In the context of escalating international speculation as to the determining factors behind Russia’s demographic crisis, the HIV epidemic is lent increasingly heightened significance. Such attention indicates an ever-more conspicuous absence, and thus an immediate need for the implementation of, sexual education on a national scale. A political climate, however, characterized by widespread Orthodox resurgence and efforts to reassert “traditional Russian values” in contrast to a perceived introduction of Western debauchery has contributed to official hostility towards international educational initiatives. Complex historical precedents for the mistrust and scapegoating of the West, together with a still-floundering economy, a reluctance to acknowledge the severity of the HIV problem, and the absence of Soviet models for such programs, simultaneously necessitate and complicate international dialogue aimed at establishing an effective, nationally standardized sexual education and HIV-prevention curriculum. Such Western organizations face the formidable task of addressing Russian resistance to develop programs which recognize, through a willingness to deviate when appropriate from standard Western models for such curricula, the socio-historical idiosyncrasies and dominant religious presence of post-Soviet Russia.
The reluctance of the Russian government to accept large-scale international assistance in inaugurating more widespread preventative educational measures is attributable to a combination of ill-informed tactics and ideological hostility. Yet, statistics indicate a distressing need for the implementation of such programs. A recent poll indicates that 2/3 thirds of respondents who understood the connection between AIDS and HIV also maintained that the disease is contracted through kissing, while ¾ were certain of its transmission by mosquitoes (Specter, 66). In a country in which, T.A. Gurko concludes in the Russian Social Science Review, “The early onset of sexual activity among adolescents…is taking place under conditions that are quite specific… <including> a low level of contraceptive awareness…”(59), and where “…at least 86 percent of those aged 17 and older are sexually active…”(Graves and Titova) alarming rates of both sexually transmitted diseases that are traditional harbingers for HIV (100 times those in Western Europe at 136 cases of syphilis per 100,000 verses a mere 1.5 per 100,000) (Kornienko), and abortion (roughly 13 abortions for every 10 live births) (Greenall) warrant particular attention. The introduction of sexual education and awareness programs becomes far more than grounds for perpetual moral debate. Addressing it is, rather, a matter of immediate demographic sustainability not afforded the luxury of promulgating ideology based on untenable conclusions.
There is little evidence, furthermore, to refute the feasibility and chances for success of international partnerships; on the contrary, past small-scale, foreign-backed educational projects have demonstrated great local promise. Efforts capitalizing on the decentralization of the Soviet school management system in 1987 and political openness directly following the collapse of the Soviet Union in 1991 met with the greatest success, as evinced by a 1992 collaboration between the Ministries of Education of the Former Soviet Union and the Netherlands. The first such initiative, this progressive alliance yielded encouraging results. As part of an experimental sex education program coordinated by the Dutch Ministry of Education and CROSS (Coordination Education Cooperation with Russia), a Dutch agency responsible for cooperative education programs in Central and Eastern Europe, prospective sexual health educators from more than 40 schools in the Krasnoyarsk region attended a two-day training seminar. Encouraged by the positive local response, the governor of Krasnoyarsk allocated funding for the initiative, and abortion rates among 15-19 year olds in the region had declined by 15% as of 2001 (Hermans-Servaas and Mayorova). In St. Petersburg, which registered 5,417 new HIV cases in 2000 compared to 440 in 1999 (Graves and Titova), a joint Russian-Swedish educational venture has thus far yielded similarly encouraging results. As reported in the St. Petersburg Times:
Aiming to share Western Europe’s strong tradition of sex education and provide a comprehensive network of institutions to assist young people and risk groups free of charge, the project was organized by the Swedish Institute for Infectious Disease Control and supported by the city and the oblast’s health committees, the Ott Institute of Obstetrics and Gynecology at the Russian Academy of sciences, and the WHO Collaborating Center and Uppsala University.” (Kornienko)
St. Petersburg project coordinator Natalya Vorobyova notes that from 1998-2003 rates of primary syphilis among 15-19 year olds decreased by five times and gonorrhea by 2.5, in addition to a 20 percent decline in chlamydia and nearly 50 percent decline in trichomoniasis (Kornienko). Both the Dutch and Swedish initiatives have worked to address hindrances to sexual education unique to the former Soviet Union, namely through comprehensive training programs geared towards creating a pool of qualified educators capable of working in conjunction with health care providers. An egregious neglect by the Soviet Union of reproductive health in schools and literature available to the public, conflated with the widespread belief that sexual health is a taboo subject and solely the domain of medical specialists, has resulted in a paucity of adequate knowledge on the part of adults and teachers. Training is thus a critical component of such programs, and provides perhaps the most convincing argument in favor of international partnerships to quickly and efficiently qualify a sufficient amount of educators to deal with reproductive topics.
