Pubdate: Sat, 20 May 2000
Source: Moscow Times, The (Russia)
Copyright: 2000 The Moscow Times
Contact:  Ulitsa Pravdy, Dom 24, 125865 Moscow, Russia
Fax: (7-095) 937-3393
Website: http://www.moscowtimes.ru/
Author: Oksana Yablokova, Staff Writer

CHILDREN WITH HIV FACE RISK OF NEGLECT

Against the backdrop of a dangerous rise in HIV and AIDS cases among 
adults, the number of children under 15 carrying the deadly virus remains 
relatively low. But AIDS experts say that due to a lack of medicines and no 
unified state policy, HIV-infected children often find themselves in more 
dire straits than adult patients.

"Adult patients can be treated with 16 medicines, while for children's 
therapy only five or six medicines are available in Russia," said Yevgeny 
Voronin, chief doctor of the St. Petersburg Infectious Diseases Hospital.

Together with other AIDS experts, Voronin attended a round-table discussion 
on AIDS among children this week, in the run-up to the solemn holiday 
commemorating AIDS victims to be marked on Sunday.

According to Health Ministry statistics, 832 children have been infected 
with HIV and 102 of them have died since AIDS was first detected in Russia 
in 1987. These children contracted the disease both from HIV-infected 
mothers and through blood transfusions or injections with recycled syringes 
in hospitals.

Voronin lamented that too many children with HIV fall through the 
bureaucratic cracks because of the absence of a clear-cut state policy.

He recalled the 270 or so children infected with the human immunodeficiency 
virus through injections with recycled syringes and catheters in hospitals 
in the southern cities of Elista, Rostov and Volgograd in 1988 and 1989.

Only 155 of them are alive today, Voronin said, and 55 of them receive 
regular treatment in the hospital he heads, where they travel with their 
parents every three months for a two-week round of therapy.

But besides these 55 children, the clinic also permanently treats 40 
HIV-infected youngsters abandoned by their parents at birth. The fate of 
these children, who have no one to depend on but the state, is unclear, 
Voronin said.

The cash-strapped Health Ministry, which allocates money for the treatment 
of such children, must also provide them with some basic education allowing 
them to function in society, as no other governmental agency will fund it.

Galina Pankova, head of the epidemiology department of the Moscow AIDS 
Prevention Center, which treats 78 HIV-infected children, including 25 
abandoned by their parents, said that even healthy children born to 
HIV-infected parents have practically no chances of being adopted.

Prejudices against people with AIDS are still strong in Russia, Pankova 
said, adding that even orphanage officials find ways not to accept children 
born to HIV-infected mothers - even if they are confirmed healthy.

Voronin said HIV-infected mothers often give birth to healthy children, but 
many doctors contribute to the growing rate of HIV infection among children 
by refusing to do Cesarean sections, fearing infection themselves.

"Routine Cesarean sections reduce the risk of infecting the infant by 50 
percent. Doctors need to be given general regulations from the health 
authorities on how to handle such deliveries," Voronin said.

Pankova said her center now treats patients with Phosfazid, a Russian 
modification of AZT, the world's most common AIDS drug. Phosfazid, licensed 
by health authorities last year, has fewer side effects and remains in the 
body longer than AZT.

Along with the statistics on children, health officials also released the 
latest overall HIV and AIDS figures this week. Over 10,000 new cases of HIV 
have been registered in the first three months of this year - as compared 
to slightly more than 18,200 in all of 1999. Over 90 percent of those who 
contracted the virus were intravenous drug users, Deputy Health Minister 
Gennady Onishchenko said Monday.

The new cases bring the total number of HIV cases to 36,133, including 832 
children, the ministry reported. Health officials warn that the actual 
incidence rate of HIV may be 10 times higher, as the country still lacks 
comprehensive diagnostic and treatment programs, and as the majority of 
those with HIV don't know they have contracted the disease.

Moscow, Kaliningrad, Irkutsk, Krasnodar and Tver remain the most severely 
affected regions and cities. 
- ---
MAP posted-by: Thunder