| The UNAIDS classifies HIV in Russia as the stage
of a concentrated epidemic. This is the second, following initial (virus
penetration into population), stage when HIV infection spreads within the
risk groups, with the number of HIV-infected exceeding 5% (threshold of
a concentrated epidemic) in at least one of the groups. In case of Russia
this group is IDU. Less than 1% of the urban
pregnant women (the main HIV marker) are HIV-positive (threshold of a generalized
epidemic).
The main danger consists in the likelihood of epidemic
to spread from the risk groups to larger sectors of the population mainly
through heterosexual contacts, and, according to the FRMC AIDS experts,
this, undoubtedly, is to happen. Taking into account that risky behavior
is widespread in Russia, it may be assumed that the epidemic would hardly
be possible to retain HIV in risk groups. Any person who has (or intends
to have) sex with another partner (in addition to his/her permanent and
non-infected one) without using a condom runs the risk (so does his/her
partner) of being infected with the lethal disease. Hence, very much depends,
both at present and in future, on the shifts in sexual behavior of the
Russians.
Unfortunately, very little known of these shifts.
Until recently the common behavior model typical of a Russian woman after
reaching sexual maturity is as follows:
sex debut;
1-2 short contacts (including sex) to select a permanent
partner;
getting married after selecting a permanent partner;
giving birth to a child soon after marriage;
marital sexual life with abortion as a back up for
contraception failure.
The social and economic changes of a few past decades
have eroded this model and shifted it towards an European-style behavior
model, later marriage and older age of childbearing.
The findings of The Russia Longitudinal Monitoring
Survey (or RLMS) showed that in 2001 most of the respondents (77.6%), irrespective
of their family status, were sexually active, in age group 14-20 almost
a third (30.3%) were sexually active during the year before the survey.
The findings also showed that men, 12% of aged 14-20, 30% - aged 21-30,
17% - aged 31-40, and 10 % - aged 41-49, had more than one sexual partner
during the year. Among women the proportion of those who had more than
one partner are much smaller: the highest of 17% was recorded in the age
group of 21-30-year.
Only a fifth of the respondents said that they
had used a condom during their latest sexual intercourse, and among those
who are not married, 24.5% used a condom. Most of the respondents also
said that a condom is used mainly as a means of contraception. What is
more, among the persons who had sex with a casual acquaintance (thus being
likely at greater risk for STDs) the number of those who did not
use a condom during their latest sexual intercourse was as follows: 48%
in the age group 14-20, 37% - 21-30, 61% - 31-40, and 69% - 41-49. This
can be regarded as a matter that arouses serious concern.
Sociological studies have offered evidence that
over the last decade people in Russia commonsed their sex life earlier
and the proportion of sexually active adolescents has grown. According
to available estimates, before reaching the age of 18 the number of those
who had sex is 70-80% among boys and more than 50% among girls.
According to the poll conducted among the ninth
to eleventh grade pupils of secondary schools in St. Petersburg (sample
size 533, aged 15-17), 39% of polled had sex contacts, with an average
number of sex partners 3.4 during lifetime and 1.7 during the last year.
Some 15% of the pupils who had sex contacts (or 6% of the polled) said
that they had had five or more partners during their lifetime. When asked
as to whether they use a condom, only 29% of the sexually active school
children replied that they always use a condom; 17% of them use a condom
in contacts with a casual partner, 26% - use a condom sometimes, and 29%
- never use a condom.
According to the findings of the survey - Is It
Easy to Be Young and In Love in Russia? - (sample size 1,600 boys and girls,
aged 15-18, in five cities of Russia), 62% of boys used a condom in their
latest sex contact, whereas 22% - never used contraception at all. Among
the sexually active students of Moscow State University, who were polled
in 1997, only about a third used a condom.
Meanwhile, the situation is changing, for the better,
though slowly. It is true, that the number of abortions reduced by about
a half during last decade and contraception use increased. It is an evidence
of less inclination to risky behavior, at least among women.
Fig. 2. Abortion
dynamics in Russia (all women, 15 to 49 years old, and adolescents), 1991=100
The condom consumption has also increased. As declared
by S. V. Novikov, general director of Elastomer (Russian condoms’
producer): «… during the last three to four years it [condom consumption]
has been rising by 5-10% a year. The company is capable to manufacture
238 million condoms a year, or about 70% market share in Russia …the increase
of consumption can be attributed to the relatively low previous level...
for the 35 million population between the ages of 19 and 35, our market
should be at least 1.5 times larger than it is now...».
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