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Russia’s Plan to Combat HIV: A National HIV Registry

Russian HIV activists fear that a national HIV registry, the newest move to combat the mounting number of HIV cases in Russia, will lead to discrimination and marginalization against HIV-positive Russians.

On New Year’s Day, 2017, Vladimir Putin issued a new registry of people with HIV, which could be used to isolate people who are infected with the virus. According to the Russian Health Ministry, the Federal Register of HIV patients aims to help ensure patients receive antiretroviral medication efficiently and to provide standardize data on the epidemic.

A proposal to make the registration compulsory was reportedly rejected by both the Justice Ministry and the Health Ministry.

“The first and most important task is to assess and collect full information on how many HIV patients we have, what treatment plans have been arranged for them, what medicines have been prescribed to them,” said Deputy Health Minister Sergei Krayevoi.

As a solution to the growing cases of HIV/AIDS in the country, Russia recently launched a campaign to make HIV/AIDS treatment more accessible. The Federal Register of HIV patients has been launched to better help distribute medicine to patients, according to Health Ministry spokesman Oleg Salagai.

As 2016 drew to a close, the number of people in Russia living with HIV surpassed one million. The number has been growing steadily since the late 1990s, and has been increasing even while the number of new cases has been falling in developed countries. UNAIDS has reported that Russia has the largest HIV epidemic in the European Region, and one of the fastest growing HIV epidemics in the world.

In July of this year, the United Nations AIDS agency (UNAIDS) said that there are 36.7 million people infected with HIV worldwide, and that number has continued to grow over the past five years. The UNAIDS current 90-90-90 goal, where by 2020, 90 percent of all people living with HIV will know their HIV status, 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy, and 90 percent of all people receiving antiretroviral therapy will have viral suppression, cannot be achieved if Russia does not do more to stem their epidemic.

“The HIV epidemic in Russia is not an abstract, theoretical threat. As noted at the highest levels of the Russian government, HIV in Russia has reached a critical level, and the epidemic is getting worse by the day,” said Vinay Saldanha, UNAIDS regional director for Eastern Europe and Central Asia.

While in the past, most Russian citizens who contracted HIV were marginalized members of society, such as prostitutes, drug users, and members from the lower income brackets, the virus now seems to be reaching people from various demographics and traveling throughout wider society. It mentioned the LGBT Community in this list, but only to group it with criminals.

Intravenous drug users have been the main driving force of the infection for the last decade with 500,000 Russians estimated to be active injection drug users. There are limited needle exchange programs—or syringe services programs, programs that the Centers for Disease Control and Prevention (CDC) have dubbed successful in reducing HIV transmission—and limited access to ART for these drug users, according to Jeffrey H. Samet, MD, MA, MPH, chief, professor of medicine at the Boston University Schools of Medicine and Public Health.

This past year, the number of heterosexual couples contracting HIV surpassed intravenous drug users. According to activists, the Russian Orthodox Church opposes comprehensive sex education and contraception, favoring “family values” as a solution to the epidemic. Even safer-sex kits with free needles and condoms must be labeled “foreign agents,” or else the nonprofits that distribute them run the risk of breaking Russian law.

In 2015, after the Russian Health Ministry published a report cautioning that the HIV epidemic in Russia was likely to spiral out of control by 2020, Dimitry Medvedev, the prime minister of Russia, urged the Health Ministry to develop a plan to combat HIV and AIDS.

The Health Ministry hopes that the new registry will get more HIV-positive citizens on antiretroviral treatment. Currently, less than 40 percent of HIV-positive Russians receive antiretroviral drugs, even though nearly all of the $338 million budget for AIDS care goes to medicine—with almost nothing for preventive education.

According to the Russian Health ministry, the new registry has already logged 824,000 people out of an estimated 850,000 patients in just four days. AIDS activists claim there may be at least another 500,000 undiagnosed cases.

"Any individual diagnosed with HIV should be interested in being included in this register since he or she will receive medicine on this basis," Salagai said.



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