No ‘Capitalist’ Disease : Soviets, at Last, Face Up to AIDS

A crudely painted sign on a wall points the way. “SPID,” it says, indicating the direction past the rusting metal turnstile along a dirt path to a rundown clinic in central Leningrad.

Three patients sit inside. Misha, who is his 30s and appears healthy, is looking at a television set balanced precariously on a stool. In another room, Valerie, a blonde prostitute, is bedridden, barely able to speak. On the next cot sits Ira, a lively redhead who contracted “the disease” from a lover from Sierra Leone six years ago.

All are suffering from AIDS.

“I read about SPID just last year,” Ira says, using the Russian acronym for AIDS. “I got frightened, so I decided to come have a test. It would have been much better if we had known more about this earlier.”

Treatment Effort Started

After years of officially dismissing AIDS as a disease of the corrupted West, the Soviet Union is now acknowledging its presence here and, with a palpable sense of urgency, has begun a massive education and treatment effort to try to make up for lost time.

The Soviet health minister has likened the AIDS threat to that posed by nuclear weapons. Film makers are producing graphic and horrifying educational documentaries that break previous taboos in showing how the disease can be transmitted.

And, in a striking admission of the problem, health officials in Leningrad opened a clinic just this month to conduct AIDS tests and provide physical and psychological treatment for AIDS patients. Clinic doctors, in their first interview with a Western journalist, said the hospital was needed because the number of AIDS cases in the country is vastly underestimated.

Shift Stirs Apprehension

The decision to acknowledge the existence of AIDS, or acquired immune deficiency syndrome, in the Soviet Union has awakened a deep apprehension and even alarm among some in a population indoctrinated to believe the disease was a horror of capitalism that would pass them by.

In Leningrad, hundreds wait in line each day for the anonymous blood tests offered at the new clinic.

The clinic doctors are walking a narrow line, trying to encourage awareness while at the same time seeking to control panic.

At times, panic seems to be winning.

One frightened woman who visited the clinic confessed that she no longer takes the subway, where she believes the virus can travel like wildfire.

In another instance, a man rushed in one day, insisting on being tested because he was convinced he had contracted the disease during a fistfight that drew blood.

And then there is a hard-core group of about 50 people who return repeatedly for blood tests to make sure they have not, somehow, caught this foreign and fatal disease.

“We spend a long time speaking to them,” said Dr. Alexander Kolmakov, director of the clinic. “We explain the ways of transmission and tell them they don’t need to come every week. But they don’t listen.”

“There is an epidemic of fear about the disease,” Soviet AIDS expert Vadim Pokrovsky told the daily newspaper Country Life this week. “Hundreds and thousands of terrified people come to us saying they have diagnosed themselves as suffering from AIDS. Some stop visiting saunas and swimming pools and are afraid of foreigners.”

Assembling a team of doctors for the clinic was even a bit of a problem, because information about AIDS had been so suppressed that even some educated Soviets thought the disease could be transmitted through a sweaty handshake.

“Some doctors refused to work with us, and almost everyone had a natural fear. But we have worked to overcome it,” said Dr. Aza Rachmanov, who is responsible for supervising the physical and psychological care of the three patients currently in the clinic.

Healthy Dose of Fear

The Leningrad doctors strongly believe a healthy dose of fear, if properly channeled into an awareness of dangers of the disease, is preferable to the alternative.

“We’re not afraid of panic--no, on the contrary, we are afraid of a lack of concern, of sloppiness in trying to prevent spread of the disease,” Rachmanov said.

The extent of Soviet medical concern over the disease might at first appear perplexing. Three Soviet citizens and three foreigners have died here from AIDS, according to official reports. A total of 192 Soviet citizens and 378 foreigners have been officially diagnosed here as carriers of the human immunodeficiency virus; the foreigners have all been deported.

This compares to about 142,000 people who have contracted the deadly disease worldwide, according to the World Health Organization. The global figures are believed to be much lower than reality, however, because many countries under-report or fail to report cases. In the United States, about 90,990 AIDS cases have been reported since the virus, which breaks down the body’s immune system, was identified in June, 1981.