While these types of local initiatives have typically met with official encouragement, Russia’s policies have been far less tolerant on a national level. The official line in regards to cries of inadequate funding for sexual education and HIV awareness programs, for which a meager one million dollars per year is designated as of the compilation of this research, cites the struggling economy and need for stringent budgetary prioritization. Yet, though Russia invested only four million dollars in 2003 in its own federal AIDS program, it allocated twenty million to the Global Fund to Fight AIDS. Brazil, in striking contrast considering its comparable population and lower per capita income, allocates nearly one billion dollars annually to such programs (Specter, 69). The more likely factors behind a refusal to accept foreign assistance are far more ideologically complex, and Russia has been steadfast in its efforts to maintain an image of power and stability. Recent examples of flagrant expenditures under Putin provide the most convincing proof of a growing focus on image over substance, including upwards of $1.3 billion spent in preparation for St. Petersburg’s 300th anniversary celebration in 2003, $300 million of which funded the renovation of the Konstantinovsky Palace in anticipation of a lavish celebration for international leaders (Weir). The 2001 raising of the Kursk submarine, estimated at a total cost of $80 million, provides further insight into pecuniary priority being given to issues of national pride, specifically those which garner widespread international publicity. Christof Ruehl, former chief economist at the World Bank, notes of the pervasive attitude towards HIV spending, “you will see the President and all the ministers and the economic advisers going out and saying to the world, with great pride, ‘Russia is a donor country. We are one of you. We are going to help solve this health crisis for these poor nations'”(Specter, 69). These sentiments are echoed by Vinay Saldanha of the Canada AIDS Russia Project, who states that “the problem…is that Russia doesn’t want to be seen to be begging to the international community”(Mainville). This seems to be the general consensus among specialists working to address HIV in Eurasia. Murray Feshbach, a senior scholar at the Woodrow Wilson International Center, draws an identical conclusion: “The country can only become more unstable as it becomes sicker, but its leaders cling to their view of Russia as it existed when there was a Soviet Union”(Specter, 68). A definitive acknowledgement of the severity of the HIV problem and the concomitant necessity of funding sexual education would, then, be psychologically defeating and an embarrassment to Russia on the international stage.
This conclusion is further substantiated by Russia’s frequent unwillingness to accept even volunteer assistance. Though the government’s declining a hundred-and-fifty-million-dollar loan from the World Bank is attributed officially to a desire to avoid incurring further foreign debt, other, seemingly less significant policy decisions framed in this context indicate more paranoid political motivations. In 1999, for example, Peace Corps volunteers were reprimanded for producing and distributing 25,000 copies of an AIDS informational pamphlet and ordered to stop by the Education Ministry (Graves and Titova). Joseph Smith, a regional officer of the Salvation Army’s St. Petersburg branch, cites a similar example of a visit by heads of the United Nations’ AIDS project in the same year, during which Russian officials “talked about <AIDS in Russia> as if it were not a problem at all—basically they sat there and said, ‘There is no problem'”(Graves and Titova). In April 1999, the charity-funded NAMES Foundation claims that the St. Petersburg administration refused financial support for its AIDS awareness event, and went so far as to attempt to charge them to host it (Graves and Titova). Michael Specter of The New Yorker provides a fitting summation of Russia’s passivity even amidst the action of world organizations in his description of a recent Moscow press conference for a new European Union AIDS awareness initiative: “There are many efforts in Russia now to focus attention on the epidemic—from the E.U., from the United Nations AIDS Program, from American researchers, and from the multinational relief organizations. The only groups that seem to be missing are Russian”(61-62).
