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Russia: Intravenous Drug Use Leading Cause of HIV/AIDS

While sub-Saharan Africa remains the region most heavily affected by HIV, a UNAIDS report says that some of the most worrisome increases in new infections are happening in other places, such as Russia. Many HIV/AIDS experts have also expressed concerns that Russia, as well as other former Soviet Union states, are facing widespread HIV/AIDS epidemics. But unlike many other parts of the world, the majority of HIV cases in Russia are due to intravenous drug use.

Russia's HIV epidemic continues to grow, though not as quickly as it did in the 1990s. Estimates vary, but it is thought that almost one million people are living with HIV in Russia. Injecting drug use is the main way that HIV is transmitted — it was responsible for two-thirds of newly registered HIV cases in 2006. Neil Smith, posting on docshop.com, elaborates on the issue.

“Certain parts of Russia are plagued by HIV/AIDS outbreaks as a result of people sharing syringes and needles. The problem is so serious that the World Health Organization has tabbed Russia as the nation with the worst HIV/AIDS epidemic in all of Europe, encompassing nearly a million infected people. VOANews.com cites ‘intravenous drug use, especially among young people’ as the primary vehicle causing the rapid infection to continue and worsen with each passing year. Moscow and St. Petersburg are believed to be the most heavily impacted areas.”

Drug addiction, along with HIV/AIDS, only became major problems in Russia after the Soviet Union fell, as opened borders made it easier for illicit narcotics to enter. Now it is estimated that between 1.5 million and 3 million people in Russia are intravenous drug users, injecting heroin and other opium-based narcotics. Many of these users inject with non-sterile syringes, increasing the risk of HIV transmission.

In his blog, Kh. Atiar Rahman talks about the growing drug problem and its ripple effect.

“Unfortunately, the social base of drug addiction is expanding. Today this disease has percolated to all sections of society, encompassing the territory – world wide, especially the depressed areas. This is leading to an avalanche-like spread of AIDS…Most of the drug addicts — up to 53 percent — are persons with no definite occupation. It is they who strengthen the army of distributors now as well, which in its turn gives go to a crime flare.”

One method being used to discourage the spread of HIV through tainted syringes are needle-exchange programs. There were more than 50 needle- and syringe-exchange projects operating in Russia last year. One such program is run by the Humanitarian Action Fund, based in St. Petersburg, who operate a mobile clinic on a refurbished bus. The bus makes nightly stops in areas frequented by drug users and provides clean needles and syringes, as well as other health and social services. This video, narrated by the organization's founder, Sasha Tsekhanovich, talks about their efforts and the stigma that drug users face.

Another method that many health experts say is critical to controlling the spread of HIV among injecting drug users is substitution treatment. For example, providing methadone, a synthetic form of opium, to heroin addicts to help wean them off heroin. Methadone treatment is not being administered in Russia, though, and the issue is considered taboo. Earlier this year the country's chief public health officer said that Russia was not ready to adopt practices such as methadone replacement therapy. A post on a Drug Rehab blog further explains.

“Methadone treatment is taboo in Russia because many feel that it is simply replacing one addiction with another. In fact, even bringing up the topic can provoke serious legal sanctions. Posting studies that show the effects, both positive and negative, of methadone treatment are illegal also. In fact, charges are often brought up against doctors that post these findings on their websites. Because methadone treatment is difficult to get in Russia, many find that the detox is ineffective and once they leave the drug rehab program, they use again.”

However, experts also point out that it's not just drug users that are being affected by HIV/AIDS in Russia. Transmission through unprotected heterosexual sex has been increasing steadily since the late 1990s as well, and there's a substantial overlap between sex work and injecting drug use. Unkie Dave, blogging on Booming Back, says the key to slowing down the HIV epidemic globally is to look at the whole picture.

“AIDS is a disease of poverty and ignorance, affecting the most vulnerable and marginalised in any society. In America it is a disease of black women, in Russia it effects intravenous drug users, in Thailand it affects sex workers, and so on. But by focusing on only one group in any culture, it gives the impression that all other groups are unaffected, leading to risky behaviour by the mainstream, and the further marginalisation of those at the edges.”

Photo of Close Up Syringe by big_chocolate_monster on Flickr.

