As the world prepares to mark World AIDS Day, Russia is coming to the realization that the rapid spread of HIV/AIDS is becoming a serious health threat.
"You have AIDS. That means that we are going to die," sings Russian pop star Zemfira.
Such a song would have been unthinkable a decade ago. In Soviet times and the early years of post-communist Russia, AIDS was rarely discussed, and there were few known cases.
The first recorded case of HIV infection, the virus that causes AIDS, was in 1987 and the disease spread very slowly after that.
But during the past five years, the situation has changed dramatically. The number of people infected with HIV has jumped from 3,000 in 1996 to about 120,000 cases by May of this year. And that is just registered cases. Officials believe there may be as many as 600,000 people in Russia infected with HIV.
Vladimir Pokrovsky is the head of the Russian Federal Center for AIDS. He says the disease in spreading at an alarming rate.
Mr. Pokrovsky says there have been 70,000 new cases of HIV infection in Russia since the beginning of this year.
Health experts say the vast majority of those infected are intravenous drug users. Most are in their teens or early twenties. They frequently share contaminated needles, a practice that contributes to the spread of HIV.
Dmitry Blagovo is the director of Return to Life, one of the few centers around the country that works with drug users to increase awareness about AIDS and how the prevent it from spreading.
Mr. Blagovo says there is little understanding within the government that although AIDS mostly affects drug users, it will soon spread to other sectors of society through sexual transmission.
Mr. Blagovo says so far, programs such as his do not get government funding, but rely on international aid.
Arkadiusz Majszyk is the representative to Russia of UN-AIDS. His program, a joint initiative of several U.N. agencies, would like to see the Russian government spend more money on AIDS awareness and prevention. "Up to now, the government is trying to do many actions, but the main action is testing, testing, and testing," he said.
Most of the approximately $4 million the Russian government spends annually in the fight against AIDS is used to test people for the virus and treat those who are already infected. Health officials say treatment costs $12,000 per patient per year - a huge burden for Russia's already overloaded health care system.
This leaves very little money for AIDS prevention and awareness programs.
Mr. Pokrovsky, from the Federal Center for AIDS, says the government is beginning to recognize that there needs to be more discussion in Russia about AIDS.
Mr. Pokrovsky says that during a G8 meeting earlier this year, Russian President Vladimir Putin publicly acknowledged that Russia has a serious AIDS problem, which Mr. Pokrovsky described as huge progress.
Mr. Majszyk from UN-AIDS also sees reason for some optimism. For the first time, the Russian government has set up a committee to focus on AIDS throughout the country. And a number of regions have started their own prevention programs.