HANGING ON THE EDGE OF HIV EPIDEMIC

RYAZAN, Central Russia -- Out of work and separated from his wife, Yury
takes the only job he can find -- chauffeuring prostitutes in this
provincial city. The women are all using heroin. He becomes close to one,
has an affair with her, and one evening while drunk accepts her challenge
to shoot up "just once."

In a matter of days, Yury is addicted. Months later, he learns he is HIV
positive. He contemplates suicide.

Yet the shock of realizing he might die of AIDS gets him off drugs. He goes
through two weeks of gut-wrenching withdrawal and stays off the stuff.

And his wife, in an act of love and pity he considers miraculous, agrees to
take him back even knowing of his infection. It would be a happy ending, if
not for the ticking time bomb in his system -- and Russia's.

The face of HIV infection in Russia is a young man, unemployed, who is
using or has used intravenous drugs -- and who has caught the disease from
injecting himself with a dirty needle. So far, comparatively few people
seem to have been infected by homosexual or heterosexual contact. Assuming,
however, that the young man is sexually active, officials fear that this
will inevitably change.

At least 201,000 Russians are HIV positive, and the country's top AIDS
fighter warns that the number of people infected but not registered with
authorities could be four to six times higher.

The former Soviet states now face the fastest-growing AIDS epidemic in the
world, the United Nations says, and international AIDS officials consider
it vital that more resources go to oppose the disease here.

There is one glimmer of hope: The number of newly registered cases of HIV
infection has actually been dropping in the last year.

But Vadim Pokrovsky, director of the Federal AIDS Center, argues that the
recent drop-off makes the situation no less alarming. "Last year, about
88,000 new cases were registered. In the first six months of this year, we
registered about 26,000 new cases -- which may seem to some analysts as a
slowdown," he said. "But the number of new cases in which the virus was
transmitted heterosexually rose to 7 percent compared with 4.3 percent last
year, which demonstrates the epidemic is spreading over the majority sector
of the population.

"And thus it begins to develop according to the African scenario, where the
majority of the HIV patients contracted it heterosexually."

In Pokrovsky's view, if just half of the HIV-infected population spreads
the virus to one sexual partner per year -- which he considers conservative
based on the African experience -- Russia could have as many as 5 million
HIV cases by 2010 and will have suffered 500,000 AIDS deaths.

"This will be very grave for the country's demographics, because 80 percent
of the infected people are between 15 and 30. They will die, and they will
not produce children. And this is very frightening indeed for Russia," he said.

HIV is striking hardest in communities of intravenous drug abusers -- young
people taking the Afghan-grown heroin that in recent years has flooded the
country via Central Asia.

Now, Pokrovsky expects a slower rise in the disease as it begins to be
spread through heterosexual sex.

Research shows there is a strong link between prostitution and drug abuse,
and the prostitutes themselves pose a major risk factor for HIV. In the
Moscow region, a survey three years ago indicated that 14 percent of
prostitutes were already infected.

Despite the danger of contracting HIV, prostitutes say many male clients
are willing to pay more to have unprotected sex -- creating an economic
incentive for the women to be more careless.

Asked why anyone would put themselves at such risk, Yury had this reply:
"There is a certain element of haphazardness in the Russian mentality," he
said, citing his own misfortune. "We are always looking for a stroke of
luck, but it seldom comes."

Soon after Yury received the news of his illness a year and a half ago, he
made a resolution: "I will do everything to make sure I do not ever infect
anyone else."

"For me," he said, "it is an ironclad rule: I will never again have sex
without a condom. I make about $100 a month, and buying good- quality
condoms leaves a breach in my family budget. I could buy cheaper ones, but
I would never do that."

Even so, he said, he can sense his wife's tension whenever they have sexual
relations. "I can't blame her," he said.

Pokrovsky sees some positive signs that people are beginning to take the
threat of AIDS seriously by using more condoms.

"We can see that the rates of syphilis and gonorrhea have dropped a bit. We
note that the use of condoms is up somewhat," he said. "But the biggest
problem is when we have evolved to a period of toleration -- meaning that
the population is no longer afraid enough of AIDS."

For example, "in June, a poll in Vlast magazine measured what issues
concerned the public. Out of several thousand respondents, there were 30
concerns listed, and AIDS was not one of them."

Pokrovsky said he sees a similar level of indifference on the part of the
nation's authorities. The expected federal budget to combat AIDS was small
enough -- 180 million rubles, or about $6 million -- he said, and then that
was reduced to $5 million.