Russia is losing the battle against HIV

Russia has one of the world's most serious epidemics of intravenous drug use. UNAIDS reports that Russia has 2 million intravenous drug users (IDUs), 60 to 70 percent of whom have HIV-related illnesses. In the past decade, the number of HIV-infected people in Russia has increased from about 100,000 to more than 1 million.

It is estimated that 80 percent of those Russians who are HIV positive became infected by using contaminated needles and syringes. The problem is not limited to Russia. Sharing syringes is also the most prevalent cause of HIV transmission in Central Asia and Eastern Europe, where it is responsible for more than 80 percent of all HIV infections.

The Russian authorities have come under strong, widespread criticism for their policies aimed at dealing with the IDU/HIV epidemic. Education to control drug abuse has focused primarily on stressing the importance of drug abstinence, and public officials have relied on criminalization as the main deterrent. That approach has created obstacles to effective addiction treatment and HIV prevention.

A policy that has proven effective in other countries is "harm reduction." This approach, one dismissed by the Russian authorities, puts prevention of HIV infection and transmission first and features needle-exchange programs and treatment with substitute drugs taken orally. However, despite the proven efficacy of harm-reduction strategies in HIV prevention, Russian authorities have failed to take full advantage of these strategies.

Harm-reduction strategies involve providing access to methadone, a needle-exchange program and addiction counseling. While detoxification is widely available throughout Russia, more comprehensive, longer-term treatment remains unavailable in many parts of the country. This failing is critical because research has shown that detoxification by itself is not an effective treatment.

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