Experts Urge Russia To Drop Abstinence-Focused HIV Strategy

Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs;  Women's Health / Gynecology
Article Date: 02 Nov 2009 - 1:00 PDT

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Experts at an HIV/AIDS conference in Russia on Wednesday urged Russian officials to end the country's focus on abstinence as a strategy for curbing the spread of HIV/AIDS and adopt a more comprehensive approach that includes harm reduction programs, the AP/New York Times reports. Currently, Russia promotes programs that encourage abstinence from drugs and high-risk sex, and officials say they are committed to a "healthy lifestyles" approach to improving public health. Critics argue that programs such as needle exchanges for injection drug users and heroin substitutes like methadone would be more beneficial. At the conference, Gennadi Onishchenko -- Russia's chief public health officer -- said Russia is "emphatically against" drug replacement therapy and needle exchange programs. He said such programs promote the sale of illicit drugs and HIV transmission.

The number of HIV cases in Russia has doubled in the past eight years, and evidence indicates that the virus is increasingly transmitted through heterosexual sex, the AP/Times reports. UNAIDS says the country's growing epidemic is in contrast to sub-Saharan Africa and Southeast Asia, where HIV rates declined during the same eight-year period. Russia has increased its spending on HIV/AIDS programs by 33 times since 2006 as part of a broad new health strategy that includes expanded drug treatments for people living with HIV. Russia has become a leader worldwide in reducing mother-to-child transmission.

However, harm reduction efforts are viewed by many Russian officials as "encouraging criminal or shameful behavior," an attitude that has "left the country increasingly isolated," according to experts, the AP/Times reports. Robin Gorna, executive director of the International AIDS Society, said, "International studies show that an abstinence-based message on drug use or sex simply doesn't work." She added that it seems like "ideology is getting in the way of public health care policy" in Russia.

According to the AP/Times, there are several successful no-cost condom and needle exchange programs in Russia that are funded through grants from the Global Fund To Fight AIDS, Tuberculosis and Malaria. But those grants are being terminated because Global Fund rules state that Russia is too wealthy to qualify for them, experts say. Gorna said that Russian nongovernmental organizations and civic groups that have handed out millions of no-cost condoms lost their Global Fund grants in August because of the eligibility rules (AP/New York Times, 10/29).

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