Since its discovery in the early 1980s, HIV has disproportionately impacted gay and bisexual men. In the United States, men who have sex with men account for more than two-thirds of all new HIV infections, according to official data, while the 2015 figure for new cases in Europe was 42 percent.
Such data puzzled Russian activist Yevgeny Pisemsky, whose own country puts that rate at around 2 percent and the rate of heterosexual transmission at nearly 50 percent -- significantly higher than in Europe and the United States.
“What, do heterosexuals there have sex differently than they do in Russia? Completely safe? Why do those numbers differ so dramatically?” Pisemsky, the head of a Russian NGO supporting people living with HIV, told RFE/RL.
Pisemsky and other HIV activists and experts in Russia say the data for HIV prevalence in Russia among men who have sex with men is deceptively low, to the detriment of the government’s efforts to stem the spread of the virus.
They say the country is experiencing a silent HIV epidemic among this demographic that is fueled in part by social stigma and wrongheaded government policies.
“They are even scared to tell their doctors about how they live their lives because they don’t want to hear the disdainful words, ‘Ah, you’re one of those,’ and then get a lecture at every appointment,” Pisemsky said.
'Poor Job Of Teaching People'
Russia, which launched a broad awareness campaign ahead of World AIDS Day on December 1, has experienced an overall surge in HIV infections and AIDS deaths in recent years that continues to rise.
It reported 103,438 new diagnoses last year, accounting for 64 percent of all new diagnoses in the World Health Organization's (WHO) European region in 2016, according to a report released this week by the WHO and the EU’s European Center for Disease Prevention and Control.
Russian Health Minister Vera Skvortsova this week touted what she said was a slowing of the rate of new infections in the country by more than half compared to an average of 10-12 percent annually since 2006.
But the head of Russia’s Federal AIDS Center, Vadim Pokrovsky, warned this week that the country was on pace again to eclipse 100,000 new infections in 2017.
Critics of Russia’s efforts to stem the spread of HIV accuse the government of failing to implement practices such as replacement therapy for intravenous drug users, provide sufficient access to antiretroviral medicines, or carry out effective educational programs.
“In my view, our prevention programs are being conducted very poorly,” Pokrovsky told a November 30 news conference. “We are doing a poor job of teaching our people, our population, how to avoid being infected with HIV.... These programs are very weak, and that’s why the number of new infections is rising.”
‘Already Difficult Environment’
Among gay and bisexual men, the true rate of HIV infection is difficult to know, said Natalya Ladnaya, a senior researcher at the Federal AIDS Center.
“I’m afraid that we simply don’t have real statistics,” she told RFE/RL.
Ladnaya said many men who were infected via sex with another man fear how that information could be used if it ended up in an official registry. The lack of accurate data about modes of transmission only serves to “give an extra push to the growth of the epidemic,” she said.
HIV activists and researchers have pointed to a 2013 Russian law banning the dissemination of “propaganda of nontraditional sexual relationships" to minors as impeding efforts to learn the true scope of the AIDS crisis among gay and bisexual men in Russia.
An article published this week by U.S.-based academics and senior UN specialists concluded that the law has “further restricted an already difficult environment” for men who have sex with men and “reduc[ed] prevention and treatment access for these men.”
Pisemsky told RFE/RL that the stigma faced by gay men in Russia is “hurting efforts to fight the epidemic across the country.”
“The lower the stigma and aggressive pressure, the more a person pays attention to his health,” he said. “Otherwise, a person is mainly thinking, ‘How do I keep them from finding out at work and at home’ and not about condoms? The government must enact antidiscrimination laws. Otherwise, preventative measures won’t work."
He said many of these men look at the official HIV statistics among their demographic and say, “See, this doesn’t impact us, and in general we’re well informed and use condoms.”
Pisemsky and other activists earlier this year launched a campaign aimed at countering discrimination against LGBT individuals, encouraging transparency about their sexual practices, and drawing authorities’ attention to the problems in tracking data for HIV infections.
The campaign, Code 103, is named for the number assigned to HIV infections via sex between men.
“We conducted a survey a while ago among HIV-positive gay men: ‘Did you say you had sexual contact with men when you were registered,’” Pisemsky said.
“More than half said 'no,'" he continued. "They are most likely registered as heterosexuals. This situation with the statistics led us to understand that there is an epidemic among men who have sex with men, but it’s invisible."
Written by RFE/RL senior correspondent Carl Schreck based on reporting by RFE/RL Russian Service correspondent Anastasia Kuzina