Soviet-era taboos help bring Ukraine to edge of AIDS epidemic (10/20/02)

Soviet-era taboos help bring Ukraine to edge of AIDS epidemic

by Conor Humphries
Special to The Ukrainian Weekly

KYIV - Former nurse Anna Maksimova wasn't worried when the results of her HIV test came back positive. It was simply impossible: she wasn't a drug user, she wasn't a prostitute. Three years later, after losing her job and having her baby threatened with acid because of her infection, she has finally come to terms with the scale of the taboos and misinformation that have helped carry Ukraine to the edge of a crippling AIDS epidemic.

Lack of information on HIV/AIDS, crystallized by Soviet-era attitudes regarding sex and drugs, have contributed to the explosive growth in rates that have seen reported cases triple in the last five years, according to the United Nations AIDS Program. Meanwhile, the same mixture of negative attitudes and ignorance among those infected has led to a situation where it is estimated that somewhere between 240,000 and 350,000 cases lie undetected by the state. And, according to research by the Ukrainian Institute of Social Research and the British Council, this figure could reach 1 million by 2006 if nothing is done to improve the situation.

People diagnosed anonymously as HIV positive don't return to register themselves as infected because of fear or shame, thus excluding themselves from official statistics, explains Laima Geidar of the All-Ukrainian Network of People Living with HIV/AIDS. Drug users fear vilification and jail sentences of up to eight years and don't come back to clinics. And the vast majority of Anna's generation 25- to 35-year-olds - simply don't see themselves as at risk despite openly shunning safe sex.

Anna, like many of her age group, failed to associate the risks of unsafe sex with HIV infection. "I thought that only people who were in the high-risk groups could get HIV. Drug users, homosexuals, people working in the sex business," she recalled. She blames the Soviet mentality for the attitudes, expressed by the ironic claim by a woman from the USSR who told American television in the 1980s that there was no sex in the Soviet Union. "For our generation it was shameful to talk about sex," said Anna, "And now it's too late, they are used to not using condoms. They know that there is HIV, that there is Syphilis, but they don't use them anyway."

Thus, when she received a positive result in a routine test in the seventh month of her pregnancy she simply didn't believe it. "I wasn't afraid," she insisted, "I was convinced that it wasn't my result." When she found out that her husband also was HIV positive, Anna resigned herself to the reality of her situation and told her husband of the news. Out of a mixture of shame and despair neither mentioned it for a month afterwards.

When she came out of her cocoon and decided to search for information about her HIV/AIDS, she quickly realized that much of the society around her was equally sheltered from the problem. It took her a month of contacting clinics and non-governmental organizations to discover that there was actually hope for her baby to be born without the virus.

At one center she was advised to have an abortion. "The doctor simply didn't know it was possible that I could give birth to a healthy child," recalled Anna. Even now, three years later, she has heard the head doctor of Kyiv's No. 4 Maternity Hospital (for Mothers with Infections) say that he had never seen a healthy baby born to an HIV-positive mother.

A month after giving birth to a healthy baby, thanks to free medicine provided by the Glaxo Smith Klein Pharmaceutical Co., Anna came out of the hospital to again face intimidation and discrimination from those around her. First she was fired without cause from her job in the office of the Yabluko political party the almost inevitable consequence of a Ukrainian employer finding out one of its workers is HIV positive, according to Anna. Then a neighbor, another nurse, tried to intimidate her out of her building after finding out about her infection from a friend in the maternity hospital. She spent a month disinfecting the buttons in the building's elevator, before threatening her child. "She said that if I didn't leave the building that she would get acid and throw it on my child," recalled Anna calmly.

Anna claims to be able to understand something of the fear that others feel against AIDS. She remembers her fear when she socialized with HIV-positive friends of a homosexual acquaintance during her college days. "I was a medical professional and I know that you couldn't get [HIV] from drinking from the same cup as someone," she insists, "but I used to look to see what bottle he was drinking from the whole time. I was afraid all the same."

Although Anna still doesn't know whether she contracted AIDS from her husband or from her work in hospitals, she sees the lack of communication between couples as another major cause of the spread of the disease from the high-risk groups to the wider population. According to the Ukrainian AIDS center, 70 percent of women currently suffering from AIDS in Ukraine become infected through heterosexual contact with their husband or partners.

Laima Geidar sees such infections as becoming more and more common as a result of the economic situation in Ukraine, which forces men to travel abroad to find work. "Their husbands go away, have sex without contraceptives and when they come home they bring their wives a "present," she explained. Similarly she claimed that sailors bring the infection to the wider population in port towns like Sevastopol and Odesa - which have some of the highest rates in the country.

Today, Anna claims to have finally overcome her deep-seated idea that she was somehow "dirty" and, as the first AIDS information bill boards go up in the capital, Anna is determined to show others the truth about HIV/AIDS. She believes that the first step is to teach the government about the realities of the virus, before dealing with the medical profession and finally the public.

In particular she thinks it is vital to end the shame attached to infection for the sake of society at large. "If a person is ashamed then he won't be open with people," she said. "If he is afraid of other people finding out about his infection, he will avoid changing his habits for fear of discovery, and the situation will get worse."

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