Russia: AIDS Treatment Hard to Get Behind Bars

With a shortage of physicians, poor patient education, and institutional barriers to medical releases, few incarcerated people with HIV/AIDS in Russia receive treatment, experts say.

Russia has about 42,000 inmates with HIV/AIDS in prisons and jails, Alexander Kononets, head of the Federal Prison Service health bureau, said in testimony to the Public Chamber last year. Since 2004, the number with HIV/AIDS has grown by 10,000, FPS figures show.

In the Leningrad region, just 100 of 3,500 infected inmates receive treatment, said Tatyana Bakulina, chief of IMENA, a St. Petersburg-based HIV/AIDS support organization for prisoners. "Sometimes a prisoner will come down with a severe fever for three days and nobody will examine him or give him any medicine," she said. "If he is in pain, there are no painkillers available." Further complicating the health outlook for prisoners who have HIV is the fact that a large number are co-infected with hepatitis C and/or TB, she said.

Many are initially diagnosed with HIV through routine testing during intake or transfers, said Valery Zaitsev, an FSP spokesperson who defended the system's treatment of HIV-positive prisoners. He said inmates with HIV/AIDS receive antiretrovirals (ARVs) and other needed treatment.

Even where ARVs are available, however, treatment adherence support and education are desperately needed, said Yelena Panasenko, a coordinator for HIV/AIDS support groups for prisoners in the Saratov region. Just a few non-governmental groups support ARV programs targeting prisoners.

Inmates' treatment situation "was pretty poor last year, but it is already getting better," said Vadim Pokrovsky, who leads the Federal AIDS Center. While medicines for infected federal inmates used to be distributed through regional governments, prisoners now receive the medication through a federal program.

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