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The emerging AIDS crisis in Russia: review of enabling factors and prevention needs

According to this letter to the editor Kalichman et al. refer to a number of important issues in their review article on the enabling factors and prevention needs of the emerging AIDS crisis in Russia. However their statements did not reflect the existing state of knowledge of the sexually transmitted infection (STI) and AIDS epidemics in the Newly Independent States (NIS). Several of the statements were inaccurate and have not been substantiated. In terms of HIV being found mainly among opiate users it was not clearly stated whether these belong to exactly the same youth sub-cultures as those associated with sexual risk behaviors and highest STIs. No mention was made of the decline of STI rates since 1997 throughout the NIS and the STI contribution to the HIV epidemic in the country remains largely unclear. In addition it is doubtful whether the general population surveys that were quoted as main sources allow for the generalizations made in the article. Finally the statement that HIV testing has generally and significantly declined over the years is inaccurate according to most sources.