Drug use is the main cause of HIV’s spread in Russia

Drug use is the main cause of HIV’s spread in Russia, where around 2% of adults have injected narcotics. As in China, authorities have concentrated on persecuting drug users and done little to protect their health. In 2003, Russia’s entire HIV prevention budget was just $1 million, and funding for harm reduction fell by 29% between 2002 and 2005.⁵⁰ Foreign donors have helped to support outreach programmes and needle exchanges in some regions, but they are few and far between. As of June 2006 the country had just 60 needle exchanges – fewer than in 2002 – and none were in Moscow. Substitution treatment – an effective way to help people give up drugs – does not exist in Russia.

In 2006, President Putin increased the federal budget for HIV and AIDS programmes, and promised to do more to tackle the epidemic. While this is encouraging news, it has coincided with increased hostility towards non-governmental organisations, and with criticism of “foreign” ideas such as condom promotion and harm reduction. Moral objections to homosexuality, drug use and commercial sex are major hindrances to HIV prevention in Russia.⁵¹

Australia

Harm reduction is taken much more seriously in Australia, where federal funding enables a wide range of outlets – including drug treatment centres, hospitals, health centres, chemists and vending machines – to distribute many millions of clean needles each year. These and other harm reduction services have been supported since the 1980s, and have been highly effective at controlling HIV. According to official estimates, the $100 million spent on needle exchanges by state and federal governments between 1990 and 2000 prevented around 25,000 HIV infections and reduced health spending by around $1.8 billion (in US dollars).⁵² Australia also has a strong history of peer outreach programmes for sex workers and men who have sex with men.⁵³