InterPress News Service (IPS); Wednesday, 22 October 1997.
Andrei Ivanov and Judith Perera

Interior Minister Anatoli Kulikov's order, and his choice of a correctional labour camp in the northern Pechora region for what is in effect a concentration camp for the HIV positive, is symbolic of Russia's increasingly draconian policy on AIDS.

All HIV-positive prisoners will be sent to the frozen centre which is already heavily guarded. Russian journalists have been prevented from filming it, even from the outside. Earlier this month a camera crew from the Russian Vesti (news) TV programme was detained for two hours after trying to film the camp from a distance. The guards tried to destroy the camera and the cassette and the journalists were manhandled and threatened.

The camp is designed to hold 2,500 prisoners and has been used for some time as a quarantine camp for prisoners with tuberculosis. Currently some 45 percent of its inmates have TB.

Local people are protesting at the plans to bring in AIDS sufferers, as on release an average of 10-12 percent of the prisoners stay in the area.

An explosion of TB and AIDS among Russia's prison population is causing serious problems for Russia's financially strapped prison service.

According to major-general Vyacheslav Ovchinnikov, the head of the Interior Ministry's prison department, some 1,179 Russian convicts are now HIV positive, almost a fourfold increase over 1996.

The likely conditions that new arrivals in the northern Pechora camp will meet can be gauged by the deadly manner in which convicts with tuberculosis are treated at other quarantine camps.

Cells are overcrowded, custody and medical treatment are inadequate and there is a lack of money for food and medicines. A total of 74,000 tuberculosis patients are currently in prisons and a further 10,000 in investigation wards.

Many convicts with TB are sent from remand cells or other prisons to special Anti-Tuberculosis Colony No 10 in Nizhny Novgorod Region. There poor conditions and lack of medical care resulted in 88 deaths in 1996, while 141 died in just the first nine mon ths of this year.

The colony was designed for 1,000 convicts, but holds twice that number and spending on medicines per patient per day is just 1,800 roubles (31 cents), compared with 50,000 (8.60 dollars) at the local town TB clinic.

The number of doctors is only 40 percent of the required level, and supplies of medicines meet just eight percent of inmates' needs.

Russian president Boris Yeltsin has proposed that parliament should authorise an amnesty for some prisoners, including those with tuberculosis, but opponents have warned that such an amnesty could lead to a major outbreak of tuberculosis in Russia in ge neral.

Russia is currently suffering a rapid rise in the number of both TB and AIDS cases. This year alone, 2,985 people were tested HIV-positive, thus increasing the total number of recorded HIV- infections to 5,550.

According to the Health Ministry's Department of Sanitation and Epidemiological Oversight, almost all people who tested HIV- positive this year were infected by sharing syringes and needles when taking narcotics.

The largest number of HIV-infected people have been registered in Kaliningrad (1,656), followed by Krasnodar (873), Moscow and Moscow region (593), Tver (383), Rostov-on-Don (373) and Nizhny Novgorod (373).

Forty babies born this year have been infected by their mothers, say health officials, who predict that by the end of 1997 the total number of sufferers could total 10,000.

But Vadim Pokrovsky, director of the Russian AIDS Centre, believes that by the end of the century the total number of HIV/AIDS patients could reach 800,000 and continue to increase.

Other AIDS specialists believe the numbers may not so high. However, says Oscar Bernal, the AIDS programme coordinator for the international relief group Medecins sans Frontieres (MSF) in Russia, the conditions for a large scale epidemic in Russia are '' very favourable.''

Attempts at control in Russia involve relatively widespread compulsory testing. Apart from prisoners, other categories liable for compulsory tests include identified homosexuals and bisexuals, people with sexually transmitted diseases other than HIV, peo ple with clinical indications of HIV. Others who fall foul of the system and who are required to take the test can include individuals identified as having casual sex, even citizens returning from abroad, blood donors, pregnant women, recipients of blood products and serving soldiers.

Workers of certain professions are also tested upon accepting employment and periodically through their employment. The professions include gynaecologists, midwives, surgeons, dental surgeons, pilots, sea fishermen, navy members, including submarine work ers, air traffic controllers, and officers responsible for launching missiles.

Once a year, everyone on record is summoned by the local militia (police), to be tested. If they do not attend they are forcibly taken to a dispensary.

Pregnant women are tested in the course of antenatal visits and often are not aware that these tests are being performed. If a woman finds out and resists being tested, she is denied either an abortion or prenatal care and assistance in delivery.

On the other hand, if she is found to be HIV positive, she is obliged to have an abortion. There is no pre-test counselling. For those with a positive test result, post-test counselling is in the form of a document that has to be signed stating: ''You ar e the carrier of a deadly disease and are criminally liable for any contact that would pass that disease to another person.''

Yet the 'favourable conditions' for an epidemic that MSF cite remain.

Russian TV now carries explicit advertisements on condom use, while MSF and other organisations are launching campaigns to promote safe sex practices among young people. But many young people cannot afford expensive condoms, which has already led to a hu ge jump in the infection rates of sexually transmitted diseases like syphilis.

Those most threatened are intravenous drug users. There are estimated to be 100,000 in the Moscow area and a single drug user sharing an infected syringe or needle can spread the disease to 100 others in the course of a year, say AIDS specialists.

Unfortunately, safe drug use is not yet a subject for advertisement. Needle exchanges have been closed by the police and a proposed new law will formally ban promotion of safe drug practices on the grounds that it encourages drug use.

Russia is not able to finance a widespread anti-AIDS campaign in its present economic circumstances, nor can it afford the expensive drugs needed to treat the disease and the infections which frequently accompany AIDS, such as TB.

The AIDS Centre, for example, receives barely enough to pay salaries, and even that does not arrive on time. (END/IPS/AI/JMP/RJ/97)

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