North Ossetia's Hidden AIDS Epidemic

The problem with HIV/AIDS in North Ossetia is that no one knows where it begins and ends.

Gennady Gutoyev, head doctor at the North Ossetian Centre for Combating and Preventing AIDS says that on the surface, the North Caucasian republic is in good shape compared with other parts of Russia. With official figures showing only 49 people infected with HIV, it appears to be ten times better off than Moscow or Saint Petersburg.

“But that does not mean that it is possible to feel superior and stop working, saying that we don’t have this problem,” Gutoyev said. “It does exist, and we don’t know yet what the real figures are. We are talking about 293 persons, but this is only approximate.”

Officially, 28 people have already died of AIDS in the North Ossetia, and 15 children have been born from HIV-infected mothers.

Many people are only too happy to accept the low figures. “I will never believe that there are so many people with AIDS in our republic,” said the director of a small firm. “That is a fantasy, it’s just people being fashionable. Other nations have people like that, and that means we do too. But even if these figures are real, why yell about it, why disgrace ourselves?”

Many of those already infected or at a high risk of infection are not seeking help.

A 17-year old wrestler who contracted HIV in Poland says defiantly, “I am not afraid of this disease because I feel OK so far, and when the crisis comes, there will be a cure invented.”

Denial is a common tactic. “I am a drug addict with 25 years experience, but as you see, I am still alive,” said another man. “I inject only expensive drugs and I keep good company.” But recently it emerged that he had caught HIV.

Gutoyev explains that the 15 to 35 age-group is worst affected, but otherwise it is hard to generalise. “Mainly it is people who don’t have jobs, and there also there are many HIV-infected people coming out of prisons. Residents of Vladikavkaz constitute 68 per cent of the total.”

The centre has worked in Vladikavkaz for many years, but is still cramped, crowded and in need of repairs.

“Above all, the goal of our centre is preventing new cases of infection and decreasing the risk of contraction,” said Gutoyev, saying the focus was on targeting drug users and people whose sexual activity puts them at risk.

Tamara Batagova, head of the epidemiology department at the AIDs prevention centre, notices that many people get tested for HIV only when it is too late, or if they are forced to, for example if they are going abroad. “People here do not yet think about the need to pay proper attention to their health,” she said.

Even more serious is a strong social taboo in North Ossetia against admitting that anyone in the family is infected.

“In this republic people do not talk openly about their problems,” said Gutoyev. “If a person has gone astray, neighbours and even relatives can turn their backs on him, for fear of being condemned for just knowing that person. But we have total anonymity here, I prohibit conversations along the lines of ‘I know whose son it is’ and so on.”

Rezvan, a young resident of Vladikavkaz, is all for isolating HIV-sufferers. “Just imagine, these people are walking around among us and can infect us at any moment,” he said. “They should simply be isolated from society, so that others cannot get in contact with them. A condom is not always available so there is a real chance to get infected by them. So let them stay far from us.”

The case of one young man from a well-known family in the republic shows how hard it is keep your anonymity in a small republic like North Ossetia. He had long suspected that he was HIV-positive, but was afraid of getting tested. “I was sure that the doctors would find out and gossip behind my back,” he said. “But I made up my mind [to get tested], and now I know for sure that I’m sick – why did I need this certainty? It is incurable anyway. And so many people have started gossiping that I don’t have the will to live any more.”

The AIDS Centre is conducting a poster and advertisement campaign to warn people of the dangers around them. But many locals are hostile to it.

“I heard that in addition to these flamboyant billboards with AIDS written in huge obscene letters, there will soon be new ones with big condoms,” an elderly resident of Vladikavkaz said indignantly. “I will be the first to spit on these billboards, and will despise our leadership if it allows this. Where is our sense of shame, where is our conscience, don’t we remember what our ancestors taught us? You should not even whisper words like that, let alone write them in the streets.”

“I too am against this kind of display,” agreed Larisa Baisangurova, chief specialist at the Centre for Prevention of Drug Addiction. She works in schools and with parents and teenage children, warning them about the need for “healthy habits”.

“Advertisements should be adjusted to our mentality,” she said. “Why do we need colourful condoms on billboards? The simple but meaningful phrase which is on some of the material is enough - ‘Knowing means living’.”

Yana Voitova reports for the Moscow Centre for Journalism in Extreme Situations, www.cjes.ru from North Ossetia.