But for many years it took courage to report an AIDS case here because of the belief that it was politically unwise. Consequently, many doctors who discovered an AIDS case apparently kept the diagnosis locked in their files. In addition, many AIDS patients, told they were suffering from other diseases, unwittingly transferred the virus to others.

100 Times More Victims

As a result, 100 times as many Soviets may have the disease as is officially acknowledged, doctors privately conceded in recent interviews at the Leningrad clinic.

Most of the Soviet citizens carrying the virus are either homosexual men or prostitutes, according to Soviet specialists. So far, none are drug users, the specialists say, but a number of AIDS sufferers have contracted the virus from medical use of unsterilized needles.

By the year 2000, according to a recent report in the Communist Party newspaper Pravda, some medical experts believe the country could have an astonishing 15 million carriers of the disease--a figure that, if accurate, would be 10 times the number estimated in the United States. About 200,000 people would have full-blown AIDS or already have died of the disease, according to the report, which has been seriously questioned by a number of authorities.

“A long time ago, some noted epidemiologists reported with certainty that this new 20th Century plague would pass us by,” the government daily Izvestia commented recently. “But the rapidly increasing number of Soviet cases shows AIDS is not somewhere ‘over there, in their country.’ It is here, among our population.”

As recently as 1987, Pokrovsky, who now refers to the “epidemic of fear,” said AIDS was not a serious problem for the Soviet Union because “the moral stands in our society are higher than, for example, in the U.S.A.”

That same year, official Soviet news media, in what the State Department called a disinformation campaign, were claiming that the CIA had genetically engineered AIDS while experimenting with biological weapons at a laboratory in Maryland.

Soviet doctors now sharply repudiate those earlier official views.

“You write for a newspaper in Los Angeles? Then it is very important that you tell your readers something,” said Dr. Andrei P. Kozlov, director of the AIDS clinic laboratory, leaning close to make his point.

“Soviet scientists never supported the idea that this virus was created in the United States,” Kozlov said. “It is necessary for the Americans to know we were not responsible for this stupidity.”

Kozlov was the first doctor to publicly identify an AIDS case in the Soviet Union, two years ago, and the first to list AIDS as a cause of the death of a Soviet citizen, just six months ago.

“I doubt Leningrad really had the first AIDS death. We were just brave enough to declare it,” Kozlov said.

Today, Kozlov’s lab, part of the clinic located in Leningrad’s Hospital No. 30, performs up to 1,500 anonymous blood tests daily.

Besides the lab, the clinic consists of a wing in the hospital set aside for AIDS patients. The facility appears sparse by American standards, with few furnishings and no attempt at cheer. But compared to dirty hospitals ridden with roaches and mice that have been described in the official Soviet media, the clinic is a gigantic step forward for the Soviet Union.

The team of doctors includes a dentist to treat AIDS patients and a pediatrician, because one of the city’s AIDS patients is a child. The doctors do their best to counsel the patients, but a psychiatrist is not included on the staff.

Even with the best of intentions, however, the Soviet Union still has some basic problems in trying to combat spread of the disease--severe shortages of both condoms and disposable needles.

Soviets growing ever more concerned about AIDS have written to newspapers complaining about the lack of condoms. The Health Ministry newspaper Medical Gazette recently reported that some desperate couples had turned to using children’s balloons.

As for syringes, Alexander I. Kondrusev, a deputy health minister, told reporters at a recent briefing that the country produced just 30 million disposable syringes last year, while health workers dispensed 3 billion injections.

The need for disposable syringes was dramatically illustrated by a case earlier this year in Elista, near the Caspian Sea.

At a city maternity hospital, 49 people, most of them children, contracted AIDS, apparently because of ignorant reuse of an unsterilized needle. The case horrified many and apparently gave fresh impetus to plans to open the Leningrad clinic.

“We used to be taught here in the Soviet Union that since we were decent people, we could not get AIDS,” Kolmakov said. “Now we know the truth--anyone can get the disease, Communist or capitalist, Soviet or American.”