”Rights here, right now!” – the reality of injecting drug users in Russia?

Deze 2 stukjes tekst zijn onderbouwd door internationale onderzoekers die zich richten op de link tussen drugs en HIV. Dit is samengevat uit presentaties tijdens het International AIDS Conference.

Fighting HIV/AIDS in Russia

While substitution treatment programmes (such as the use of methadone) are illegal in Russia, needle exchange and other harm reduction programmes have been tolerated. Their coverage has been rather limited, however, and they have mostly been implemented through projects run by non-government organizations (NGOs) and funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria. As a middle-income country Russia is no longer eligible to receive grants from the Global Fund. In 2008 the Russian government indicated that it would continue to support successful harm reduction programmes.

In 2009 government statements, however, it was announced that such programmes will be terminated as the Global Fund grants run out while Russian HIV prevention efforts will be targeted at the general population through more general health promotion measures. The Global Fund went to the extraordinary decision to prolong it’s support to Russian harm reduction programmes and to review it’s eligibility criteria.

Fear of Punishment for Addiction

Anya Sarang confirmed that this is the situation in Russia at present: the government provides no funding for harm reduction programmes to IDUs. The prevention focus is on the so-called general population and the promotion of healthy lifestyles. Drug use is seen as a criminal offence and is treated accordingly. Sarang pointed to the international evidence showing that this policy leads to fear among the drug users, who will be afraid of accessing the health services that they need. Thus the effect on HIV rates is likely to be negative.
Furthermore, many health workers are skeptical of giving anti-retroviral drug treatment (ART) to IDUs since they are seen as unable to follow the regime for taking the medicines. Sarang, who also touched upon drug criminalization issues in countries such as Thailand, China and Iran, advocated strongly for access to health and protection of human rights as well as dignity, for people who use drugs.

Drug-Users Trust NGOS, not State
Meylakhs confirmed that prevention campaigns directed towards the general population are inefficient for IDUs. Though most IDUs trust information given by various information sources, they do not always act upon it. In smaller towns and villages IDUs are particularly vulnerable with respect to the availability of HIV/AIDS services, presence of NGOs and confidentiality issues. In some cases this leads to the avoidance of seeking services. Apart from information campaigns none of the informants had encountered other government prevention measures. Many of the informants underscored the necessity of targeted interventions, such as needle exchange programmes. Most of the IDUs preferred to work with NGOs rather than state agencies. However, they generally expressed trust in and good relationships with their doctors.



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