Society
Russia’s HIV Epidemic Is Getting Worse amid Conservative Politics, the Ukraine War
February 12, 2025
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Rustam Alexander
Melbourne University and author of Red Closet: The Hidden History of Gay Oppression in the USSR
Historian Rustam Alexander writes about how the Kremlin’s conservative and repressive turn, together with the war in Ukraine, has reignited an HIV epidemic in Russia that goes back to the final years of the USSR.
Vadim Pokrovsky, a prominent epidemiologist and advocate for HIV/AIDS awareness and treatment in Russia. Source: VK
An HIV epidemic is still raging in Russia, with more than a million Russians estimated to be living with the disease. The country’s leading HIV/AIDS specialist, Vadim Pokrovsky, has been sounding the alarm ever since the collapse of the Soviet Union and has candidly acknowledged in interviews that the situation remains dire.
The ongoing war in Ukraine has worsened the epidemic. In September 2024, an exiled Russian media outlet reported that the number of new HIV cases in the military had shot up since early 2022. The increase was fivefold as autumn 2022 and over fortyfold as of early 2023. By the end of that year, HIV was diagnosed among Russian soldiers 20 times more often than before the war.
HIV/AIDS in the late Soviet Union
The story of the HIV epidemic in Russia dates back to the 1980s, when Soviet authorities initially sought to use the disease as a propaganda tool against the US. They also blamed it on so-called “risk groups,” which included homosexuals, prostitutes and drug addicts. Against this backdrop, the mass infection of newborns with HIV in hospitals in Elista, Volgograd and other Soviet cities in 1989 served as a rude awakening for both Soviet officials and the public.
It suddenly turned out that the main culprit in spreading the virus was not homosexuals or prostitutes, but rather the Soviet healthcare system, with its chronic shortages of syringes and poor ethics. In the first decade after the collapse of the Soviet Union, the virus continued to spread at record pace as an impoverished Russia had no money to curb the epidemic.
When Putin became president in 2000, the authorities’ policy toward HIV/AIDS remained mostly unchanged. The government continued to allocate meager funds for fighting the epidemic, and Vadim Pokrovsky’s warnings about the HIV crisis fell on deaf ears.
The ongoing war in Ukraine has worsened the epidemic. In September 2024, an exiled Russian media outlet reported that the number of new HIV cases in the military had shot up since early 2022. The increase was fivefold as autumn 2022 and over fortyfold as of early 2023. By the end of that year, HIV was diagnosed among Russian soldiers 20 times more often than before the war.
HIV/AIDS in the late Soviet Union
The story of the HIV epidemic in Russia dates back to the 1980s, when Soviet authorities initially sought to use the disease as a propaganda tool against the US. They also blamed it on so-called “risk groups,” which included homosexuals, prostitutes and drug addicts. Against this backdrop, the mass infection of newborns with HIV in hospitals in Elista, Volgograd and other Soviet cities in 1989 served as a rude awakening for both Soviet officials and the public.
It suddenly turned out that the main culprit in spreading the virus was not homosexuals or prostitutes, but rather the Soviet healthcare system, with its chronic shortages of syringes and poor ethics. In the first decade after the collapse of the Soviet Union, the virus continued to spread at record pace as an impoverished Russia had no money to curb the epidemic.
When Putin became president in 2000, the authorities’ policy toward HIV/AIDS remained mostly unchanged. The government continued to allocate meager funds for fighting the epidemic, and Vadim Pokrovsky’s warnings about the HIV crisis fell on deaf ears.
“Back then, Russia was eager to receive help from various international organizations to fight the epidemic.”
For example, in 2003 the World Bank sponsored one of the first international humanitarian aid programs in Russia, called Prevention, Diagnosis and Treatment of Tuberculosis and AIDS. The next year, the Global Fund to Fight AIDS, Tuberculosis and Malaria sponsored multiple projects in Russia, with the funding extending until 2018.
At the same time that Western countries were providing HIV patients with HAART – highly active antiretroviral therapy – which dramatically improved their quality of life and life expectancy, very few in Russia had access to it.
Doctors had to make brutal decisions: who gets the treatment and who does not. Those deemed “socially unpromising” (a phrase doctors even wrote on patients’ medical cards) were considered “unworthy.” They were denied HAART and inevitably died. By “socially unpromising” doctors usually meant active drug users or people with a history of drug use.
