HIV Now Haunts Streets of Former Soviet Model City

By RICHARD BOUDREAUX

Sept. 29, 1996 12 AM PT

TIMES STAFF WRITER

SVETLAHORSK, Belarus —

First came the power station and the chemical plant. Then they built the prefabs and filled them with young workers from across the Soviet Union. The planners even left some green space in this model city of the Khrushchev era.

Next came the children, bored by it all, and the drugs they injected for escape. By the early 1990s, bloody syringes and hypodermic needles littered the playgrounds, courtyards and elevators of the look-alike apartment blocks.

Finally this summer, like a silent and invisible explosion, came the virus.

A result of communal drug use and youthful recklessness, the human immunodeficiency virus has spread through the city of 72,000, infecting at least 514 people since June. Doctors fear that up to half the estimated 7,000 drug users here, or about one in every 20 residents, might test positive for HIV, which causes AIDS.

“When I didn’t have a syringe, I would ask a friend to shoot me up,” said Sergei, a 30-year-old drug addict who has the virus. “I knew that’s how it spreads, but I thought it was somewhere far away, somewhere in America. I never thought it could reach a small place like ours and ruin so many lives.”

The HIV outbreak, stunning and frightening to people here, is the worst recorded so far by any former Soviet city. But it is only part of a larger epidemic spreading with drug abuse through dozens of communities in Russia, Ukraine and Belarus, according to officials who track the illness. If unchecked, they say, the epidemic could strain those nations’ fledgling democracies.

Most of the newly infected are young addicts or casual injectors of poppy straw, a cheap liquid opiate brewed from poppy plants grown in the region. It is traditionally cooked in a kitchen by a small circle of users, but last year the tea-colored narcotic began moving across borders in wholesale batches to networks of dealers.

The virus is fanning out along drug routes from Ukraine’s Black Sea coast, where Gypsy families have a foothold in the burgeoning market, according to law enforcement and drug specialists.

Some officials believe entire batches of the drug--up to 10 gallons each--have been infected by blood serum that is often mixed into the drug to preserve its potency during shipment. On the user end, larger numbers of people are sharing drug vials and syringes, hastening the spread of HIV from one carrier’s blood to another’s.

Ukraine, the center of the epidemic, has registered 8,256 HIV cases since the end of 1994 in a country of 51 million people. Russia, with three times the population, is starting to catch up; 387 cases have been reported this year, double the 1995 rate, with hundreds more expected by winter.

Although these numbers are small compared to those in the West, specialists say the ingredients for explosive growth are all present. The collapse of Soviet order weakened law enforcement and health care systems and brought growing rates of unemployment, migration, drug abuse, prostitution and sexually transmitted diseases. Ignorance about the virus remains widespread.

“The epidemic could eventually cause more devastation here than Chernobyl,” said Valeri V. Tkatchouk, deputy representative of the U.N. office in Belarus, referring to the 1986 nuclear disaster that sickened people throughout Ukraine, Russia and Belarus.

Restless Youth

Like so many other communities in the region, Svetlahorsk had the makings of an HIV time bomb. Its factories are crippled. The city’s population is young (average age 30), and its young are restless. A 100-gram dose of poppy straw costs $1.30--cheaper than a bottle of vodka. There is little else to do here.

It is fairly easy to spot drug addicts in Svetlahorsk. They tend to be young men with long hair, tight pants and earrings. They seek out suppliers twice a day--between 8 and 11 in the morning and 1 to 4 in the afternoon--then shoot up and stumble home in a daze.

“You become relaxed, very quiet, peaceful,” said a longtime addict in his 30s. “You see life through rainbow spectacles.”

The HIV epidemic here came to light after a 20-year-old railroad worker took his mother’s advice and traveled to Minsk, the Belarussian capital, to treat his addiction. He persuaded his wife, who had picked up his drug habit, to join him, and both tested positive there for HIV.

Svetlahorsk reacted with a mix of Soviet-era police methods and enlightened leadership, grappling with some emotional issues that await other former Soviet communities in the virus’ path.

Health workers put notices in mailboxes of known drug users inviting them to be tested for HIV. Few came forward, so Mayor Alexander S. Yakobson ordered police to escort them to the lab. Some officers climbed fire ladders to seize addicts from their apartments.

