Tomorrow I go to the US consulate to find out whether I got my US visa. If I’d lied on my visa application, I wouldn’t have to worry. But I said the truth, and now I’m worried I won’t get the visa. I admitted that I used drugs in the past. For the past 10 years I’ve been open about my HIV status and my drug use history. I can’t lie about these things anymore. I just don’t do that. In 2004 I was given an MTV award for being honest about my status. Now, it’s quite possible that my honesty will cost me a US visa.
I have to get to this AIDS conference. Our patient movement for access to HIV treatment in Russia, “Patients in Control,” has won the Red Ribbon award this year and I really want to be there to accept it. I also have to be there for “EVA”–a network that advocates for the rights of women living with HIV in Russia. Our network is at the beginning stages of its development and I need to learn from other countries with similar initiatives. Perhaps, other conference participants could learn something from me as well. During the many sessions I am scheduled to participate in I want to talk about doing advocacy work in countries with limited political freedoms and supporting human rights movements under these conditions. I think that would be interesting for activists from China or other countries in which the political situation is similar. But right now all I can think about is that this conference is taking place in the US and I might not get a visa because I’ve used drugs in the past.
The previous conference was in Vienna. I opened that conference. In front of thousands of people I talked about our region, about Russia, about people who use drugs and are living with HIV, and are dying. I was really nervous, but I think I did well. That conference was unique–it had a strong emphasis on our region, Eastern Europe and Central Asia. Because there were a lot of Russian participants, we staged a protest and a press-conference and succeeded at getting the Global Fund to extend its grant. More than 10,000 Russian prisoners and migrants were able to receive their ARVs for another year. We also broke the silence on the ARV stock-out crisis in Russia—finally, people outside our country were talking about our problems! All this was possible because the Austrian consulate didn’t ask us questions about past drug use or sex work. There was a general understanding that this was an AIDS conference and that our participation mattered.
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I’m used to thinking that the US is a country that promotes tolerance. It would be sad to find out that this extends to everyone but people who have used drugs. To be fair, I have to admit that my own country isn’t very tolerant towards people who use drugs either. A considerable part of our population, including some human rights activists, believes that forcible detention, beatings, starvation, humiliation and handcuffs constitute legitimate and effective drug treatment. Those who advocate for evidence-based drug treatment methods are in the minority. Russia’s drug laws are becoming more and more severe, and yet there are almost no free drug treatment centers in the country. There are no such centers for women with children. The only thing available is detoxification, which could hardly qualify as drug treatment and is not available to pregnant women. Our doctors have nothing to offer to pregnant women who use drugs. Some progressive doctors may tell them to continue using street drugs to avoid going into withdrawal and suffering a miscarriage. But more often the advice is to either get an abortion or to quit using drugs.
Not only does my country not have drug treatment, we also have regular interruptions of HIV treatment and diagnostics. According to our latest study on HIV treatment access and ARV pricing policy in Russia, the amount of HIV medications procured by the government in 2012 will not be sufficient to cover all those in need of treatment (200,000 people according to the official sources.) There are currently about 100,000 Russians with HIV and a CD4 count of less than 350 who are not receiving treatment. And yet, according to the same sources, only 5,000 new patients will be able to start treatment in 2012. When our clinics run out of treatment, they tell their patients to buy their medications. Needless to say, that’s difficult or impossible for most patients, and particularly problematic for people who use drugs. What’s worse is that more often than not, people who use drugs are discouraged from seeking HIV treatment in the first place. As one of the doctors at an HIV clinic put it: “Thank God, we’ve managed to set up our treatment programs in such a way that drug users don’t come here anymore.” At the same time there are only a handful of low-threshold drop-in centers operating in Russia where people who use drugs can start treatment, receive counseling on adherence issues and other support they need.
What we have in Russia as a result of state policy denying access to harm reduction measures and opioid substitution treatment is an epidemic that continues to grow, particularly among people who use drugs. Then again, my country has never declared itself to be tolerant or democratic–there are no conversations about equality and no promises being made here. It’s tragic, but at least they’re honest.
The US is a different story. Tolerance and equal opportunity mean something here. In the past, there used to be another question on the visa application–about people’s HIV status. Now that the question is gone, the ban on holding International AIDS Conferences in the US could be lifted, and many people living with HIV are finally able to come to the US. But people who use drugs, sex workers and former prisoners are still treated unfairly. It would be great if our rights could matter, too.
P.S. Today I received my visa. This means that I can attend the conference and do all the things I was hoping to do. The staff at the consulate asked me why I was going to the conference, when was the last time I used drugs and whether I had any prior convictions. I told them the truth.
I know I am lucky, because many of my friends and colleagues simply aren’t able to go. But I can’t help but wonder: wouldn’t it be better not to be in a situation where you have to ask yourself, even for just one second: “Would it be easier if I lied?”