A Social 'Neutron Bomb'.(HIV infections in Russia)(Brief Article)(Statistical Data Included)

Elena Yaskevich hunches over her desk and lights up another cigarette. Her office phone, one of Moscow's few drug-addiction hot lines, rings once again. She begins yet another round of questions, the same as the last. "How old is your daughter?" Pause. "I see, 17. Vich?" the Russian word for HIV. Solemnly, she nods as she gets the mother's expected reply.

Even pros like Yaskevich have been blind-sided by the tidal wave of HIV that's hit Russia over the past two years. "This is a serious threat," she says, likening it to a "neutron bomb." That bomb has already exploded among intravenous drug users. The question is when it will go off in the general population. Officially, Russia has diagnosed 129,261 new cases of HIV over the past year and a half, including this July. That's the highest rate of infection in Europe, making Russians seven times more likely than their Western counterparts to contract the virus. And the real number of new cases could be anywhere from five to 10 times higher, according to experts. "This is a catastrophe," says Dr. Alex Gromyko, an HIV adviser to the World Health Organization. "Within the space of two years, Russia has gone from the bottom of the list to No. 1."

Infection rates are increasing almost exponentially. More than 63,000 cases have been counted during the first five months of this year, three times the rate of two years ago and double the total for the 12 years between 1987 and 1999. That's modest compared with Africa, where 17 million people have already died. But Russia's HIV-watchers feel like people preparing for a hurricane: they can close the shutters, but that won't save their home. Dr. Gromyko makes no predictions, except to say he is sure that within two or three years several million Russians will be infected. "When the deaths will be counted in the millions," he says, "then we will start to understand the tragedy."

HIV can quickly spread to the general population in a country like Russia, where standard protections against the sexual transmission of the disease are often not used and abortion is still a popular form of birth control. And clearly, few of the dramatic steps needed to combat a general epidemic are being taken. This April, Russia refused a $150 million World Bank loan for treating tuberculosis and AIDS. Reason: Health Ministry officials were reportedly "not satisfied" with certain conditions of the loan. And while Russia plans to commit $5 million on the fight ...