MOSCOW — On a frigid evening on the outskirts of Moscow, two HIV-prevention activists unzip backpacks, pull out packs of hypodermic needles and start discretely approaching people leaving a nearby pharmacy with an offer that could save their lives.
One man, cheeks sunken and behavior jittery, takes a plastic bag full of needles, a tube of ointment for sores and a pamphlet of material about disease prevention. “Thank you,” he says, quickly making eye contact before hurrying away.
While the rate of HIV infection is on a global decline as World AIDS Day is marked Tuesday, the number of new infections in Russia continues to rise. By 2016, the country’s Federal AIDS Center estimates the total number of those diagnosed with HIV will reach 1 million. The majority of new infections occur among injecting drug users when dirty needles are shared.
So-called harm reduction programs — which distribute clean needles and condoms as well as provide methadone substitution therapy — are shown to reduce the spread of diseases such as HIV. But the Russian government has refused to fund such initiatives, saying this approach to treatment enables addicts to continue living their dangerous lifestyle.
Activists have tried to bridge the gap.
“We know we can’t reach everyone and you can’t force anyone to stop using, but at least this provides the tools people need to reduce the spread of diseases,” said Lena Groznova, who has been participating in the Andrey Rylkov Foundation’s outreach program for the past three years. The foundation’s activists are out nearly every day in Moscow, waiting around pharmacies that sell non-prescription eye drops used to enhance the effect of opiates.
Though such clean needle distribution programs are allowed to operate, a decline in international funding severely limits the scope of their activity.
In 2009, Russia was supposed to take over the work of one of the major HIV prevention and treatment donors, the Global Fund to Fight AIDS Tuberculosis and Malaria, which operates exclusively in low-income countries and no longer considers Russia eligible based on this criterion.
“We assumed that the government was picking up all the pieces and taking over the treatment component for all of the people in need. However, the treatment that was being done by the community was not being supported by the government,” Nicolas Cantau, the Global Fund project manager for Eastern Europe and Central Asia, told The Associated Press. “We were all taken by surprise.”