6 comments

  • infection through intravenous drug use is also the first most common method of transmission in Malaysia. Various needle exchange are already in place on top of other programs to address substance abuse. National statistics revealing the reduction of drug addicts in the country is definitely an encouraging sign. Nevertheless, I agree with Unkie Dave, in tackling the spread of HIV/AIDS one must be careful not to place too much emphasis on one group that the others are ignored. We must realise that the spread of HIV is an issue that cross cut more than just poverty. Overcoming cultural, political, and religious resistance in the effort of introducing harm reduction methods is not an easy task and must be preceded with strategies towards a behavioural change.

  • On the 1st day of the conference @Miami Downtown Hilton, Thursday 13 of November 2008 at 7pm there will be a workshop on the need to start Syringe Exchange Programs in Miami, Florida or any place else in Florida and/or other locations in need. The workshop will be facilitated by leaders of organizations who have been doing Needles Exchange Program for over 20 years.

    Leaders from the North America Syringe Exchange Network http://www.nasen.org/ , who can provide Starter Kits and Technical Support as well as cheaper cost of needed equipment will also be available for discussion. Any interested party is invited to participate. We actively seek the participation of church members and pastors; the health related professionals; attorneys; government officials as well as employees and local authorities.

    Persons who wish to attend the Syringe Exchange Workshop do not need to be a participant to the conference. But You most contact me about

    this meeting and/or Paula Santiago@harmreduction.org (202) 213-6276 x15 about participating in the conference as participant or vendor.

    We know that syringe exchange works; we know the political will is more open to today’s reality. Blacks and Hispanics are amongst the largest percentage of new HIV and Hepatitis new cases due to IV Drug use. We are working against the silences, censorship, myth, misinformation and lack of action. Please contribute to the solution.

    On Federal Funding Syringe Programs

    You can go to the harm reduction coaltion site http://www.democracyinaction.org/dia/organizations/HRC/campaign.jsp?campaign_KEY=25278

    or this other site.

    http://capwiz.com/aac/issues/alert/?alertid=11709611 this act will allow Federal Money to be use in Syringe programs

    This website will sent a letter to your Federal Congress Representative, but also if you know others who may be interested helping you can send them the information so they can help too. Please help use win and stop the spread of HIV and Hepatitis.

    Saving Lives and Money

    Besides saving lives, these needle exchanges deliver a huge financial payoff. Consider the case of an HIV-positive addict who infects eight others in a one-year period (a very modest estimate). If each turns to Medicaid to pay his or her lifetime medical costs (at an average $119,000 plus), that’s about a $1 million burden for taxpayers–money that could have been saved if the one addict had been in a needle-exchange program.

  • […] by aidsfiction on September 21, 2008 This Global Voices article discusses AIDS in Russia.  The article mentions that the majority of AIDS cases come from […]

  • […] gradually taking root in Ukraine. For example, the first methadone substitution therapy programs, still illegal in Russia, were introduced in Ukraine in 2004 (for more info, see this report – .pdf file – by the […]

  • […] gradually taking root in Ukraine. For example, the first methadone substitution therapy programs, still illegal in Russia, were introduced in Ukraine in 2004 (for more info, see this report – .pdf file – by the […]

  • Not just intravenous drug use, that being a symptom of the more general problem we believe, as stated in our own report on Ukraine:

    “We see a staggering array of social problems arising directly from poverty, including but not limited to tens of thousands of children in orphanages or other state care; crime; disrespect for civil government because government cannot be felt or seen as civil for anyone left to suffer in poverty; young people prostituting themselves on the street; drug abuse to alleviate the aches and pains of the suffering that arises from poverty and misery; HIV/AIDS spreading like a plague amidst prostitution, unprotected sex, and drug abuse; more children being born into this mix and ending up in state care at further cost to the state; criminals coming from poverty backgrounds, ending up as bandits, returning to communities after prison, with few options except further criminal activity.”

    Something in the order of 250 million dollars has been allocated to prevention in Ukraine and yet the HIV rate has increased to 1.6% of population, according to UN estimates.

    Yet there is no response from Western European governments to this impending crisis. I focus on the UK government, in a call for action to support humanitarian efforts:

    http://www.facebook.com/groups.php?ref=sb#/group.php?gid=18278215199

    The plan has already been delivered and responded to by both Ukrainian and US government. Our UK FCO have simply disregarded it, as have many of our politicians.

    http://www.p-ced.com/projects/ukraine/national/

    Jeff Mowatt

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