Evaluation of HIV/AIDS Education in Russia Using a Video Approach

Article excerpt

During the past 20 years, when the human immunodeficiency virus (HIV) became widespread, acquired immunodeficiency syndrome (AIDS) has taken a toll of more than 11 million lives, which exceeds the toll for all other infections combined.[1] Similar to other viral infectious diseases, HIV does not recognize any geographic, political, ethnic, or gender boundaries. With increased international mobility of people, and diversity of job markets, no country or region is safe from contracting the disease. Increasing incidence and prevalence of HIV/AIDS infection worldwide is apparent. On May 16, 1999, the World Health Organization (WHO) released some chilling statistics: HIV infection is the fourth-leading cause of death in the world. It claims more lives than cancer, and is catching up with cardiovascular diseases, injuries, and acute respiratory conditions among the elderly. By the year 2000, according to the WHO prediction, there will be 40 million HIV carriers worldwide.[1]

From 1987 when the first AIDS-related death was registered in Russia until early 1999, 13,532 more people have been infected and 364 have died.[1] This official toll is strikingly less than in Africa or Western countries. Even so, the situation in Russia is changing for the worse, as the HIV-infected population and AIDS-related deaths are increasing dramatically.[1,2] From January to April 1999, 2,500 cases were registered, which was twice as many as the 1998 toll. By the end of 1999, medical experts estimated the figure at no less than 20,000.[1]

This steep rise in HIV/AIDS cases has roots deep into Russian history. The Russian Revolution of October 1917 opened up discussion of sexuality and introduced the most liberal legislation in the world at the time.[3] Nevertheless, in the early 1930s, command and administrative control of sexual affairs replaced social and moral regulations which resulted in the sexual illiteracy of the public. After collapse of the Soviet Union in the early 1990s, the sexual revolution induced a state of shock in an environment of social, political, economic, and moral crisis and among a sexually ignorant, conservative, and fundamentally sexist population.[3]

Like other revolutions in Russia, the far-reaching sexual revolution, too, has caused great damage, especially among the young by decreasing public health indicators throughout Russia and increasing sexually transmitted diseases (STD).[4,5] Weakening of censorship and control over sexually explicit material stimulated the production and dissemination of pornographic publications, films, and videos, the availability of sex aids in street kiosks, the opening of sex shops, and a proliferation of sex shows and strip clubs.[3,5] Due to inflation, unemployment, poverty, desperation, breakdown in morality, and lack of laws prohibiting prostitution, increasing numbers of teen-age prostitutes show up at railway stations or on major urban streets after dark.[3,5,6] In addition, recent political reforms, removal of restrictions on traveling, and initiation of openness brought an increase of infected visitors from within or abroad into urban areas of Eastern Europe such as St. Petersburg with the possibility of transmitting the virus to others.[7]

Studies show that Russian people are not adequately protected against HIV/AIDS infection.[2,6] To make the situation worse, the Russian health care system is undergoing radical transformation.[8] While advances in developing new medical regimens to some extent have proven effective in treating HIV/AIDS patients (but not curing), the high cost remains prohibitive. The cost of AIDS treatment appears beyond the means of most patients and of the state itself.[1] A mere 200,000 rubles was provided for research on AIDS treatment, and 2 million rubles for AIDS prevention projects in 1998.[1] The traditional Soviet system, with heavy reliance on medical interventions and prolonged inpatient hospitalizations, is threatened by lack of resources. …