Sharing needles in the Urals

Saturday, January 22, 2005
source: International Herlad Tribune

MOSCOW
On a recent trip to Moscow, I saw about as many discarded drug needles as vodka bottles on the stairwells. It reminded me of a trip to Chelyabinsk, in the southern Urals, in 2000. I was accompanying Anya, a Russian immigrant to the United States, to the place where she spent her youth as a heroin addict.
I remembered a party in a dilapidated apartment in Chelyabinsk. The mood was subdued. Techno music played in the background. I was invited into a small kitchen and offered a shot of vodka. After a few hours, the people at the party opened up and told me what their life was like under the foggy veil of heroin. One by one, they revealed stories and showed me their tattoos - the places on their trackmarked forearms where they would inject each other.
Every one of them, about 15 people, now has full-blown AIDS - except for Anya, who left before the epidemic reached Chelyabinsk in the mid-1990s. All of them shared needles. They were best friends, after all.
Experts say that almost 1 million people in Russia are infected with HIV. Chelyabinsk, once a secret Soviet city and an industrial and cultural center, has one of the highest rates of HIV infection per capita, as the city acts as a pipeline for drugs coming through Kazakhstan from Afghanistan. It posts 15 to 30 new HIV infections per day. According to the Russian Ministry of Health, 90 percent of the HIV-positive residents in Chelyabinsk - and throughout Russia - are infected by sharing needles, cookers or syringes with their friends.
Much of the approach to combating the AIDS epidemic in Eastern Europe and Central Asia has focused on abstinence and condoms, following the American model. With most of the infections in Russia occurring among drug addicts, sex workers or prison inmates, this strategy doesn't work. To top it off, many officials in Russia still deny there is a problem.
AIDS is still considered taboo by many in the Russian political elite, including President Vladimir Putin's cabinet, and there is a lack of public recognition of the problem.
The epidemic has especially severe consequences for women. Many young Russian women are poor, so they often fall into the sex trade or drugs. I met some women in Chelyabinsk who had resorted to sleeping with dealers or had become dealers themselves to get their fix.
Anya had been fortunate, or relatively fortunate.
At about the time I was in Chelyabinsk with her, she hooked up with an old flame, Cyril, and they decided to have a baby. Cyril was waiting for results from an HIV test. On my second day there, the testing center informed them that the results weren't certain, because the roof had fallen in on the testing center - literally. Money being short for most things in Russia, AIDS clinics in 2000 were not holding up.
On a balcony of Cyril's apartment, whose only furniture was a beaten mattress on the floor, Anya wrung her hands with nervous expectation. "Will you tell my story?" she asked. I promised I would.
Eventually, they got a call from the clinic, Cyril had tested positive for HIV. Anya, miraculously, had not.
The international community should increase the pressure on the Russian government to get serious about AIDS and drugs. Otherwise, hundreds of thousands of Russians are likely to die in the next five years.

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