At a recent Kennan Institute seminar, Judyth Twigg, Associate Professor, Department of Political Science and Public Administration, Virginia Commonwealth University, and former Title VIII-Supported Short-term Scholar, Kennan Institute, and Murray Feshbach, Senior Scholar, Woodrow Wilson Center, discussed the threat of HIV/AIDS in Russia and what can be done to prevent a devastating epidemic in that country. Feshbach stated that the true rates of HIV/AIDS infection in Russia are difficult to ascertain due to Russia's poor public health system and the social stigma associated with the disease. However, he believes that within the next few years, death rates from the disease will soar as Russians who became infected with HIV in the 1990s start developing AIDS.

According to Twigg, HIV/AIDS in Russia is most prevalent among intravenous drug users and commercial sex workers. The spread of HIV/AIDS can be partially attributed to the growth of these two groups in the chaotic social and economic environment of post-Soviet Russia. She noted that the geographic distribution of HIV/AIDS cases is uneven, with 50 percent of cases in only nine regions. However, she argued that the disease is beginning to spread to other demographic groups and other regions. The breakout into the general population may occur more rapidly in Russia than in the West, in Twigg's view, because intravenous drug users and commercial sex workers are not clearly defined or segregated groups in Russia. The sharing of needles is common in Russian drug culture, and it is not uncommon for drug users to have sexual relations with people who do not use intravenous drugs. Similarly, many women who are employed in low-wage jobs will engage in commercial sex work occasionally in order to supplement their incomes.

Feshbach argued that the AIDS epidemic could have disastrous consequences for Russia. The country, he noted, is already experiencing significant demographic decline and a crisis of public health. Even optimistic estimates from international organizations such as the World Bank indicate that by 2010, death rates from AIDS and related illnesses in Russia will be much higher, in per capita terms, than they ever were in the United States. In addition, the spread of HIV/AIDS is closely associated with the spread of tuberculosis, which is already a serious problem for Russia. Feshbach explained that the economic consequences of the AIDS epidemic will be especially serious because most people who die will be between the ages of 25 and 40—in other words, at the height of their potential economic productivity.

The Russian government has not yet begun to treat HIV/AIDS as a serious problem, according to Feshbach. Discrimination against people who are HIV positive is common, and many people deny that the disease poses a threat to people other than intravenous drug users and commercial sex workers. However, Feshbach believes that the increasing number of babies born with HIV may serve to change public perception that people who get AIDS have engaged in deviant behavior. Twigg argued that the Russian government does not devote significant financial resources to addressing the HIV/AIDS crisis, and the money that is spent is often wasted on ineffective mass screening practices rather than on targeting risk groups. She noted also that the structure of Russia's public health system and the strictness of its anti-drug laws discourage people from seeking testing and treatment.