San Francisco Chronicle (SF); Saturday, September 14, 1991
David Tuller, Chronicle Staff Writer

That might not seem so unusual in San Francisco or New York. But Roshupkin, a slender 22-year- old with a gentle smile, lives in Moscow.

And, he says, he is committed to doing whatever is necessary to improve the Soviet Union's dismal record of caring for the growing number of people with HIV infection and AIDS.

One by one, Roshupkin ticks off the problems: Health care workers are unfamiliar with proper sterilization techniques; condoms, clean syringes, and medicine are all in drastically short supply; breaches of confidentiality of test results and discrimination against those with HIV is rampant.

"I found out I was infected (with the AIDS virus) in 1988, and I lost one job after another," said Roshupkin, who along with Moscow gay leaders wants to create an independent center to offer support services to those infected.

Throughout most of the 1980s, Soviet officials maintained that AIDS -- called SPID in Russian -- was not a problem there because the country had almost no drug abusers and homosexuals. They claimed that the epidemic was a sign of capitalist decadence, and some official media even insisted that the virus might have been created by U.S. scientists as part of a biological warfare campaign.

RECENT CHANGES

That view has changed dramatically. According to current official estimates, there have been about 650 cases of infection with HIV, the virus that causes AIDS, in the country; 54 people have actually developed AIDS.

However, virtually all health officials acknowledge that there are hundreds if not thousands of cases that go unreported. "The official numbers do not adequately reflect reality," said Dr. Asa Rakhmanova, chief epidemiologist and director of the city's AIDS program in Leningrad -- or St. Petersburg, as it will be called again beginning October 1.

In fact, two years ago, Pravda reported that by the year 2000 the country could have up to 15 million people infected with HIV and 200,000 AIDS cases. Rakhmanova and others say that many gay men avoid testing and treatment because of fear of prosecution under the country's harsh sodomy laws.

Although such prosecutions have become rarer in recent years, sex acts between adult males are still punishable by up to five years in prison under Article 121 of the Russian penal code. "People are not going to come to us if they're afraid of persecution, so the repeal of Article 121 is extremely important," said Rakhmanova.

Discrimination against people infected with HIV remains widespread, too. Marina, a young woman from a city of 50,000 who was interviewed recently at Moscow's main HIV clinic, said that she was fired from her job and that even her hometown doctors refused to treat her once she was known to be infected.

"I live in fear that the neighbors will set my apartment on fire and that my mother will still have problems even after I die," Marina said.

Marina and other patients at the HIV clinic seemed overcome with emotion at the visit by a delegation of Americans, who were in the Soviet Union to attend a gay and lesbian rights conference. Natasha, a soft-spoken woman who was about to deliver a baby, cried when members of the group gave her packets of food and money for clothes for her child.

LACK OF MEDICINE

Like others infected with HIV, Marina and Natasha report several times a year to one of the AIDS clinics in the major cities for observation and treatment. Although AZT is available for those whose immune systems show signs of collapsing, medications for many of the opportunistic infections that characterize the disease are not.

"My heart is painful all the time, because I really want to help my patients, but there is no medicine," said a doctor who works with AIDS patients at a large city clinic.

With the change in the Soviet political climate, a growing number of American groups -- including the Center for Attitudinal Healing in Tiburon and the International Center for Better Health in Los Angeles -- have become active in AIDS education in the Soviet Union.

In November, the San Francisco-based International Gay and Lesbian Human Rights Commission will launch Project SPID Limit in Moscow and St. Petersburg to distribute condoms and Russian- language safe-sex materials, organize discussion groups and train AIDS volunteers and counselors.

"The information that has been distributed there is very gay-negative and sex-negative," said Kevin Gardner, a fluent Russian-speaker who will coordinate the program. "Reaching people in a way that will not make them feel alienated is a matter of life and death."

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