles in narlaprevir. The Industry and Trade Ministry would allocate 120 million rubles on clinical trials, Sergei Tsyb, head of the ministry’s Department for Chemical Engineering and Bioengineering, promised in 2012.

A R-Pharm spokesperson confirmed receipt of the funds.

R-Pharm registered narlaprevir in 2016. In the spring of 2017, during a meeting with the business community, President Putin promised R-Pharm’s director general Vasily Ignatiev that the government would allocate funds to procure the company’s drugs for hepatitis C patients.

“I will also keep this in mind when allocating resources for healthcare in 2018 and the following years, in 2019 and 2020. It will be necessary, of course, to use what you have developed,” Putin said.

Mr. Pokrovsky is certain the Health Ministry’s decision to reduce procurements of interferon-free drugs could have been influenced by Russian manufacturers wanting to compensate their costs at the state’s expense.

The R-Pharm spokesperson insisted that the company, like other manufactures, received a request from the Health Ministry to quote its prices for narlaprevir and dasabuvir.

“Our price offers for the drugs were the same as last year’s,” he said.

In total, according to the Community’s calculations, in 2019, the Health Ministry can spend 473.5 million rubles [approx. 6.3 million euros] on the procurement of drugs for treating chronic hepatitis C, as opposed to 1.1 billion rubles [approx. 14.6 million euros] last year.

In November, Vademecum wrote that, in 2019, the Health Ministry would also reduce its overall procurement of antiretroviral drugs under its program for providing drugs to people infected with HIV, including patients who were infected with HIV in combination with the hepatitis B and C viruses. However, although it would spend far less money, it planned to expand coverage to a mere sixty percent of those needing treatment.

Ms. Onufriyeva has asked the Health Ministry to consider increasing procurements and moving away from the chronic hepatitis C drugs scheduled for purchase in 2019 and towards drugs that have proven effective. The latter should be supplied to patients with HIV plus viral hepatitis C, including those suffering from advanced liver fibrosis and cirrhosis.

She has asked Mr. Alexeyev to assist her in protecting the interests of patients by sending inquiries to the Health Ministry, asking them to explain the reasons for the cuts in procurements and the selection of outmoded drugs. She also asked him to verify whether the Health Ministry’s actions were in compliance with antitrust laws.

She told Vedomosti she had not received replies to her letters.

vich

“How the Numbers of HIV-Infected Patients Have Changed, 2013–2018.” The red columns indicate total numbers of patients; the orange columns, first-time infections. Figures are given in thousands of people. Source: Rosstat. Courtesy of Vedomosti

Mr. Alexeyev explained the delay in replying. The letter contained a good deal of specialized and medical information, and it was under review by independent experts working for the Russian People Front’s Honest Procurements Project.

“The Russian People’s Front has drawn attention to problems with the list of essential and vital drugs, and their procurements, and this letter is the latest alarm,” he said.

According to Mr. Alexeyev, the Russian People’s Front has been reviewing the Health Ministry’s procedure for including medicines on the list and had already been in touch with the government.

hep b and c

“How the Numbers of Hepatitis Patients Have Changed, 2013–2018.” The dark blue bars indicate first-time cases of chronic hepatitis B; the light blue bars, first-time cases of chronic hepatitis C. Figures are given in thousands of people. Source: Rospotrebnadzor. Courtesy of Vedomosti

If the grassroots organization Community of People Living with HIV believes the industry regulator acted in a way that violated specific regulations on procurements or antitrust statutes, it can file a complaint with the Federal Anti-Monopoly Service (FAS) in the manner prescribed by law, said Maxim Degtyarev, deputy head of the Department for Oversight of the Social Sector and Trade at FAS. For the time being, however, FAS had no grounds to perform an inspection.

The Industry and Trade Ministry did not respond to our request for information.

Elena Filimonova contributed to this article.

Translated by the Russian Reader

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

__________

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.