AIDS: A GLOBAL ASSESSMENT : SOVIET UNION AND EASTERN EUROPE : Straining for Containment

A nation of 280 million people, the Soviet Union acknowledges only four cases of AIDS--one in a Soviet citizen and three in African students. Health officials say that only 54 AIDS virus carriers have been detected in the country.

But these same officials have, within the last several months, launched a major AIDS public education campaign and established a national network of AIDS testing centers, primarily to screen donated blood. More than 100 centers will open this year, and 300 more are planned by the end of 1988.

“I have no doubt that we shall have this illness and that it will grow from month to month and year to year,” said Dr. Vadim Pokrovsky, who runs an anonymous AIDS testing clinic in Moscow where about 70 citizens a day have their blood checked.

The Soviet decision to go forward with a massive AIDS education and detection program despite few officially reported cases of the disease mirrors the situation in many Eastern European nations.

Health authorities throughout the region, with the apparent exception of Romania, have made some attempt to inform the public of the risks of AIDS.

It may prove much more difficult, however, for these nations to actually cope with a significant volume of AIDS cases. Although health care in most East Bloc countries is nominally free of charge, health care resources are meager compared to those in most Western nations. Many medications are in short supply.

In addition, modern laboratory and record-keeping facilities are often lacking; as a consequence, blood test results may be less reliable.

Perhaps the most concerted AIDS educational effort has been launched by financially strapped Poland, which can barely afford to keep a supply of syringes and needles in its hospitals. Widely distributed posters and decals warn against promiscuity. A direct mail campaign to provide AIDS information to every household is being prepared.

So far, governments have attributed only 20 deaths to AIDS in the entire eight-country region. But there is no certainty that the official data is complete. In the Soviet Union, for example, newspapers only recently ran their first candid stories about the existence of prostitution, homosexuality and drug addiction. Bulgaria and East Germany have also made such admissions.

The one acknowledged AIDS case in a Soviet citizen is a homosexual man identified only as “N.” N, according to press accounts, previously worked in in the Central Africa nation of Tanzania as a Soviet government specialist.

N transmitted the virus to four other men, and one of the men fathered a child and both his wife and the baby proved to be AIDS virus carriers as well, according to Dr. Valentin Pokrovsky, president of the Soviet Academy of Medical Sciences and Vadim’s father. N also was a blood donor and transmitted the virus by this means as well.

Elsewhere in Eastern Europe, hundreds of individuals infected with the AIDS virus have been detected, primarily in Hungary and Yugoslavia. Most are said to be hemophiliacs or homosexuals, except in Yugoslavia where 75% of those who have tested positive for the AIDS virus are intravenous drug users.

AIDS has triggered little public hysteria, but fears of the disease crop up in sporadic episodes. In June, neighbors of an AIDS patient in Belgrade, Yugoslavia, refused to allow him to return home from the hospital, complaining that they would be forced to share toilet facilities.

Some hospital personnel in Yugoslavia and Poland have also tried to keep their distance from AIDS patients. In Poland, the shortage of nurses is so severe that nurses have little to worry about if they refuse to care for AIDS patients, according to Dr. Sofia Kuratowska, a member of the country’s special AIDS task force.

A key concern in economically weaker countries is the ability to afford extensive AIDS antibody screening of blood donors. In Czechoslovakia, the youth daily newspaper Mlada Fronta has complained that only 5,000 blood donors and 10,000 other people have been tested for the disease. Most of these tests were done by sending blood samples out of the country, according to health officials.

Some nations have made foreigners a prime target of their AIDS control programs.

Bulgaria requires all applicants for visas of one month or more to be tested for the AIDS virus on arrival; if the results are positive, they are deported.

The Soviet Union has singled out foreign students for mandatory blood checks and has sent home 40 who tested positive.

Although Valentin Pokrovsky said in an interview that homosexuals, prostitutes and drug users “must be under permanent surveillance,” the Soviet Union has no official plans to give them periodic blood tests or examinations.

Instead, the government hopes to improve its educational programs, a potentially difficult task in sexually prudish Soviet society.

“I believe that our educational work is very bad so far,” Pokrovsky said in a recent magazine interview. “There’s too much sensationalism and not enough explanations in everyday language. The cat is not called a cat.”

AIDS IN EASTERN EUROPE Bulgaria . . 1 Czechoslovakia 7 East Germany . . 3 Hungary . . 3 Poland . . 2 Romania . . 2 USSR . . 4 Yugoslavia . . 10 TOTAL CASES 32