Russia is the third in the world in the number of HIV-infected

Photo: deposiphotos

Friday evening in a busy area of ​​Moscow, next to the entrance to one of the 24-hour pharmacies, there is a woman with a shock of bright pink hair and offers all passersby plastic bags with clean syringes. Anna Alimova is at the forefront of the growing HIV epidemic in Russia.

“Most drug addicts have hepatitis. And many of them have HIV,” she says.

According to UNAIDS, in 2015, Russia ranked third in the number of HIV patients after Nigeria and South Africa. According to the Russian Gosstat, more than half of infections are transmitted through intravenous drug use. The level of infected in the country is growing rapidly.

The corner of the street where Alimov is conducting his action is littered with used syringes and empty bottles of eye drops, which are sold in pharmacies without a prescription. Some Russian drug addicts buy drops, which are usually used for the expansion of the pupils, and prick into the vein. This drug enhances the effects of previously in the blood substances. Abuse of this drug for other purposes may cause hallucinations, pain in the kidneys, hyperthermia and tremor. Re-use of the syringe after this drug is a major factor in the spread of the HIV epidemic.

One man, who came out of the pharmacy, took a bag with clean needles from Alimova. She asked him about the state of health.

The man is strikingly thin, with dark shadows under his eyes. He said that 20 had been diagnosed with HIV years ago, and for that very reason he had lost so much weight. He also said that he lives with his wife, who is HIV-negative and their common child.

“Will you take free condoms?” asks Alimova.

Then she gives him a business card of the Andrey Rylkov Foundation, a small Moscow charity organization where Alimov works as a volunteer.

The stunning level of the epidemic.

The Russian Federal AIDS Center reports that over the past 5 years, the average infection rate has been 10% per year. In December, the center reported that more than 1,1 million HIV infections were reported in Russia. Over the past decade, the problem has only worsened.

“This didn't happen overnight. In Russia, the level of the HIV epidemic has been growing over the past 15 years,” said Vinay Saldana, UNAIDS Regional Director.

According to her, the aggravation of the HIV epidemic in Russia is due to a number of factors, including vague government policies on this issue and ignored social problems.

The chances of survival

Over the years that have passed since the discovery of the virus in the United States, 36 has conducted a large number of studies on HIV and AIDS around the world. WHO has developed a so-called roadmap that should help combat the spread of the disease.

But in Russia, a number of effective recommendations that have already helped reduce the level of diseases in a number of countries have not yet been implemented.

For example, Masha (name changed), who used heroin for 20 years. In 2003, she received positive HIV and hepatitis. During 14 for years, she visited the state AIDS clinic, where she came to take a test for the disease, but in all that time she was not given HIV treatment at the clinic.

“Doctors tell me that my virus is within the normal range,” she says.

According to Masuda Dara, head of the United Nations Program to Fight Tuberculosis, HIV / AIDS and Hepatitis, in Russia almost one third of all diagnosed cases of HIV infection are treated with antiretroviral drugs.

“This is one of the key issues on which the World Health Organization is engaged in dialogue with Russia. People with HIV should receive treatment as early as possible to increase their chances of survival and reduce the risk of transmitting the virus,” he says.

Ulcers and discrimination

Masha also said that HIV-positive people face discrimination in Russia. When she recently went to the doctor to examine an open ulcer on her leg, the result of drug abuse, he refused to examine her when he learned she had HIV.

“He said: “Get out of my office,” Masha recalled with tears in her eyes.

"We talk about the HIV epidemic, but what we're really seeing is an epidemic of plagues and discrimination," Vinay Saldanha said.

Health experts say that the actual number of people living with HIV in Russia probably far exceeds official statistics, because many people are afraid to be tested because they do not want to face discrimination in society.

A comment could not be obtained at the Russian Ministry of Health.

Methadone search

International health organizations recommend methadone as a substitute for street drugs. Alternatives, such as methadone, are administered orally, eliminating the risks associated with injections with needles, which are the cause of new HIV-infected people in Russia.

However, the Russian government has banned all methadone clinics. Critics of this initiative argue that the legalization of the distribution of methadone will help to increase drug addiction in Russian society.

Alimova believes that methadone could really help many drug addicts to reduce their dependence on substances and get on the road to recovery.

Needle distribution

Health experts say that implemented programs for the distribution of clean needles have been successful and have greatly helped in reducing the spread of HIV.

At the same time, in Moscow, in a city with a population of more than 12 million people, only the Andrey Rylkov Foundation distributes clean needles.

Alimova, who, thanks to the foundation, was able to get rid of 10-year drug addiction, is one of the 15 fund staff.

Foundation staff every night on a small bus delivering medical supplies to different streets and courtyards of Moscow. On one of those nights, two haggard men approached Alimova’s bus.

“Can I get some twos and threes?” one man asks, referring to the 2- and 3-milligram syringes.

Rylkova Foundation employee Maxim Malyshev gives men plastic bags filled with syringes, bandages, ointments and doses of naloxone, a medicine that can counteract opioid overdose. He also offers used clothing and books.

“God bless you,” one of the men says before walking away.

“More than half of these people do not have an official place of residence in Moscow,” says Malyshev. Without registration, people do not have the right to public health care in the Russian capital.

Foundation workers also conduct a rapid HIV test. On this night, Alimov had to inform several of his “patients” that they were HIV-infected.

“We usually try to support the person and tell the truth about HIV, that it doesn’t mean you’re going to die. This means you need to seek medical help,” she said.

“Every country reaches a turning point”

Last year, a controversial government decision threatened the work of the Rylkov Foundation. The Justice Department has labeled the foundation a "foreign agent" because it receives foreign funding and is politically active. The organization's main funders are the Levi Strauss Foundation and the Global Fund, two philanthropic groups that work to combat HIV/AIDS and other infectious diseases.

“Unfortunately, over the past few years, a number of public and non-governmental organizations have been labeled as foreign agents,” said Vinay Saldana of UNAIDS.

He hopes that the Russian government’s strategy to fight HIV, announced last year, will alleviate the pressure on organizations such as the Rylkov Foundation, by directly funding local civil organizations.

Saldanha says the scale of the HIV epidemic has been realized at the highest levels of government. According to UNAIDS, statistics show that the virus has spread far beyond traditionally vulnerable groups, such as drug addicts, sex workers and homosexuals, and reached other population groups.

“Every country reaches its tipping point,” Saldana said. “It seems to me that in the Russian Federation it came last year, when a million cases of HIV infection were diagnosed.” “This is no longer just a problem for the health sector,” he added. “The impact of HIV on demographics, on fertility, on the number of children born with HIV, on economic productivity is becoming noticeable.”

Night fight

Near the round-the-clock pharmacy, where Alimov conducts his propaganda, the traffic on the roads is lively, as always at midnight. Cars, from which the rumbling music is heard, are pulled up to the corner of the street, passengers jump out of them into the pharmacy and back.

A trembling woman named Katya appears and hugs Alimov. Instead, she gets a bag with syringes and bandages. Before jumping into a taxi, Katya points at Alimov and says: "These guys are here so that the diseases do not spread." After a couple of minutes, four guys come up to the Rylkov Foundation bus. Two men immediately fill the syringe with tropicamide. Right there, under the tree, they inject it into their veins. And disappear in Moscow night.

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