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Drug treatment in the age of HIV/AIDS in Russia
M. Ovchinnikova1, D. Lohman2
1Fund for Medical and Social Reforms front Aids, Saint-Petersburg, Russian Federation, 2Human Rights Watch, New York, United States
Issues: Drug users make up about 80% of people living with HIV/AIDS in Russia and likely even a greater percent of those in need of antiretroviral therapy. Though free antiretroviral drugs finally became available through governmental AIDS Centers, many drug users still do not have access to ARV therapy.
Description: Since early 2007, FrontAIDS has conducted two research projects on accessibility of ARV treatment for drug users. One research project, undertaken jointly with Human Rights Watch, was focused on low quality of drug dependence treatment as an impediment to users’ access to ART. Documentation was carried out in four Russian cities and included interviews with 60 injecting drug users, over a dozen of whom were living with HIV and AIDS. The other study is an ongoing monitoring of access to hepatitis C, HIV and tuberculosis treatment in 20 Russian regions. Our research revealed: problems with procurement and distribution of ART in Russia; a lack of important diagnostic tests; lack of treatment for opportunistic infections; and discriminatory attitudes by health care providers that have in effect denied treatment to drug users in need. In addition, our research found lack of clear government support for harm reduction programs proven to reduce HIV infections among injecting drug users, insufficient engagement of harm reduction programs in ART provision, inadequate information about HIV at government health care facilities; and lack of coordination between HIV, drug dependence, and tuberculosis clinics.
Lessons learned: Advocacy for reforming the system of HIV care for drug dependant people should be a high priority for NGOs providing HIV services in Russia.
Next steps: After the findings of the research report were publicized, a new activist group in St. Petersburg, Russia, has emerged. The group will advocate for improving access to ARV therapy and high-quality medical care for drug users living with HIV.
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