Russia’s harsh drug policies are fueling an AIDS epidemic

Russia’s burgeoning AIDS epidemic is fueled by government policies that deny HIV-prevention services to those most at risk and also allow discrimination against people with AIDS to flourish, Human Rights Watch said in a report released today.

The 62-page report, “Lessons Not Learned: Human Rights Abuses and HIV/AIDS in the Russian Federation,” documents how harsh drug policies and routine police harassment of injection drug users—the population hit hardest by AIDS in Russia—impedes their access or makes them afraid to seek basic HIV-prevention services such as syringe exchange, which is available in other countries around the world. Now that AIDS is rapidly spreading into the general population, these misguided policies have widespread consequences.  
“Instead of learning the basic lessons of how to fight AIDS from countries that have older epidemics, the Russian government is endangering the broader population by putting up barriers to HIV-prevention services for those most at risk,” said Joanne Csete, director of the HIV/AIDS Program at Human Rights Watch.  
Drug users, who may be detained for possession of miniscule amounts of narcotics, become an easy target for police when arrest quotas need to be filled. These practices keep many drug users from seeking clean syringes since they fear detention, or being identified or registered with the state as drug users. Russia also bans the use of methadone for heroin-substitution therapy, which is a central part of HIV prevention for heroin users in many countries.  
The Russian government excludes active drug users living with AIDS from antiretroviral treatment, a counterproductive policy in a country where over 85 percent of people living with HIV/AIDS acquired the disease through drug use. Harsh drug laws also ensure that most drug users will spend time in state detention, which puts them at further risk for HIV infection. Russian prisons are breeding grounds for HIV since federal authorities ban syringe exchange and fail to provide condoms and other HIV-prevention services in these facilities.  
An amendment to the Russian Criminal Code, enacted in December by the State Duma, would allow for the reform of federal drug laws, thus enabling consumers of small quantities of drugs to avoid prison sentences. In recent months, however, federal drug control authorities have recommended even harsher penalties than those in force before the amendment was enacted. The new regulations are scheduled to be released in mid-May.  
“If the Russian government wants to show that it takes AIDS and human rights seriously, it should reject overly punitive measures for small-time drug users and ensure that all drug users have access to a full range of HIV-prevention services,” said Csete. “Russia’s continued ban on methadone is completely unjustifiable given the strong track record of substitution therapy in fighting both AIDS and heroin addiction.”  
Drug users living with HIV/AIDS and other HIV-positive people face discrimination in the workplace and in access to government services, based on their HIV status. This is at least partly because the government has invested so little in informing the public about the basics of HIV transmission.  
“President Putin offered to donate $20 million the Global Fund to Fight AIDS, but his own government limps along with barely a quarter of that amount devoted each year to fight the disease at home,” said Csete.  
The Russian government should enact federal drug law reforms in the spirit of the Duma’s amendment to the criminal code, Human Rights Watch said.  
Human Rights Watch also called on the government to expand access to services that provide clean syringes for drug users, and rescind the ban on methadone for the treatment of heroin addiction. Moreover, the government should allow drug users to receive antiretroviral treatment for AIDS, and invest in public-education programs to ensure that all Russians have access to scientifically sound information on HIV/AIDS.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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