Evolution of AIDS policy in the Soviet Union. II. The AIDS epidemic and emergency measures.

Officially only one fully developed case of AIDS was identified among Soviet citizens in the USSR before October 1988. The case was extensively studied by the AIDS team of the Central Institute of Epidemiology and described in Soviet medical journals.' The 35 year old man, K, was brought to the institute clinic at the beginning of 1987 with advanced Kaposi's sarcoma. Three test systems (the Soviet made Antigen and Western Organin teknika and Diagnostic Pasteur) proved that he was positive for HIV, and the diagnosis was confirmed by immunoblotting at the Institute of Virology. He contracted the HIV virus through homosexual contacts in East Africa, where he had worked as an official in 1981. In July 1982 he developed a complex illness and was brought to Moscow for treatment. (According to the Soviet popular magazine Ogonek he was taken from the airport to the Institute of Epidemiology in Moscow with typical initial signs of AIDS. Mononucleosis was, however, diagnosed, and he was discharged in 1983 after prolonged treatment.2) Nobody knew anything about AIDS in the USSR at the time that he was released from hospital and returned to his native city (which was not named). Since the summer of 1983 he had had 22 homosexual partners; five of them were found to be HIV positive in 1987, and some had initial signs ofAIDS. Three female partners (of 24 tested) and one child were also found to be infected. Three female partners could not be traced, nor could all the male partners of the women positive for HIV. One woman and two men positive for HIV had been blood donors. Five people (two of them children) had been infected by them through blood transfusions. Their blood had also been used to produce immunoglobulin and albumin, but it was suggested that the technology of these processes inactivated the HIV virus. All 15 members of this infection group were under observation (which probably meant in hospital isolation). It is important to note that K was first diagnosed as having Kaposi's sarcoma in 1985. He remained the AIDS index case for nearly 19 months, but in October 1988 a new case of AIDS was diagnosed in Leningrad posthumously. A description of this new case has so far appeared only in the mass media.' Olga L, a worker in the central heating network Teploenergo and an evening student in one of the Leningrad colleges, had already died when the samples of her blood taken shortly before her death were tested for HIV and proved positive. She had a long history of many illnesses and had been treated in different Leningrad hospitals many times without being tested for HIV. It seems that she had also worked as a part time prostitute and was well known in the "foreigners" bars of some hotels frequented mainly by Finns (her photograph was later published in some Finnish newspapers). The Soviet medical industry began to mass produce test kits for HIV infection in 1988. Previously the kits had been made by the volunteer scientific staff of two laboratories of the Institute of Virology.4 Several other diagnostic systems that had been developed in other institutes proved to be unreliable. At the beginning of 1989 about 17 million people had already been tested. The spokesman for the Ministry of Foreign Affairs, Gennadi Gerasimov, told foreign journalists in January 1989 that the tests had proved positive for 334 foreign visitors and 112 Soviet citizens.'