MOSCOW, Jan. 11 -- The number of Russians with HIV/AIDS is probably at least three times the official figure of 300,000, according to a study by two American scholars. The study says authorities need to act aggressively with drug therapy, prevention and education to stem the spread of a disease that for now is concentrated among young people.
"If the leadership continues to pay only lip service to the issue . . . then the consequences in the very near term of 2 to 3 years, and certainly a decade from now, will be devastating to the society, to family formation, to the military, to productivity of labor, to continued growth of the Gross Domestic Product," wrote Murray Feshbach and Cristina Galvin of the Woodrow Wilson Center in Washington in a report underwritten by the U.S. Agency for International Development.
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Authorities in Russia have no information on the mode of transmission for at least half of the new cases, preventing clear analysis of the disease's trajectory through a society that continues to stigmatize people with HIV, the study found. In addition, "many physicians are bribed not to classify the patient's illness as one of the illnesses that carry a stigma."
HIV testing has dropped off markedly, with 2.5 million fewer Russians tested in 2003 than in 2002, according to the report. In explaining that decline, it noted that financing responsibility for test kits has shifted to regional authorities, who are sometimes indifferent to the health threat.
The report, which compared Russian and international statistics, found that the HIV/AIDS epidemic in Russia differs significantly from the disease in North America and Western Europe in terms of age. "In the West, broadly speaking, some 70 percent of the population afflicted with this illness are . . . over 30 years of age," the report says. "In Russia . . . over 80 percent are under 30 years of age."
The march of the disease through Russia's young is vividly illustrated in the number of potential army conscripts who test positive for HIV, the virus that causes AIDS. In the last five years, the number testing positive has increased 25 to 27 times.
The epidemic among the young stretches across the country. The authors reported that in the small region of Sverdlovsk, "approximately 130 newly conscripted men tested positive for HIV and were, therefore, turned away by the draft commission."
"It is perhaps too late to prevent the concentrated epidemic from eventually generalizing to the entire population," the report states, though it says HIV infection is probably still concentrated among intravenous drug users.