Such measures taken to inhibit the implementation of sexual health and HIV prevention programs are justified by the government on account of a fundamental mistrust of all-things Western, including the moral impetus behind the efforts of international organizations on either end of the political spectrum. The most notable defeat suffered by sexual education advocates is generally considered to be the blocking of a 1996 UNESCO project, undertaken at the request of the Russian Ministry of Education and in collaboration with the United Nations Population Fund, due primarily to pressures from the recently-allied Communist Party and Orthodox Church. The project, which sought to evaluate the attitudes and knowledge of students and develop a workable, nationally tailored sexual education curriculum over a span of three years, quickly became a highly contentious political issue. Noted Russian scholar Igor S. Kon describes his dismay at the project’s fate:
Before it was even born, the project came under fire and was labeled as a “Western ideological plot against Russian children”. An aggressive group of Pro-Life activists filed a complaint with the communist-dominated Parliament’s National security committee. In some Moscow district towns people were asked in the streets: “Do you want children to be taught in school how to engage in sex? If not, please, sign the petition to ban this demonic project”. Priests and activists told their audiences that all bad things in Western life were rooted in sex education, that Western governments are now trying to ban or eliminate it, and that only the corrupt Russian government, at the instigation of the “World sexological-industrial complex”, was acting against the best interests of the country. All this was supported by pseudoscientific data (for example, that in England boys begin to masturbate at 9 years of age, and at 11 they are already completely impotent) and other lies.
The notion of an alliance of Western powers in direct opposition to a renewed Russian Orthodox Church has proven pervasive and highly potent. Kon goes on to note that, “At an important round-table in the Russian Academy of Education on March 6, 1997, influential priests declared that Russia does not need any sex education whatever in the schools, because this had always been done successfully by the Church…” The force that the Orthodox Church exerts over policy-making and public opinion is powerful, the import of which is especially significant given its vehement opposition to any form of contraception. “The Russian Orthodox Church has objected to cinema ads promoting safer sex, and billboards promoting the use of condoms raised complaints from the authorities that they were harming public morals,” reports Irena Maryniak for Eurozine. While Russia, generally regarded as being in the midst of a sexual revolution, largely ignores documented common practice in informing relevant official policy, this compartmentalization is highly detrimental in the context of a public health crisis. Maryniak continues, “But official prudery apart, Russians take pride in sleeping around, and the possibility of heterosexual transmission raises few real qualms. Sex is freedom, risk is joy, and hygiene or sanitation are not always the highest priorities.” International organizations are consequently left frustrated in the face of this insistence on an unrealistic level of moral piety to the exclusion of statistical warnings, causing them to be still more suspect in the eyes of a government with which they have long been at odds. Elements hostile to such initiatives, furthermore, are adroit at manipulating this historical tension to justify a lack of decisive action and failure to distribute accurate information to the public regarding sexual health. In light of the absence of such readily available information prior to glasnost’, guidance in this direction is naturally found in existing Western models, contributing to a vicious cycle of resentment and suspicion. If non-Orthodox, morally-lax foreign societies and their collective media are to bear the onus for Russia’s infiltration by sexually transmitted diseases and the practices through which they are spread, it follows that prevention attempts are to be equally distrusted.
Somewhat paradoxically, Russia’s escalating HIV infection rate, which most galvanizes and warrants the involvement of the global community in developing preventative educational programs, is often presented to the Russian public as a key incentive against Western involvement and awareness campaigns. The interpretation of HIV and AIDS as foreign afflictions indicative of moral decadence provides a tangible and persuasive alternative to which the Orthodox Church and conservative governmental elements juxtapose themselves, resulting in a stigma that brands prevention and treatment of the diseases as an unworthy cause. HIV is viewed instead as deserving of legal punishment on account of its historical ties to drug use and homosexuality, an approach that becomes increasingly antediluvian as infection rates skyrocket in the heterosexual community.