Left with no choice but to die quietly or make the government pay for the treatment, “socially unpromising” patients – some already in the late stages of AIDS – organized the FRONT AIDS movement. They chained themselves to government buildings, endured beatings from the police and even slit their veins in police stations, doggedly demanding treatment.
Zigzags in Russian government HIV/AIDS policy
Their actions caught the attention of domestic and international media, forcing Putin to take notice. He eventually declared that anyone could receive treatment “regardless of their past.” In 2006, in a striking reversal of the government’s previous policy of indifference, Putin acknowledged HIV as a critical issue.
Money was allocated, and treatment for those who needed it was provided (occasional disruptions in drug supplies continued though).
It seemed that the Russian government was now ready to properly address the issue of AIDS. In 2006, international experts commended Russia for its “highly successful” needle and condom exchange programs, as well as its success “in reducing transmission of the disease between mothers and their babies.” Seeing that Russia may finally be able to manage the virus on its own, the Global Fund to Fight AIDS, Tuberculosis and Malaria even stopped grants to Russia, as it was now “too wealthy to qualify.”
In spring 2012, as Putin returned to the Kremlin against the backdrop of the biggest political protests of his rule, he immediately began tightening control and searching for scapegoats to deflect public anger. In July 2012, for instance, he signed the notorious foreign agent law.
Nongovernmental organizations operating in Russia that received funding from abroad had their activities heavily restricted, and some, including those working on HIV issues, were subsequently forced to shut down. Later, in 2013 Putin signed a law against “gay propaganda,” which aggravated Russia’s HIV epidemic.
At the same time that Western countries were providing HIV patients with HAART – highly active antiretroviral therapy – which dramatically improved their quality of life and life expectancy, very few in Russia had access to it.
Doctors had to make brutal decisions: who gets the treatment and who does not. Those deemed “socially unpromising” (a phrase doctors even wrote on patients’ medical cards) were considered “unworthy.” They were denied HAART and inevitably died. By “socially unpromising” doctors usually meant active drug users or people with a history of drug use.
Left with no choice but to die quietly or make the government pay for the treatment, “socially unpromising” patients – some already in the late stages of AIDS – organized the FRONT AIDS movement. They chained themselves to government buildings, endured beatings from the police and even slit their veins in police stations, doggedly demanding treatment.
Zigzags in Russian government HIV/AIDS policy
Their actions caught the attention of domestic and international media, forcing Putin to take notice. He eventually declared that anyone could receive treatment “regardless of their past.” In 2006, in a striking reversal of the government’s previous policy of indifference, Putin acknowledged HIV as a critical issue.
Money was allocated, and treatment for those who needed it was provided (occasional disruptions in drug supplies continued though).
It seemed that the Russian government was now ready to properly address the issue of AIDS. In 2006, international experts commended Russia for its “highly successful” needle and condom exchange programs, as well as its success “in reducing transmission of the disease between mothers and their babies.” Seeing that Russia may finally be able to manage the virus on its own, the Global Fund to Fight AIDS, Tuberculosis and Malaria even stopped grants to Russia, as it was now “too wealthy to qualify.”
In spring 2012, as Putin returned to the Kremlin against the backdrop of the biggest political protests of his rule, he immediately began tightening control and searching for scapegoats to deflect public anger. In July 2012, for instance, he signed the notorious foreign agent law.
Nongovernmental organizations operating in Russia that received funding from abroad had their activities heavily restricted, and some, including those working on HIV issues, were subsequently forced to shut down. Later, in 2013 Putin signed a law against “gay propaganda,” which aggravated Russia’s HIV epidemic.
“According to Pokrovsky, the number of HIV-positive people in Russia stood at around 930,000 people in 2015, up from about 500,000 in 2010.”
LGBT activists in St Petersburg, Russia. May 1, 2017. In 2013, Vladimir Putin signed a law against “gay propaganda," making public manifestations of this sort dangerous and later impossible. Source: Wiki Commons
In 2015, Vladimir Pozner, one of Russia’s most well-known media figures, invited Pokrovsky to his eponymous TV show. Pozner began by quoting one of Pokrovsky’s statements made in a previous interview:
I personally know HIV-positive heads of regional administrations, Russian ministers, Duma deputies, lieutenant generals, Heroes of Russia, famous artists, popular TV presenters, directors, editors, clergy... Sometimes I think: if the minister of finance actually knew that there are HIV-positive people around him, perhaps he would allocate more money to fight HIV infections [in Russia]...
