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Try out PMC Labs and tell us what you think. Learn More. The Siberian region of Tomsk is one of 89 regions, or oblasts, in Russia. It lies on the south east of the West Siberian Plain and is rich in oil and gas. The incidence of HIV in the region is not high by Russian standards— This compares with a national incidence of per But the characteristics of the epidemic are probably typical of those seen in many other oblasts.
Life expectancy in Tomsk is low. On average men live to the age of 58; women live to Alcohol is also a big problem, as is drug misuse. It has an estimated intravenous drug users and between and commercial sex workers different surveys show these disparate figures. A neighbourhood health centre called Our Clinic, which runs a needle exchange programme and an outreach service to sex workers, encourages both groups to have a test for HIV every three months. Vladimir, aged 29 years, has been injecting drugs for 13 years. He got into drugs shortly after the Soviet Union was dismantled inhe says.
His strict school went from teaching eight subject to Without enough teachers to fill the new schedule discipline at the school faltered. With free time and little else to do drugs helped pass the time. Drugs are cheap, says Vladimir, and readily available.
Russians call it hanka. Other people make their own concoctions of drugs—one called vint is made of synthetic stimulants gleaned from prescribed drugs and then injected. Vladimir is one of about people who use the needle exchange service offered by Our Clinic. He is married and free of HIV. He injects every day with opium or hanka and also smokes cannabis. He says he would like to give up drugs one day. But with no replacement programmes available and little support for drug withdrawal, the task can seem daunting.
Many commercial sex workers in the city also use drugs. But the rates of infections among sex workers tell another story. However, the people in and around the city of Tomsk are fortunate. In the first grant from the Global Fund to fight AIDS, tuberculosis, and malaria to be approved in Russia went to a consortium of non-governmental organisations.
Forty two regions applied to take part in the project, and Tomsk was one of those selected because of its experience in running harm reduction projects. Work on several projects began in earnest in February last year and includes prevention and treatment strategies.
Tomsk city boasts a tertiary AIDS clinic with a large network of doctors, psychologists, and support staff. Currently 19 people who attend the clinic are getting highly active antiretroviral therapy. A further five people, who are inmates of the prison service, are eligible for treatment, but all have refused therapy. Dr Alexander Chernov, chief physician at the AIDS centre in Tomsk, says that they were told not to accept the treatment by other inmates. Prison officials say that some men were deterred by side effects of the drugs, and others preferred to wait to start treatment when they were released from prison, which was due to be soon.
The town lies not far from Nizhnervartovsk, which sits directly on the drug route between Afghanistan and Kurdistan to the east and Ukraine to the west. There are 10 people with HIV in Nizhnervartovsk, and the disease has spread from there to Strezhenevow. To access treatment is an km round trip.
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