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Few Deaths, But HIV Infection Reaches 1.5 Million in Russia

By David Holley
LOS ANGELES TIMES -- MOSCOW

While the number of AIDS deaths is still low, an epidemic of HIV infection is raging in Russia, with up to 1.5 million Russians now carrying the virus, the country’s top expert on the disease said Thursday.

Vadim V. Pokrovsky, head of the Health Ministry’s AIDS Prevention and Treatment Center, made the statement at a news conference called to promote a battle against HIV/AIDS in Russian prisons, where the disease readily spreads and is then transmitted to the broader society as inmates are released.

Russia has 235,000 registered HIV/AIDS cases, but the actual number is estimated at 700,000 to 1.5 million, Pokrovsky said. This includes 37,000 inmates who are confirmed to be infected. The Russia-wide totals are up from just 442 registered cases in 1990 and 1,080 registered cases in 1995.

An all-star cast of international health organizations appeared at the media event, which was focused on a new Russian-language health manual designed for use by prison doctors. But in an indication of why the epidemic rages on, Pokrovsky said in response to a question near the end of the news conference that the book is full of nice ideals but is detached from reality.

“The book reflects the best practices and the best intentions,” Pokrovsky said. “Of course, the book should be adopted taking into account the economic situation in this country. The book reflects the ideal situation. It doesn’t take into account the real situation. The financial situation today does not allow the implementation of these ideas into Russian reality.”

The news conference was attended by representatives of the World Health Organization, Medecins Sans Frontieres, Penal Reform International and Moscow-based AIDS Foundation East-West. But no one at the news conference gave any strong indication that key preventive measures recommended in the manual would be acted upon.

The World Health Organization book paints a bleak picture of problems in Russian prisons and many other penal institutions around the world that contribute to the spread of AIDS.

A Russian prisoner survey cited in the manual found that of 1,087 respondents, 20 percent said they had injected drugs while in prison, and of that group 64 percent used shared equipment.

The manual suggests three ways to limit the transmission of HIV from drug use: providing sterile needles, providing bleach so prisoners can sterilize needles, and providing methadone maintenance treatment to addicts.

Russian prison authorities generally say that given overcrowded conditions and the susceptibility of poorly paid guards to bribery, keeping prisons drug-free is an impossible task.