AIDS In Russia 'Scarier Than
Africa' Yet Ignored

By Peter Graff

MOSCOW (Reuters) - AIDS is soon to ravage Russia with consequences that may be even more catastrophic than in Africa, yet the public is barely even aware the epidemic has arrived, Russia's top AIDS official said.
After decades of little contact with the disease, Russia and Ukraine have suddenly been caught unprepared in the throes of the world's fastest growing epidemic of the HIV virus.
Of Russia's 180,000 officially registered infections, 100,000 occurred just last year. Experts guess the actual number of Russian cases is as high as one million, more than one percent of adults.
"Every year, we see the number of new cases doubling. If this continues even two or three more years, we will see not one percent, but two, four, eight," Vadim Pokrovsky, head of the Russia's official AIDS centre, said in an interview.
Because infected people do not immediately fall ill and require treatment the disease is still all but invisible, spreading before the public has a chance to see its effects.
There are as yet no teeming clinics packed with the desperate and the dying, no armies of children orphaned by the disease or destitute patients begging on the streets. The untreated will not begin to die in their thousands for a decade.
But all that is coming soon, and virtually nothing is being done to prepare society for the consequences, said Pokrovsky.
"People do not see this danger. Maybe it is because, for so many years we warned them 'AIDS is coming. AIDS is coming'. And it never came," he said. "We expected it sooner. It came later. And now people still think we're just making noise.
Russia's AIDS epidemic is already far worse than in Western Europe and North America, where the disease struck high risk populations of drug users and homosexuals but stopped before becoming widespread among the rest of the public.
Just how much worse it will get is not yet clear. It began in Russia among drug users and has not yet spread widely to the public at large through heterosexual sex, as it did in Africa.
But Pokrovsky points to sky-high rates of other sexually transmitted diseases, which are signs of widespread risky sex and increase the chance of transmitting AIDS. Russia has syphilis rates hundreds of times higher than in the West.
"In this, Russia looks more like Africa," he said.
And even if Russia's epidemic stops before it reaches the double digit infection rates in some parts of Africa, the demographic and economic impact would prove even more severe.
"In Africa, there are high birth rates, but in Russia the birth rate is low. If we have a rate of only three percent infected, population would fall by six percent," Pokrovsky said.
"In Russia, AIDS is scarier than in Africa. There the population is replaced. In Russia it will not be."
Since HIV patients usually do not require medical treatment until years after being infected, the financial burden of the disease has yet to be felt.
So far, the state is treating only 5,000 patients. But to keep up just with officially registered cases, it will have to treat 100,000 in 2005 and costs will explode.
As in Africa, Russia will probably have to deny treatment to most patients and sentence them to certain death.
Pokrovsky estimates a public relations campaign to curb the spread of AIDS would cost $75 million. But the softspoken, ginger-bearded young doctor has had no luck in winning funds.
Not one prominent public figure has acknowledged being HIV infected, though Pokrovsky has treated a handful.
His clinic, behind a muddy construction site in a dreary outlying Moscow district, hardly looks like ground zero in the 21st century's most pressing public health catastrophe.
"I'm crying: 'Wolf! Wolf!'. And people say, 'That's just old Doctor Pokrovsky."
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