On Monday in Rio de Janeiro, scientists at the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment called on Russia and neighboring states to end their ban on the use of methadone to treat injection drug addicts.

Professor Chris Beyrer, the founding director of the Center for Public Health and Human Rights at Baltimore's Johns Hopkins University, praised Russia for recently reversing its policy banning drug users from taking part in free AIDS treatment programs. "But they are still opposed to methadone use, which remains illegal there. They need to get as many people as possible off the needles," said Beyrer, who called methadone "essentially an AIDS prevention tool."

Another scientist at the conference said Russia only agreed to treat drug addicts with AIDS because doing so was a condition attached to millions of dollars in foreign aid. Others noted that, with the exception of those from Ukraine, AIDS figures from the region are not viewed as reliable. Ukraine, where 1.4 percent of adults are HIV-infected, has launched a substitution therapy program but angered AIDS groups with its recent proposal to ban methadone.

Fast-growing AIDS epidemics like those in Belarus, Ukraine, Russia, and Kazakhstan have never before been seen in countries which, like these four, are experiencing declining populations, Beyrer said, "So the implications may be more severe as the disease infects mainly young people and there is already a shortage of them. All this is due to a rising tide of heroin, with injection infecting people almost exclusively. But next we'll have a lot to do with sexual patterns of drug users."

There was some good news, however. Beyrer said evidence suggests that, at least among prostitutes, condom use is becoming the norm in Russia.

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