Pokrovsky confirmed that this was no exaggeration, which clearly made an impression on Pozner. This was a revelation for one Svetlana Medvedeva, the wife of then-PM Dmitri Medvedev, who happened to be watching the show. As Pokrovsky later revealed, Medvedeva personally asked the heads of Russian TV channels to cover the issue more extensively, and they complied without demanding any payment in return. Medvedeva subsequently conducted a number of events to spread awareness about HIV/AIDS in Russia, as well.
Nongovernmental media outlets also made efforts to educate the Russian public about HIV/AIDS. Presenter Pavel Lobkov came out with his HIV diagnosis, becoming the first high-profile Russian journalist to do so. Popular Russian bloggers talked about life with HIV, but their less famous colleagues who did the same sometimes had to pay a high price. One of them, Ilya Bronsky, received a barrage of hate messages for his activism and was even attacked. Meanwhile, the number of HIV cases continued to rise.
With Putin’s full-scale invasion of Ukraine in 2022, the lives of HIV-positive Russians got much harder. The war has exacerbated disruptions in the supplies of therapies for HIV across HIV/AIDS hospitals and centers outside of Moscow and St Petersburg. Likewise, Putin’s harsh crackdown on the LGBTQ community, including a law against “LBGT extremism,” are driving queer people underground, making them less likely to seek treatment.
The Russian government seems to be less and less sympathetic to HIV-positive people. In 2023, it began to recruit and send HIV-positive convicts to the front lines in Ukraine, making them wear red wristbands to indicate their positive status and thus ensuring they were treated with disdain both by doctors and by the military. In January of this year, Russian newspapers featured the story of a contract soldier from Chelyabinsk Region who, despite testing positive for HIV while in Ukraine, has not been deemed unfit for service.
In December, Pokrovsky stated that 30,000 Russians of working age die annually from HIV/AIDS.
I personally know HIV-positive heads of regional administrations, Russian ministers, Duma deputies, lieutenant generals, Heroes of Russia, famous artists, popular TV presenters, directors, editors, clergy... Sometimes I think: if the minister of finance actually knew that there are HIV-positive people around him, perhaps he would allocate more money to fight HIV infections [in Russia]...
Pokrovsky confirmed that this was no exaggeration, which clearly made an impression on Pozner. This was a revelation for one Svetlana Medvedeva, the wife of then-PM Dmitri Medvedev, who happened to be watching the show. As Pokrovsky later revealed, Medvedeva personally asked the heads of Russian TV channels to cover the issue more extensively, and they complied without demanding any payment in return. Medvedeva subsequently conducted a number of events to spread awareness about HIV/AIDS in Russia, as well.
Nongovernmental media outlets also made efforts to educate the Russian public about HIV/AIDS. Presenter Pavel Lobkov came out with his HIV diagnosis, becoming the first high-profile Russian journalist to do so. Popular Russian bloggers talked about life with HIV, but their less famous colleagues who did the same sometimes had to pay a high price. One of them, Ilya Bronsky, received a barrage of hate messages for his activism and was even attacked. Meanwhile, the number of HIV cases continued to rise.
With Putin’s full-scale invasion of Ukraine in 2022, the lives of HIV-positive Russians got much harder. The war has exacerbated disruptions in the supplies of therapies for HIV across HIV/AIDS hospitals and centers outside of Moscow and St Petersburg. Likewise, Putin’s harsh crackdown on the LGBTQ community, including a law against “LBGT extremism,” are driving queer people underground, making them less likely to seek treatment.
The Russian government seems to be less and less sympathetic to HIV-positive people. In 2023, it began to recruit and send HIV-positive convicts to the front lines in Ukraine, making them wear red wristbands to indicate their positive status and thus ensuring they were treated with disdain both by doctors and by the military. In January of this year, Russian newspapers featured the story of a contract soldier from Chelyabinsk Region who, despite testing positive for HIV while in Ukraine, has not been deemed unfit for service.
In December, Pokrovsky stated that 30,000 Russians of working age die annually from HIV/AIDS.
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