As HIV Epidemic Hits Russia, Crux of Problem is Jail

Prisons are helping make the former Soviet bloc home to the world's fastest-growing HIV epidemic, according to a report last year from UNAIDS and the World Health Organization. Between 1996 and 2001, the number of registered new HIV infections in Russia annually surged to more than 87,000 from about 1,500.

Russia faces an enormous challenge containing the disease. Draconian drug statutes mean possession of even a minute amount of heroin can bring years behind bars for thousands of young people. About a sixth of Russia's roughly 195,000 registered people with HIV are currently in jail. Judging from Russia's high rates of STDs, HIV could spread furiously.

Internal prison policy and medical policy do not contribute to AIDS prevention. Condoms are not allowed. Prisoners who are HIV-positive are segregated from those who are HIV-negative, but tests are neither reliable nor consistently administered. Most importantly, drug use among prisoners guarantees the sharing of unclean needles. Many Russian doctors oppose needle exchange programs. Methadone is illegal in Russia.

Some critics say change must begin outside the jails with Russia's tough criminal code and its hard-line medical establishment. The drug laws practically guarantee that anyone caught with any quantity of heroin, the most popular injection drug in Russia, can expect to spend a long time behind bars. In the United States many experts consider the incarceration of drug users one of the main contributing factors to the spread of HIV among African-Americans, the hardest-hit group in America. Most US prisons also don't distribute condoms or needles in prison.

An alliance of Russian drug-control police, prison authorities and human rights advocates is pushing a bill to increase penalties for big time drug dealers and reduce them for small-time users. One major change would be to raise the official recommendation on the amount of heroin that could lead to a serious prison term. These changes will not be offered until next year. AIDS activists say the Russian health establishment has stacked the deck against drug users by denying them methadone and other therapies that could stabilize their lives.

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