Academic journal article Washington International Law Journal

Toward a Legislative Solution to the Growing Hiv/aids Epidemic in Russia: A Case for Expanded Health Privacy

Academic journal article Washington International Law Journal

Toward a Legislative Solution to the Growing Hiv/aids Epidemic in Russia: A Case for Expanded Health Privacy

Article excerpt

I. INTRODUCTION

"If the [Russian] leadership continues to pay only lip service to the issue [of HIV/AIDS]... then the consequences ... will be devastating to... society, to family formation, to the military, to productivity of labor, [and] to continued growth of the gross domestic product."1 Russia faces one of the fastest growing rates of Human Immunodeficiency Virus ("HIV") infection in the world. The HIV epidemic there has been characterized by "explosive outbreaks among vulnerable populations ... ."3 Between 1997 and 2005, the number of officially registered HIV positive individuals in Russia ballooned from 3623 to 327,899.4 While estimates vary, it is likely that one million Russians (over one percent of the population) are infected.5 At the current rate of infection, more than fourteen million Russians could be infected with HIV by the year 2020.6

In 1995, the Russian Federation adopted comprehensive legislation prohibiting discrimination based on HIV infection or Acquired Immune Deficiency Syndrome ("AIDS").7 Because of the potential for Injecting Drug Users ("IDUs") to act as a bridge to the general population,8 the Russian government has begun to take greater legislative steps to stem the epidemic, and, in 2006, committed greatly increased funds to HIV/AIDS prevention and treatment.9

Yet more than ten years after the passage of comprehensive HIV/AIDS legislation, Russians living with HIV/AIDS continue to face discrimination based on their health status.10 Knowledge that HIV test results will remain confidential may encourage individuals to get tested.11 Conversely, a lack of adequate protection for private health information may discourage individuals from learning their health status and seeking treatment. While Russian law provides protections for health privacywhich may include information related to HIV infection-the parameters of such protections are largely undefined in the law.

Given the Russian government's recent dedication to combating the spread of HIV/AIDS, this Comment seeks to identify potential barriers to HIV prevention in Russian law. Part II of this Comment examines how social stigma related to drug use and to HIV infection in Russia has hindered voluntary HIV testing and concludes that additional protections for health status may encourage individuals to seek care.13 Part III contends that because the perceived privacy of health-related information may encourage HTV testing which, in turn, may reduce transmission, Russian law related to HIV/AIDS should contain strong protections for health privacy. Part IV argues that Russian law expressly protects the right to health privacy, but contends that conflict in existing law leaves the parameters of health privacy uncertain. Part V establishes that a lack of clear remedies for violations of health privacy exacerbates the unclear parameters of health privacy protection. Part VI compares Russian laws protecting health privacy to comprehensive health privacy legislation in the United States, the Health Insurance Portability and Accountability Act ("HIPAA").14 It concludes that, despite jurisdictional and institutional differences between the United States and Russia, Russian law should, like HIPAA, clarify the statutory right to health privacy, the remedies tied to the violation of that right, and the path to legal redress for the right's infringement.

II. SOCIAL AND GOVERNMENTAL FACTORS HAVE CONTRIBUTED TO THE SPREAD, AND HAVE HINDERED TREATMENT, OF HIV/AIDS IN RUSSIA

Various social factors, including injection drug use, have contributed to the spread of HIV/AIDS in Russia. Against this social background, the Russian government has historically allocated little money to HIV/AIDS care,16 and legislative enactments have impeded treatment of IDUs.17 Yet a recent increase in funding for HIV/AIDS indicates heightened governmental attention to the growing epidemic.18

A. Social Factors Have Aided HIV/AIDS Transmission and Impacted Disease Progression

Various social factors have impacted HIV transmission and disease progress in Russia. …

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