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Michel D. Kazatchkine, executive director of the Global Fund to Fight AIDS, TB and Malaria, told reporters at a news conference that he hoped the Russian government would keep the harm reduction programs going. But Onishchenko, speaking at the same event, did not say whether the Russian government would do so.
AIDS was virtually unknown in Russia and elsewhere in the Soviet Union prior to the collapse of Communism. What started as an epidemic among male injection drug users here in the late 1990s has gradually moved into the communities of sex workers. By 2007 about 44 percent of new infections in Russia were among women, according to UNAIDS, raising fears it could move into the general population.
Onishchenko blamed the increase in HIV infections to the surge in Afghan poppy production over the past decade, a trend that has flooded the former Soviet Union with heroin.
Russia, with a population less than half that of the U.S., has 13 percent of the world's heroin users and they consume about one-fifth of the drug used worldwide each year, according to an October report by the United Nations Office on Drug Control.
Though Russia has adopted federal laws forbidding discrimination against HIV-positive individuals, widespread discrimination continues, according to a December 2008 United Nations report on AIDS in Russia, Eastern Europe and the former Soviet Union.
People living in the region are routinely asked to provide health certificates that reveal their HIV status, the report found. Hospital workers often casually identify HIV-positive patients to bystanders and co-workers, U.N. researchers said, and hospitals frequently segregate HIV-positive patients, treat them with scorn or charge them extra, hidden fees.
HIV-positive children face discrimination at school, including forced disclosure of their status and segregation from other students, while in the labor sector, many employers are wary of hiring HIV-positive individuals.
AIDS activists say that discrimination drives many of those infected to avoid testing and treatment.
In addition to harm reduction, Russian and foreign health experts on Wednesday debated the size of the country's AIDS problem and the adequacy of the government's response.
While the U.N. estimates Russia has 1.1 million people with HIV, the government says it has registered just half that number -- a total of 501,000 cases.
Kazatchkine of the Global Fund said Wednesday that only 23 percent of Russians who should be receiving anti-retroviral therapy for HIV are getting it. He said most nations are providing such therapy to 35 to 40 percent of those infected.
Onishchenko questioned what he called this "strange data," saying that everyone who needs it is getting the drug regimen, except for a small percentage of injection drug users who walk away from the program.
"They are receiving treatment unless they escape treatment," he asserted.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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