International organizations trying to help curb the epidemic objected to the forced testing on the grounds that it violates human rights and tends to drive addicts deeper underground, away from people who can help.

“The instant reaction of the authorities was to test more, test more, identify more cases, isolate them and you stop the epidemic,” said Dr. Lev Khodakevich, head of the regional U.N. Program on HIV/AIDS for Ukraine and Belarus. “It’s a very Soviet reaction.”

Mayor Yakobson admits he may have overreacted but argues that by uncovering the extent of the infection he shocked the city into action. He later won applause from the United Nations for publicizing the epidemic and rejecting his police chief’s demand to lock up every addict.

“International practice has shown that repressive measures do not work,” the mayor told a call-in audience on local television. “Concealing the problem does not work either. Besides, it’s not my style.”

The mayor’s education campaign has revealed colossal anxiety and ignorance about HIV. Audiences jam public forums and hotlines with such questions as: Can HIV spread with money? Is the river contaminated? Is humanitarian aid from the West safe? Can’t we just shoot all the addicts?

Dr. Svyatoslav M. Samoshkin, the city’s deputy chief physician, uses an extreme warning to quiet those who would punish the victims:

“We heard a rumor that people with HIV are carving sharp edges into the handrails of stairwells and smearing them with contaminated blood,” he told a packed school auditorium one evening. “They want you to cut your hand and catch their virus. I don’t know if it’s true, but if we persecute these people, this kind of ‘AIDS terrorism’ is more likely. Don’t try to unmask them. Let them live quietly among us, as they always have.”

The audience gasped.

“I’m telling my son not to touch handrails,” Zina Bochko, clutching her sixth-grader, said afterward. “It’s unnerving to live in such a town. It makes my hair stand on end.”

Other townspeople avoid clutching straps on city buses and going to the dentist.

From Minsk, the city has secured an emergency supply of disposable syringes and disinfectants, enough to shield its under-equipped hospital from the virus for six weeks. The United Nations is soliciting foreign donations of syringes and condoms to help keep HIV carriers from infecting others.

Crackdown Problems

Svetlahorsk police have thanked the United Nations for its advice to go after drug dealers rather than users. But few users will testify against their dealers, so the police are demanding foreign aid to buy video and wiretapping equipment for undercover work.

Meanwhile, universities in Minsk are demanding blood tests from Svetlahorsk applicants. Drug users are shunned by their neighbors. When the United Nations offered to train townspeople to counsel the infected, only five volunteered.

HIV carriers are finding the city too small a place to conceal their ailment; one has tried to kill himself.

But the biggest problem may be the addicts’ own indifference. Despite the shock of the epidemic, the boredom, aimlessness and fatalism that drove the young to shoot up are still overpowering, townspeople say.

“Younger addicts don’t care,” said Sergei, who like other infected people would not give his last name. “Someone will say, ‘I’ve got HIV; I’m not going to give you my syringe.’ But the younger addict will say, ‘Shoot me up anyway.’ They don’t see the point of living.”

Toll of Hopelessness

Misha, 18, is an exception.

He sat in a hospital ward, his shaven head perched awkwardly on his gangly body. A top graduate of his technical school, Misha tried to join the army this summer and took a physical. A few days ago, he was sent home for testing positive for HIV.

Clutching a towel, he started to speculate about his future.

A fist tapped on the window. Misha’s friend, the pusher who hooked him on poppy straw a few months ago, peered in, waved and quickly vanished.

“I could go out and utter one word and in a minute I’d have a fix,” Misha said. “I know I’ll live longer if I quit. But if I stay in this town, it will be impossible. Here you don’t know what to do with your life, so you shoot up. I don’t know where to go, but I need to get out of here.”

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A Deadly Trail

HIV spread slowly in the former Soviet Union, mainly through sexual contact, until a 1995 outbreak among intravenous drug users in Ukraine. In 1996, HIV has spread rapidly within Ukraine and along drug-trafficking routes from Ukraine to Belarus and Russia.

Ukraine: 8,449 cases of HIV reported since 1987. 8,256 of them in 1995 and 1996.

Places hardest hit:

Odessa

Mykolayiv

Donetsk

Simferopol

Lugansk

Cherkasy

****

Russia: 1,449 cases of HIV reported since 1987, 387 of them in 1996.

Places hardest hit:

Tyumen