Although HIV/AIDS affects the whole of society, it will be impossible to stop the epidemic without large-scale programmes for prevention, diagnosis and treatment for the key populations. Aleksey Lakhov, deputy director of the St. Petersburg charity foundation Humanitarian Action, writes about the current state of HIV prevention in Russia.

On 1 December, the World AIDS Day is commemorated all over the world. The theme of this year’s World AIDS Day was “Communities make the difference”. According to the Joint United Nations Program on HIV and AIDS (UNAIDS) definition, these communities include networks of people living or affected by HIV, such as gay men and other men who have sex with men, people who inject drugs, sex workers, women and young people, counsellors, public health workers, civil society organisations and activists. That is, they include the so-called key populations with regards to the spread of HIV infection.

According to the Russian Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor), more than one million people in Russia are HIV positive. The main way of HIV transmission in our country today is the sexual one, first of all heterosexual. However, key populations (sex workers, men having sex with men, and people who inject drugs) continue to impact significantly on the spread of HIV. Compared to the general population, new HIV infections occur 10 times more frequently among people who inject drugs and inmates in prisons, and 87 times more often among men who have sex with men.

The St. Petersburg charitable foundation “Humanitarian Action” has been working with key populations since 1997. In a study that we conducted between February and July 2019 among 650 clients of our programmes, HIV infection was detected in 36% of those who used drugs. Only 56% of those were registered in the St. Petersburg AIDS centre, and only 60% of the registered people were receiving anti-retroviral treatment. Yet, as we know, early treatment (and, accordingly, early diagnostic) is crucial in preventing the spreading of HIV infection.

Indeed, the number of new HIV infections in people who use drugs is declining year by year. However, increased use of new psychoactive drugs like “bath salts” (synthetic stimulants), especially among young people between 16 and 25, is a cause for alarm. This may also indirectly affect the spread of the HIV epidemic. Without large-scale programmes for prevention, diagnosis and treatment targeted the key populations, it will be impossible to stop the HIV epidemic in Russia – which again means that the burden of HIV/AIDS will be an increasingly pressing problem for the entire society.

Aleksey Lakhov is the deputy director of the charitable foundation Humanitarian Action (St. Petersburg) and a member of the board of the organisation Together Against Hepatitis. For many years, Aleksey has been working on projects to help key populations, access to testing and treatment of HIV infection and viral hepatitis.