Increased rate of new diagnoses in former Soviet Union runs against a global decline

This article is more than 1 year old

This article is more than 1 year old

Stigma around homosexuality and drug use means Russia and some former Soviet Union countries risk developing out-of-control HIV epidemics, experts have said, after data showed a record number of new cases last year.

Most new cases in the former Soviet Union in 2017 were from heterosexual sex as the disease spreads beyond high-risk groups, according to the World Health Organization (WHO) and the European Centre for Disease Prevention and Control.

The increased rate of new diagnoses in the region since 2012 runs against a global decline and Masoud Dara, HIV specialist at the WHO, said it could be “an early indication of overspill in the general population”.

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“HIV starts off [in] key populations – meaning drug users, commercial sex workers and men having sex with men – but after that it [increases] exponentially ... if there is no more intervention,” Dara said.

In Russia official data shows there were more than 104,000 new HIV diagnoses in 2017, taking total cases to more than 1.2 million. Experts have said this is probably an understatement.

“We don’t have enough medication, we don’t treat every patient,” said Nikolay Lunchenkov, a doctor at the Moscow regional Aids centre. “We are increasing the number of people who receive antiretroviral therapy, but it’s still not enough.”

The number of HIV treatment courses bought by the Russian government rose 37% to about 360,000 last year according to the NGO Treatment Preparedness Coalition.

Methadone, which research has shown helps to prevent injecting drug users passing on HIV, is banned in Russia.

“We also don’t have enough data about men who have sex with other men, because of high levels of stigma,” said Lunchenkov, who is openly gay.

The number of Russian men who were infected with HIV through having sex with another man more than doubled to 695 between 2008 and 2015, according to official data.

Discrimination against LGBTI people means those at risk of HIV/Aids are afraid to seek out testing and treatment, experts say.

Russia was ranked Europe’s second least LGBT-friendly nation in 2016 by ILGA-Europe, a network of European LGBT groups.

A requirement introduced in 2012 for some international NGOs working in Russia to register as “foreign agents” led to a decrease in organisations working with groups vulnerable to HIV, said Oli Stevens, a HIV researcher based in Britain.

“The message was very clear, MSM (men having sex with men) are not us, they are the other, they are not part of society we’re trying to build,” said Stevens.

In the rest of the former Soviet Union new cases of infected drug users have fallen 45% to 6,218 a year in a decade, while new cases of heterosexual transmission increased 59% to almost 18,000.

Activists blame widespread discrimination against LGBTI people for an eightfold rise in transmission among men having sex with men, to more than 1,000 cases annually.

“State-sponsored homophobia and transphobia [have become] a crucial issue,” said Yuri Yoursky of the Eurasian Coalition on Male Health, which supports men with HIV/Aids in the region.