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By MIKE ECKEL, Associated Press Writer Mon May 15SARATOV, Russia - Vitaly is the face of Russia's AIDS epidemic, epitomizing many of its most troubling characteristics. The 23-year-old furniture maker, a former intravenous drug user, tells few people that he carries the virus that causes AIDS, fearing harassment and discrimination. Should his immune system fail, it's likely he won't get the drugs needed to keep him alive. "It's considered a dirty disease. People are afraid of it. It's become a joke for many. No one wants to deal with people who are infected," said Vitaly, who asked that his last name not be used because of those fears. Critics say neglect of AIDS victims by authorities and callous treatment by regular Russians are part of a culture of denial that has helped place Russia on the verge of a public health crisis, as AIDS and HIV infections spread. Russia has 334,000 officially registered HIV- or AIDS-infected people. The UNAIDS agency puts the figure at nearly 900,000 and many others say the real number is likely well over a million, around 1 percent of the country's population. The critics also believe the epidemic will deepen amid Russia's decrepit health care system, plummeting health standards, a rising tide of illegal drugs and ubiquitous discrimination. With hundreds gathering Monday for a major AIDS conference in Moscow, international health experts continue to warn that Russian officials have been too slow to react to a problem quickly moving beyond the traditional core of at-risk people - drug users, gay men and prostitutes - into the wider population. Without dramatic policy decisions, experts warn, Russia will be overwhelmed. "Russia's politics of AIDS will be misguided and contentious until its leaders and public believe that they face a threat worth fighting," Celeste Wallender [двоешник], an expert at the U.S.-based Center for Strategic and International Studies, wrote in a policy paper in December. Russia's AIDS/HIV prevalence rate was about 1.1 percent of the population in 2003, according to the United Nations' AIDS program. By comparison, the United States recorded a 0.6 percent rate and France 0.4 percent. The rate for the African country of Botswana was 37.3 percent. Last month, President Vladimir Putin pledged a twentyfold increase in federal funding to fight the disease and the issue tops the agenda for the Group of Eight major industrialized nations summit in St. Petersburg in July. In his annual state-of-the-nation address this month, however, Putin made no mention of the disease, instead focusing on Russia's sharp decline in population. The head of the Russian Orthodox Church recently called Western-funded non-governmental organizations doing AIDS work immoral. The city legislature in Moscow, which has the highest rate of HIV infection in Russia, accused foreign NGOs of fueling the epidemic. Provincial population centers such as Vitaly's home region of Saratov, 450 miles southeast of Moscow, also face a broadening epidemic. Authorities in the region are working with the Global Fund to Fight AIDS, Tuberculosis and Malaria to help drop the costs for anti-retroviral therapy - drugs that can help manage AIDS' immunity-debilitating effects. But a lack of funding still means only about 10 percent of people who need treatment receive it. Lyubov Potemina, director of the regional AIDS center, says the number of HIV-infected infants born to infected mothers has been cut dramatically and that more and more people are being tested as a matter of routine. Yet, she says, nearly two-thirds of all new HIV cases last year were due to sexual transmission - a symptom of how the disease is spreading into Russia's heterosexual, non-drug-using population. In another indication of how dire Russia's epidemic is becoming, younger and younger people are becoming infected. Russia's top AIDS official, Vadim Pokrovsky, says 1 percent of Russia's 18- to 24-year-olds are infected and at least 100 Russians become HIV infected every day. With the government slow to respond to the problem, NGOs such as Lyudmila Borisenko's "Megapolis" youth organization, have largely been at the vanguard of anti-AIDS efforts. But a new law threatens to hamstring NGO efforts by creating onerous bureaucratic regulations. Borisenko, whose organization educates youth about HIV/AIDS, says the disease remains highly stigmatized. People responded negatively when she first started her work 10 years ago, after Saratov recorded its first HIV infection. "Doctors, parents said 'Why are you doing this? You're burying your children,'" she said. "Now we tell them, 'We're saving our children.'"
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