Michael Specter states that “AIDS was portrayed as the most ruinous manifestation of Western decadence, the Supreme Soviet had already introduced some of the strictest anti-AIDS laws in the world, among them a five-year prison term for infected people who knowingly exposed others to the disease”(61). As the Russian public struggles to reclaim its Orthodox history and the Communist party its political influence, efforts to introduce HIV, a topic inherently sexual in nature, into the educational agenda are labeled as pro-Western and thus somehow opposed to rebuilding traditional Russian values. “This is the first country with a declining population that AIDS has hit in this way,” says Steven Solnick, chief Ford Foundation representative in Russia. “And that changes everything. It makes the problem more urgent, of course, but in the Kremlin it creates a complicated political dynamic. AIDS gives the forces that are hostile to change a reason to enforce a conservative social order” (Specter, 62). Many go so far as to view AIDS, in spite of the escalating population deficit, as a kind of purifying force affecting only those undeserving of effort or funding. “The argument that the Russian government gives is simple: if there are not enough syringes in hospitals to treat young children, if the old babushka who has lived through so much is without support, why should we spend money on drug users?” confirms UNAIDS representative Arkadiusz Majszyk (Mainville). The government, then, is a primary source of anti-HIV invective, exacerbating animosities towards organizations striving to distribute preventive information and challenge dated attitudes towards the threat to the heterosexual, non-drug using community. Specter notes in his article that “One Russian woman I have known for years, a prominent liberal, said, ‘AIDS might be a good thing, in a way, because it is killing people who only destroy the country anyway'”(66). Anthropologist Michele Rivkin-Fish points out, as well, that AIDS discussion is conspicuously absent even among the efforts of many sexual health advocates. She attributes its stigma as a foreign problem largely to its comparatively late impact on Russia:
While health providers demonstrated great concern with the rapid rise of STDs such as syphilis, it is ironic that AIDS went virtually unmentioned—especially given the fact that the former is a harbinger of HIV. This…is likely a reflection of having relied on their own clinical experiences in shaping their lectures. By the midpoint of 1996, fewer than 200 cases of HIV infection had been reported in St. Petersburg, and approximately 600 were documented in Moscow (Specter, 1997). …In conversations with me, several physicians explained that they considered it a relatively remote, ‘foreign’ preoccupation…'(Rivkin-Fish).
Russian taboos regarding HIV and the demographic groups it primarily affects are incontestably rooted in legitimate observations as to the disease’s initial impact on the country, and it is understandable given both Soviet silence on sexual issues and its treatment by conservative political forces that government officials, educators and the population at large are loath to acknowledge its wider impact. The rapid spread of sexually transmitted diseases throughout the young, heterosexual community, however, belies these social conceptions, which are only perpetuated in the absence of an educational agenda addressing such concerns.
Increasing widespread alarm over Russia’s population decline functions also as ammunition for opponents of sexual education and HIV prevention programs. A firm belief that Western, specifically American, authorities are committed to systematically weakening Russia through manipulation of HIV statistics or the disease itself prevails. It follows in such a line of reasoning that sex education, a Western tradition and the movement towards which receives massive international support, is an ideal forum for indoctrinating beliefs and urging practices which will further this undermining mission. An ISAR (Initiative for Social Action and Renewal in Eurasia) report touches upon the population panic fueling much of the anti-sex education movement, asserting that “…nationalist politicians may be swayed by arguments that limiting access to family planning and contraception will ensure a Russian majority population. …The opposition to family planning and sex education as a threat from the West is alarming and deserves attention”(Dorsch and Peterson). Michael Specter writes, “I was even told, by Aleksandr Goliusov, of the Ministry of Health, that the infection rate in Russia wasn’t nearly as bad as Western experts have asserted, and he implied that the West was simply trying to humiliate Russia by inflating the figures and comparing them to Africa’s. ‘Isn’t much of this coming from your C.I.A.?’ he asked, with some justification”(65).
The fact that a rampant AIDS epidemic in Russia is especially germane in the international community due to a potential security threat is indisputable; however, this line of reasoning is effectively and underhandedly utilized to convince the public of Western encouragement of a population crisis, a strategy that, if executed, would be decidedly self-detrimental. A distortion of the Russian Planned Parenthood Association’s official slogan, “The birth of healthy and wanted children, responsible parenthood,” in the communist journal Pravda and religious news publications as “One child per family” illustrates this insistence on proving a Western objective of depopulation. Igor Kon notes that according to the Orthodox website <zhizn’.orthodoxy.ru.htm>,
…the main danger for Russian children and their parents are not abortions, HIV and syphilis but the International Planned Parenthood Federation (IPPF), which expresses the interests of the contraceptive industry, and the United Nations Population Fund, which is interested in the depopulation of Russia, so that the West can appropriate its natural resources. Parents are being taught how to sabotage any attempts to introduce sex education, even including taking their children out of the schools. They are told that condoms are inefficient against both HIV or STDs, and also against pregnancy.
