waarom de hulp nu niet werkt

Main points :
Although HIV/AIDS has long been a taboo subject in Russia, since 2005-06 the authorities have been giving the issue more attention and funding. Despite this, the number of HIV-infected Russian citizens is on the rise: currently, approximately 1,1% of the population between 15-49 years of age are estimated to be infected. Injecting drug users make up a large risk group - more than 70% of Russian HIV-carriers have been infected through the use of unclean syringes.

Why does the authorities' new commitment have so little effect?
- HIV/AIDS competence and treatment concentrated at few, central hospitals and little involvement of other societal sectors.
- Stigma and discrimination of HIV-positive people and high risk groups (injecting drug users, MSMs, prostitutes) still widespread, among authorities, health personell and the general population. Campaigns targeted towards high risk groups are controversial and few.
- Methadone treatment illegal in Russia, needle exchange-programmes controversial and underfunded.
- Regional differences in level of commitment to and way of organizing campaigns and treatment.
- Influence of individuals and personal relations between key stakeholders important.

Myths debunked through findings in this project:
- "Most Russians have little knowledge about how HIV/AIDS passes from person to person". In fact, people - including risk groups - in the areas studied are generally well informed about how one can be infected.
- "Most Russians are sceptical towards targeted HIV-prevention programs, they have 'conservative views' on this". Representative surveys in Arkhangel'sk and St. Petersburg found that 90% support education on sexual issues in the schools, more than 70% support needle exchange-programs, and a majority supported methadone treatment.

Conclusions:
- Despite increased Federal attention, Russian authorities at different levels are still reluctant to fund programs targeted at risk groups.
- The authorities do not take much note of international recommendations when it comes to these issues, reforms depend on increased pressure from the inside.