Russia's hard line on drug use making HIV prevention difficult

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Russia’s worsening HIV crisis is being exacerbated by government policy, police harassment and prejudice, according to a report released today by Human Rights Watch.

The report documents how harsh drug policies and routine police harassment of injecting drug users (the group most affected by HIV in Russia) impede access to basic HIV prevention services, including needle exchanges.

According to UNAIDS, almost 200,000 individuals are thought to be HIV-positive in Russia, and although the majority are injecting drug users, Human Rights Watch is warning that repressive policies are contributing to the rapid spread of HIV in the non-drug-using population.

Under Russian law it is possible to be arrested for possession of even tiny quantities of drugs, and Human Rights Watch suggests that the police see drug users as easy targets when fulfilling arrest quotas. The fear of arrest and imprisonment is reported to deter drug users from using needle exchanges and other HIV prevention services.

Russian policies on access to antiretrovirals aren’t helping either. Although 85% of HIV cases in Russia involve drug users, the Russian government excludes active HIV-positive drug users from receiving free anti-HIV medication.

The risk which drug users face of imprisonment is also contributing to the spread of HIV. Needle exchange programmes are banned in Russian prisons, and federal prison authorities do not provide condoms to inmates either.

Methadone replacement therapy, which is seen as key to HIV prevention for injecting drug users in other parts of the world, is banned in Russia, further undermining HIV prevention efforts.

Human Rights Watch also highlights the widespread prejudice and discrimination which HIV-positive individuals face in Russia, which is partly due to the failure of the Russian government to invest in public HIV education campaigns.

Although Russia has pledged $20 million to the Global Fund to Fight AIDS, its domestic HIV prevention budget is less than $5 million, says Human Rights Watch.

For effective HIV prevention to take place in Russia, Human Rights Watch recommends that the Russian government should expand access to needle exchanges, lift the ban on methadone treatment for heroin addiction, allow drug users to receive free HIV treatment, and invest in a scientifically sound public HIV education programme.

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