Fighting for AIDS drugs in Russia
By CNN's Ryan Chilcote
ST. PETERSBURG, Russia (CNN) -- In parts of central and eastern Europe, needle-sharing by drug users is the main way the AIDS virus HIV is spread.
But the epidemic is now moving rapidly outside the drug community and being transmitted by prostitutes.
While the number of cases continues to increase, the availability of drugs to treat HIV patients is sparse -- causing some activists to take desperate measures.
In St. Petersburg, activists recently carried coffins to a government building to protest against a shortage of medicine to treat people infected with HIV.
"We didn't just come here to hang out, we came here because real people are dying right now -- there are people in the hospitals right now that can't get medicine," says HIV support group leader Alexandra Volgina.
The activists' protest was ignored, but they promised to return repeatedly until someone listens.
Russia's second largest city has more than 30,000 people known to be HIV-positive -- but just two hospitals to cope with them.
Drugs can delay or prevent HIV developing into AIDS, but hospital managers say they have only half of the medicine they need. That shortage forces doctors to decide who's worth saving.
"First and foremost we have to think about the children who are born HIV positive and their mothers to keep them alive," says Dr. Elena Vinogradova.
Drug users are the lowest priority. Sharing dirty needles is still the biggest cause of new HIV cases in Russia.
One user, Zhenya, says he no longer shares needles and that more people are aware of the dangers. Still, the problem continues.
"This is the usual thing, that there are 15 people and one needle for all of them. And it's going around," Zhenya says. "They have no money to buy new."
Drug users can swap old needles for new at St. Petersburg's only exchange point, but many users are suspicious. Natasha helps keep herself and many others clean.
"They bring me their used needles," says Natasha. "They're afraid of coming to the (exchange point) so they ask me."
Across the city, the biggest support group for St. Petersburg's HIV-positive population is marking its second anniversary.
"Knowing there are a lot of people who are similar to me ... that I'm not alone with my problems ... helps me live with it," says Zhenya.
The celebrations provide a happy break from the battle many of them are waging to stay alive. But amid the happiness there is anger.
"The situation now is plain genocide," says activist Alexander Rumyantsev. "Genocide is when doctors have to decide who gets and who doesn't get medicine ... because they don't have enough. That's fascism."
But, argues one doctor, "I can't take the pills away from a child and give them to someone who's using drugs. ... The day a junkie needs to take his pills, he shoots up and is in a state of oblivion (and) he skips the pill."
Meanwhile, officials predict sex will soon overtake drug use as the main source of HIV transmission -- spreading the problem into the general population.
One prostitute, Tanya, says 90 percent of the girls she knows who sell sex for money shoot drugs. But she believes HIV is no threat to her.
"I don't know one person who died from it," she says, "even though they run around shouting that there are dead people lying all over the place."
Without more drugs available, doctors will face even more difficult choices.
