Siberian City Faces Full-
Blown AIDS Epidemic
IRKUTSK, Russia (AFP) - A week ago Masha, a 19-year-old heroin addict, found out that she is HIV positive. Now she fears she may have passed on the deadly virus to her boyfriend when he was back on army leave last summer.
"We had such a beautiful romance that month, I even stopped injecting drugs. I just don't know what do to. Maybe I infected him. One time we didn't use a condom," the thin dark-haired girl despaired.
"I can't write to him there about my condition. Who knows what that might drive him to," she said staring down at the white hospital floor.
On the outskirts of the historic Siberian city of Irkutsk lies a sprawling red-brick complex where a small AIDS centre and clinic are battling with a frightening explosion in HIV cases among young injecting drug users who transmit the illness to each other by sharing contaminated needles.
Doctor Yulia Rakina, whose team of 36 physicians is responsible for testing incidence of HIV among the three million people who live in Irkutsk and the surrounding region, said they were struggling to cope with the outbreak.
"We don't have the proper resources. The authorities don't appear to have realised that the scale of the problem has changed dramatically," she said.
Unknown here before 1992, 37 cases of the HIV virus that leads to AIDS were registered by January 1 last year.
Twenty-three months later more than 7,500 people have been tested HIV positive -- a staggering 10,000 percent increase -- and the figure is forecast to rise by another third before the end of the year 2000.
But because of fear and self-denial among addicts, who represent 95 percent of all HIV cases in Irkutsk, the real statistics are actually six times higher because few of them are volunteering for tests, according to Doctor Rakina.
A region where an estimated one quarter to a third of young people aged from 15-25 are using drugs, Irkutsk lies third behind the Moscow region and the Russian capital in the nation's HIV league table.
Like other big cities where drug abuse is closely tied to HIV, the fear is that the disease could soon begin to spread much faster through unprotected sex, with condoms rarely used by Russian youth who nowadays experiment with multiple sexual partners.
"We must learn how to deal with this situation. It's of vital urgency," admitted the head of Irkutsk's regional health committee, Ludmilla Kitova.
But the health chief insisted that the authorities' long-standing policy of directing their budget towards testing for new HIV cases and treatment, leaving little money to fund vital prevention measures, would be maintained.
"We have very limited resources. Our programme is purely medical. We are ready to work with international organisations in this sphere but we would need a great deal of money (from them)," she said.
Top officials from the United Nations' anti-AIDS programme, which is helping to launch prevention campaigns in 17 Russian regions but has been rebuffed in Irkutsk, say this attitude is disastrously short-sighted.
"A lot of money is going down the drain. Money is there which they are spending on testing. They have to rethink how to reallocate resources to prevention," said the UN programme's coordinator Tatyana Shoumilina.
Despite 20 million tests a year in Russia, which pointlessly target low-risk groups, only 70,000 HIV cases have been identified, she pointed out.
The money should instead be spent counselling young people how to avoid sexually transmitted diseases and HIV infection, providing addicts with clean needles and distributing free condoms.
International organisations for their part are not willing to assume the responsibility for mounting such a campaign because the aim is to foster local initiative which will prove sustainable in the long-term, she explained.
"This is typical of the fear and withdrawal that we have observed in Russia in relation to HIV and AIDS," commented the UN official.
Doctor Rakina agreed, complaining that in post-Soviet Russia, hostility towards a section of society seen as delinquents and misfits made it hard to persuade decision-makers to spend scarce resources on working with drug addicts.
"It is very hard to win over the general population and those who don't work in this sphere, even the regional administration. You have to make people understand that the key task is not even treatment but prevention," she said.

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