Thirty-eight year-old Haidar, who only wants to use his first name, began using heroin as a teenager.
Injection drug use was part of a criminal lifestyle that put him in prison for 13 years and cost him his health.
”I learned about having HIV this year. I have TB-HIV. That is, I have both tuberculosis and HIV,” says Haidar, as he sits on a bed in a small room he shares at a drug addicts’ rehabilitation center outside Moscow.
Haidar found out he had HIV, the virus that causes AIDS, after arriving to get treatment for his addiction.
While the rate of HIV infections in Europe is shrinking, the number of Russians infected with HIV is growing annually by 10 percent and in the past year, surpassed 1 million, according to groups tracking global infection rates.
Most acquired the virus like Haidar by sharing infected needles or paraphernalia. Haidar says he thinks he became infected by sharing a spoon used to cook heroin. “I always chose my companions to share it with carefully; although for the last year or two, I was rather careless,” he says.
It is, unfortunately, an all too common attitude among heroin addicts.
“There are a few [people] who I know well, who are infected [with HIV],” says Haidar. “They still continue to use drugs no matter what. They take medications, but continue to use heroin.”
Haidar says he would have used a clean needle exchange program if it were available; but, Russia pulled support from such programs years ago and made opiate substitution therapy illegal, despite its record of reducing HIV transmission.
Authorities argue the programs encourage drug addiction and prefer to push for abstinence. The efforts have so far failed to make a dent in what is fast becoming Russia’s HIV epidemic.
Russian Health Minister Veronika Skvortsova this month said the spread of HIV has become “critical” in 10 Russian regions. Health care authorities in Russia's Yekaterinburg declared an HIV epidemic, saying 1.8 percent of the city's population are infected. Officials have since played down the comments.
At a second annual HIV forum Monday in Moscow, Skvortsova said the ministry's main objective was to prevent the development of an epidemic as well as reduce deaths from AIDS.
“To prevent HIV from spreading among drug addicts, a complex rehabilitation and re-socialization program is being implemented based on a strategy of reducing demand or motivation, leading to a voluntary turning down of drugs by establishing a network of specialized rehabilitation centers with non-commercial groups and religious entities involved.”
Rehabilitation for injection drug addicts can work, at least for those who avoid HIV and get help before it is too late.
Dmitry Baranov used to share needles with other heroin addicts before he kicked the habit and became a volunteer at the Vershina-Navigator Foundation helping other drug addicts. He was lucky.
“Out of the guys I used drugs with together, I can state that there were seven of us, and just two currently remain and they have HIV. All the rest died.”
On the wall at the foundation’s rehabilitation center is a face mask of Russia’s communist revolutionary Vladimir Lenin with the words, “I’m also addicted. Revolution is my narcotic!”
Critics say Russia is focused too much on moral arguments for abstinence instead of education and services.
“This is a weak, non-effective policy,” says Alexander Savitsky, the chairman of Russia’s Union of People Living with HIV. “One requires a direct service, a live contact with humans. One requires training, to bring in all that to school and to those layers of the population who are most at risk.”
Russian authorities are reluctant to address the HIV problem at the street level.
In June, they added the only Moscow group handing out clean needles and advice to addicts on the street, the Andrei Rylkov Foundation, to its list of “foreign agents.”
The label, which evokes Cold War-era connotations of spying, means the group received foreign funding and its activities were deemed political. Rights groups say the label discourages cooperation and has forced some groups to close their doors.
Russia’s economic problems have also forced budget cuts in health care that may affect access to needed medicine used to treat HIV.
Russia’s Health Ministry cut the budget for buying HIV medications in 2017 by 13.5 percent, reported the RBC news website, just as more spending is needed.
Ricardo Marquina Montanana contributed to this report.