The stigma associated with homosexuality and drug use means that Russia and some countries of the former Soviet Union are at risk of becoming an uncontrolled HIV epidemic, experts say, after data showed a record number of new cases last year.
Most of the new cases in the former Soviet Union in 2017 were associated with heterosexual sex, because the disease spreads beyond high-risk groups, according to the World Health Organization (WHO) and the European Center for Disease Prevention and Control.
The increase in the frequency of new diagnoses in the region since 2012 has run counter to the global recession, and Masood Dara, an HIV specialist at WHO, said this could be an “early indicator of overflow in the general population.
"HIV begins [in] key consumers, i.e. drug users, sex workers and men who have sex with men – but after that [increases] exponentially … if there is no more interference, "said Dara.
In Russia, official data show that in 2017 there were more than 104,000 new HIV diagnoses, totaling more than 1.2 million. Experts said this is probably an understatement.
“We don’t have enough drugs, we don’t treat every patient,” said Nikolai Lunchenkov, a doctor at the Moscow Regional AIDS Center. "We are increasing the number of people who receive antiretroviral therapy, but this is still not enough."
The number of HIV treatment courses purchased by the Russian government increased by 37% to 360,000 last year, in accordance with the NGO Preparedness Coalition.
Methadone, which studies have shown to help prevent injecting drug use among HIV-infected people, is banned in Russia.
“We also lack data on men who have sex with other men because of the high level of stigma,” said Lunchchenkov, who is openly gay.
According to official data, the number of Russian men infected with HIV through sex with another person more than doubled to 695 between 2008 and 2015.
Experts say discrimination against LGBTI people means that people who are at risk for HIV / AIDS are afraid to seek testing and treatment.
In 2016, Russia was recognized as the second largest LGBT-free country in Europe, a network of European LGBT groups.
The requirement, introduced in 2012 for some international NGOs working in Russia to register as “foreign agents,” has reduced the number of organizations working with groups vulnerable to HIV, said Oli Stevens, a HIV researcher based in the UK.
“The message was very clear: MSM (men who have sex with men) are not us, they are different, they are not part of the society we are trying to build,” said Stevens.
In the rest of the former Soviet Union, new infections of drug users fell by 45% to 6,218 per year over the decade, and new cases of heterosexual transmission increased by 59% to nearly 18,000.
Activists blame widespread discrimination against LGBTI people for an eight-fold increase in transmission among men who have sex with men, to more than 1,000 cases per year.
"Homophobia and transphobia, state-sponsored [have become] this is an important issue, ”said Yuri Vashsky of the Eurasian Coalition on Men's Health, which supports men with HIV / AIDS in the region.