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. Last Updated: 07/27/2016

Combating Russia's AIDS Curse

KALININGRAD, Western Russia -- Alexander Dreizin runs an AIDS cafe for drug addicts. He serves up tea, sympathy and clean needles.

His is a one-doctor battle against an epidemic that is marching through Russia on the back of a dramatic surge in drug use. From the Baltic Sea to the Pacific Ocean, AIDS has made speedy inroads against the futile resistance of under-funded hospitals and clinics.

By year's end, officials at the federal AIDS Prevention and Cure Center in Moscow predict, at least 500,000 Russians will be infected with HIV, which causes AIDS.

"The outbreak is horrifying," said Vadim Pokrovsky, director of the AIDS center. "The epidemic is developing geometrically."

Nowhere has the alarm been sounded more desperately than in Kaliningrad. The region, separated from the rest of Russia and surrounded by Poland, Lithuania and the Baltic Sea, is Russia's per-capita AIDS leader.

Officially, the city of the same name is home to 2,621 people who have tested positive for HIV. Local doctors resist the idea that Kaliningrad has a higher AIDS rate than the rest of Russia. They point out that the province has been quicker than most in testing residents at local hospitals.

Comparative rates of regional HIV infection are not fully reliable. But the difference between Kaliningrad and its Baltic neighbors is shocking. Estonia, Latvia and Lithuania, with almost 8 million people combined, report 421 HIV cases f one-sixth the number in Kaliningrad, population 1 million.

Kaliningrad is far from alone in the HIV fight. Moscow has the fastest growing rate of new infection, according to Russian officials. The main drug abusers are middle-class and rich youths with time and money on their hands, said Irina Savchenko, an official at the Health Ministry's anti-AIDS headquarters in Moscow.

Dreizin focuses on stopping the spread. Federal law prohibits handing out clean needles, but officials here and in other towns ignore the law.

But it is far from certain that clean needles can stem the tide of HIV, given the habits of Russia's drug abusers. Kaliningrad addicts have taken to a deadly variety of mixtures to provide a low-cost high. Chyorny, or "black," is a mixture of boiled opium combined with chemicals. Another opium cocktail called khanka costs as little as $1.50 a hit. Lately, injections of veterinary anesthetics have become popular. Often, these narcotics are sold from vats in which addicts dip their syringes.

It takes only one unclean needle to infect the kompot, or "stewed fruit" as it's called in drug slang. "The drugs themselves are the agents for contagion," Savchenko said.

Russian officials say the first AIDS case appeared in Russia in 1987; the first case in the United States was reported in 1981. As Russia and the rest of the former Soviet Union opened to the outside world f and to drug trafficking f a society that thought itself immune from Western evils became a leading importer of AIDS.

"It is like the fulfillment of a curse. We wanted to catch up with everything in the West, so the first thing we succeeded in was getting HIV," Dreizin said.

Dreizin speaks to his patients with easy authority. He set up his cafe and clinic last year, converting a basement that was once a drug shooting gallery into a shiny refuge. He depends on foreign donations to pay for items ranging from the examination equipment to condoms to sugar for the tea.

In one room of his cafe-clinic, nurses give gynecological examinations to prostitutes. In another, Dreizin and his team of psychiatrists counsel addicts on safe sex and how to break their drug habit. Finally, there is the cafe, where drug users play chess, chat with their friends and pick up clean needles.

Alexander, 39, a former electrician, said he began to take drugs at the urging of his brother, a smuggler, who got him started on diet pills. "I was getting fat and it bothered me," he said. "Later, he persuaded me to try heroin." Two years ago, when he tried to sell blood at a clinic, he discovered he was HIV-positive.