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May we trust to AIDS statistics?
First of all those statistics is almost
absent. The data provided by Goscomstat is really scarce, just numbers
of infected and died.
The medias basically obtain their data from two sources: Goscomstat
(these data in fact are produced by Minzdrav), and Pokrovski AIDS/HIV center.
Goscomstat data are conservative, while the data from the second source,
as a rule, are alarmist with very high numbers. As far as I understand,
there is a single source for both sets of data, and while Goscomstat publishes
the real counts of events, Pokrovski center impose some additional procedures
to "correct" the raw data, i.e., simply multiplies the number of cases
(by 5 or 10 according to my informers).
The testing could happen either voluntary or obligatory, and the latter
applies to risk groups (donors, workers of specific professions, prisoners,
etc.). The voluntary test is also a consequence of a suspicion, which reflects
a possibility of contraction the virus. When the test is a must, a consultation
on prevention also took place as a part of the procedure. In other words,
tests are collected from that part of the population, which has definitely
higher risk of infection than average Russian.
There is no reliable base to assume, that this segment of population
adequately represents the national population, as, probably, is believed
at Pokrovski center. Taking into account tens
of million (!!!) tests already made and annual number of tests exceeding
ten million, it is very difficult to assume the existence of a large number
of unscreened cases. I may even assume, that the true number is less than
reported one because of the possible double count (especially of anonymous
tests). Anyway, the methodology of Pokrovski estimates of HIV epidemic
is not transparent, and thus it is not trustworthy.
The Russian Longitudinal Monitoring Survey - RLMS
(report for April 2002) also concerns HIV tests:
37.9 percent of all respondents were tested at least once,
however only 44.5 percent of them have found out about the result; 53.1
percent told, that never tested, and 1.7 percent did not answer. Of those
tested 49.1 percent made it during last 12 months. The test was recommended
to 44.7 percent of pregnant women, and 97.9 percent of them agreed to test,
but only 93.3 percent of tested women received the result of the test.
When a (medical) Dr X. makes a statement, that the number of HIV-infected
or infected with (virus) Y is equal to Z, this does not mean, that s/he
informs public about its health conditions or morbidity level. It is more
likely that s/he actually performs an advertising, or PR action. Unfortunately,
such statements occur too frequently to believe a medical community. Fortunately
and unlikely, all demographic parameters could be verified. The experience
of cooperation with medical (wo)men led me to conclusion, that concerning
statistics they cannot be trusted, and it is relevant not only to ours
(Russians), but all around the globe. Unfortunately, medical community
with the vices and defects depicted above dominates global mass media.
"Garant" (Russian law data base package) returned a
list of 155 docs searching a string "HIV/AIDS"; it means that the government
knows about this problem. Surely, government resolutions and enactments
will not stop an epidemic. AIDS can only be stopped at an individual level,
and for this purpose the main directions are dissemination of relevant
information, enlightment, and provision of education, since the erroneous
beliefs and convictions about ways of transfer of a HIV-infection and means
of protection from it are widespread.
As well as in many other cases, Goscomstat data seems closer to a true
situation, than estimates of other organizations. Criticism of official
statistics is a common place, but arguments are usually poor or almost
absent. It is almost a default assumption that if everything in Russia
is bad, the statistics is bad too. Fortunately, it is not correct (in both
parts).
AIDS initially appeared outside of Russia, this pest came to our country
from abroad; therefore reproaches to Russian Federation in distributing
HIV epidemic are unfair. In this country (according to the main sanitary
doctor) the struggle against this infection is conducted rather successfully,
even WHO recognized our accomplishments.