Pubdate: Thu, 25 Nov 1999 Source: International Herald-Tribune Copyright: International Herald Tribune 1999 Contact: http://www.iht.com/ Author: Michael Wines, New York Times Service DRUG ABUSE BLAMED FOR HIV SURGE IN MOSCOW MOSCOW Needle-sharing among intravenous drug users has set off an explosive increase in HIV infections, with the number of new cases reported in Moscow so far this year more than four times greater than in all of 1998, the World Health Organization said. The principal AIDS expert in Russia for the UN agency, Arkadiusz Majszyk, said the sharp increase was quite likely to continue for at least two or three more years, spreading to sexual partners before it levels off. "It's a real epidemic picking up," Mr. Majszyk said Tuesday. "A critical mass of injecting drug users is coming to the picture, and because of this, one or two cases of HIV -- the virus that causes AIDS - coming from outside the region is enough to start a very quick wave-of infections." The total number of Russians officially registered as HIV-positive --23,509 - -- remains low, Mr. Majszyk said, and only 445 deaths from AIDS have been reported nationwide. But the Russian government estimates the true number of HIV cases at five times the reported number. Mr. Majszyk added that, as a rule of thumb, Western specialists generally use a factor of 10. Whatever the true number, he said, the steep rise in the rate of infection is alarming -- and sometimes astounding all by itself. So far this year, the WHO report states, 12,425 new cases of HIV infection have been recorded in Russia -an increase of 358 percent over the total for all of 1998, and more than the total number of cases reported in all preceding years. The Moscow region recorded more than 4,000 new cases so far this year. In Irkutsk, a city of some 670,000 in southern Siberia, the number of reported cases leapt from 68 as of last January to 2,191 today. Three-quarters of the reported infections occur among men, the report states. The greatest rate of infection is among people between the ages of 18 and 25. Improved reporting methods may account for a small portion of the increase in known cases, Mr. Majszyk said. But the evidence points overwhelmingly to an epidemic borne by drug addicts, who he said comprise about 90 percent of the new cases. Nobody knows the true number of drug users in Russia, a nation of 146 million people, but experts place the total at about 2.5 million, with 2 million of them needle users. HIV can be spread among drug users not just by sharing needles, but by methods used widely in the former Soviet Union to prepare drugs for injection, which can contaminate the drug solution. The WHO report states that the rise is equally alarming in Ukraine and parts of Eastern Europe, where drug use and prostitution have promoted the spread of HIV. - --- MAP posted-by: Doc-Hawk