Current models suggest that HIV prevalence in Russia will increase from 0.7% to roughly 4-5% between 2002 and 2005. Multiple, focal epidemics are now occurring throughout the country in such marginalized populations as drug users, sex workers and men who have sex with men. Although community-based, representative, HIV prevalence data for these populations are very limited, what data are available describe extremely high rates of infection. Studies from Togliatti City (Samara Oblast), Kaliningrad, Moscow, and elsewhere have found between one-third and one-half of those surveyed to be infected. In the last decade, Russia has seen an explosive syphilis epidemic, and sharply increased rates of gonorrhea. A general trend towards earlier sexual debut and low rates of condom use among Russian youth raise serious concerns about the future direction of the epidemic.
Several factors have hindered an effective response to the epidemic. To date, HIV/AIDS prevention programs have had low rates of coverage of the highest risk populations; behavior change communication campaigns have promoted generally diffuse messages; inadequate attention has been paid to STIs; and institutional, policy and operational barriers to care and treatment have been insufficiently addressed.
By directly engaging PLWHA and individuals from vulnerable and marginalized communities, and by designing prevention and care efforts with them to address their needs, the USAID/Russia 2002-2005 HIV/AIDS Strategy will achieve a reduction in the escalating rate of HIV infection and will reduce the projected impact of the epidemic upon the Russian economy and society. The Strategy anticipates three main results to support this objective:
1. Improved HIV/AIDS service delivery (BCC, VCT, STI) interventions
2. Improved use of epidemiological data for programming and policy development.
3. Improved replication, adoption and use of lessons learned.
The strategy continues USAID/Russia’s previous emphasis on youth, on the development of increased local capacity to respond to the epidemic, and on stregthening programs in three geographical areas: Moscow city, Saratov oblast and Samara oblast. Additionally, NGO partnerships and networks will be supported to extend efforts in these areas, and into areas of emerging epidemics, for example in the Russian Far East and Siberia. USAID/Russia’s 2002-2005 Strategy will work effectively in collaboration with the Russian Government, the international donor community, and local NGOs and leaders