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The area once known as the Soviet Union is now comprised of 17 different countries. One of those countries is our featured country in this installment of HIV Around the World. The Russian Federation (Russia) is mired in an HIV epidemic that is slowing taking its toll on the entire region, from both a public health perspective and an economic perspective.

Let’s take a trip to the Russian Federation, once the hub of the mighty Soviet Union, now the hub of an HIV epidemic.

Russia – Demographics

First some facts about Russia:

• Stretching from Eastern Europe across Asia, Russia is the largest of 17 independent nations that were collectively known as the Union of Soviet Socialist Republics (USSR), or the Soviet Union.

• Geographically, Russia is about twice the size of the United States yet has a population of about 143 million, about half as many people as the U.S.

• While there are over 140 languages and dialects across Russia, the official language is Russian.

• There are three primary ethnic groups; Russian (80 percent), Tatar (four percent), and Ukrainian (two percent).

• The primary religions are Russian Orthodox, Islam, Judaism, and Roman Catholic.

• Russia boasts 100 percent literacy, as 3 million students attend 519 schools and 48 universities. However, there is a disproportionate emphasis on science and technology education while fields of study such as business and economics lag behind.

• Russia faces a demographic crisis as births lag far behind deaths. An aging population, combined with an increasing death rate of working-age males due to alcoholism, heart disease and HIV, has contributed to the negative population growth rate. This negative population growth is expected to cut the Russian population by 30 percent over the next 50 years.

The State of HIV in Russia

Here are some facts about HIV in the Russian Federation:

• Many experts believe Russia has the fastest growing HIV rate in the world, with new cases doubling every 12 months.

• Russia represents two-thirds of all HIV cases in Eastern Europe and Central Asia

• While the number of "registered" cases are 300,000, experts believe the number to be closer to 3 million when unregistered cases are considered.

• Eighty percent of infected people in Russia are under the age of 30.

• A combination of young people being infected and an aging population is resulting in a decreasing workforce and population; if left unchecked, this trend will have a significant economic impact by the year 2020.

The History of HIV in Russia

HIV and AIDS emerged as a public health issue at the end of 1986. According to documented reports, the first HIV case was a man who contracted the disease while in Africa. He then allegedly passed the infection on to 15 Soviet soldiers with whom he had unprotected sex.

Because privacy laws did not exist in Russia at that time, these infections, complete with names of the infected, were widely publicized via mass media, using these men as examples of the types of "corrupt lifestyles" that result in AIDS. To make matters worse, homosexuality was illegal at the time, further stigmatizing these men and, in the process, HIV as well.

In the late 1980's, mandatory HIV testing was instituted across the Soviet Union. Most often this testing was done without the consent or knowledge of the person being tested. By 1991, over 142 million people had been tested, practically none of which were anonymous in nature.

Positive tests were dealt with harshly, with very aggressive contact tracing in order to find others who may also be infected. Prevention at that time consisted of fear-based ad campaigns and severe persecution of people with positive tests.

The early 1990's saw the peak of political unrest in the Soviet Union, pushing the HIV problem into the background. Foreign prevention literature, once translated into Russian, could no longer be found in the country. Public prevention campaigns ceased to exist at a time that many consider to be the age of Russian “sexual revolution”. Anonymous sexual liaisons were commonplace, safer sex was non-existent, and IV drug use was on the rise. As one would expect, this all resulted in a huge increase in HIV and other sexually transmitted diseases.

After the break-up of the Soviet Union and the formation of the independent Soviet states, HIV was again a low-priority issue. With the emphasis on the newly independent Russian Federation, HIV agencies commanded little importance and even less funding. Poor networking among the few HIV organizations that existed resulted in an inadequate flow of information between the agencies. Russian medical professionals received very little training on how to recognized and treat HIV and related illnesses.

Today in Russia, things have not improved as much as one would think. HIV is a growing problem for many of the same reasons it began 20 years ago. The leader of the Russian Federation, Vladimir Putin, has vowed to commit more resources to the HIV problem. Yet, little progress is being made.

Go to page 2 to see who is infected.