Planned Parenthood educational efforts in particular have encountered vehement media resistance, and for many conservative voices, have come to embody these putative depopulation objectives. Dr. Elena Dmitrieva, Chair of Public Affairs at the University of St. Petersburg, reports for the IPPF that “The author of another article…describes sex education as a means of decreasing the birth rate and thus the Russian population. …The authors of these articles are of the opinion that <state-funded sex education> would force the Russian tax payer to pay for its own decrease”(Dmitrieva). The recognition by the Russian public of the immediacy of population decline lends such critics of sex education particular resonance and creates an opportunity for easy distortion of facts, contributing to the spread of HIV and a continued reliance on abortion through a perpetuation of widespread ignorance as to reproductive health.
The political polarization of Russia’s sex education debate is especially extreme given the moral and religious tones of both proponents and opponents of establishing such programs. While the Western model is typically based in an insistence on biological accuracy aside from moral assertions, Russian educators envision themselves as redefining sexual boundaries and morality in direct opposition to repressive Soviet policies. Sexual health educators make no efforts to distance programs from religious beliefs, attempting to work rather within the context of the Orthodox Church’s renewed significance in society and in conflict instead with what they deem as overly conservative Soviet forces. Kon points out that “Sexual symbols and values, which earlier had been peripheral to the ideological nucleus of culture, now became a sort of watershed dividing ‘right’ and ‘left’, as well as the generations. Sexuality quickly began to polarize and politicize. This created a host of very acute political, moral, and aesthetic problems that society was just as ill-equipped to understand—let alone resolve—as had been the universally damned state power”(Rivkin Fish). Rivkin-Fish observes in a 1999 study that Russian sexual education lectures, in contrast to the scientific approach of most Western models, oppose themselves in a primarily moral way to Soviet practices of reproductive ignorance and neglect: “…only a minimal amount of time was devoted to descriptions of physiological processes surrounding puberty, menstruation, and conception. …Most lectures…concentrated explicitly on conveying moral concerns about sexuality and reproduction”(Rivkin Fish).
Educators are faced with the difficult task of reversing what they see as the deeply inculcated repression of the Soviet regime, and this objective becomes the foremost concern. Rivkin-Fish goes on to notice of one such educator, “…he saw himself working in explicit opposition to the views promulgated by the Soviet regime… With a substantial dose of sarcasm, he opposed the content of his lectures to ‘the taboos’ constructed by ‘our wonderful Soviet regime’, explaining that the silence surrounding sexuality was harmful and inappropriate.” It is clear, however, that these proponents of sexual education, while advocating programs that are radical in comparison to the treatment of reproductive matters in the Soviet Union, have very strictly defined parameters of acceptable sexual behavior, and do not go so far as to look outside religious conceptions in informing their tactics. “By naturalizing sexual desire but containing it within the bounds of self-pleasure or marriage,” concludes Rivkin, “sex educators hope to undo the attitudes promoted by the Soviet regime without opening the doors to an ‘anything goes’ policy. Individual self-consciousness and self-knowledge may now be necessary, but are only acceptable as long as they lead to practices sanctioned by the laws of ‘human nature’ as ordained by God.” She goes on to provide an appropriate excerpt from one such lecture, highly personal in approach, emphasizing the divinity and naturalness of sexuality:
…Stay home alone, so nobody will see you or disturb you. Light some candles, put on music—not technopop that gets your neck out of joint—but Mozart, Vivaldi, Bach, and get into the atmosphere. Put on your best dress, stand in front of a large mirror, look at yourself and tell yourself, ‘I’m beautiful, I’m unique and irreplaceable…Consider yourself a creation of divine significance…’
This particular educator further elucidates his motivation in admonishing Rivkin-Fish, “You must understand, Michele, we humans must not play God. We must recognize the laws of nature and the laws of God.” There is thus an inherent conflict between the Western emphasis on the objective provision of information regarding sexual health and contraception, and the Russian desire to frame such initiatives in a uniquely post-Soviet, moral context.
In light of Russia’s lack of domestic initiative in establishing effective sexual education programs, supported by the renewed voice of the Orthodox Church and conservative political factions including the Communist party, it seems natural that world organizations seek involvement in developing and helping fund a preventive curriculum. The debate over participation is fueled largely by conflict between ideological inflexibility and empirically-based necessity, namely Russia’s hesitance to be perceived as a fallen superpower in need of international succor; its categorization of HIV as a manifestation of Western decadence and consequent lack of attention to the problem; and an inherent conflict in Western and Russian approaches to sexual education. It is imperative, however, that Russia take steps to address this widespread sexual health ignorance through fostering a national sexual education curriculum and comprehensive HIV awareness campaigns, and that international organizations recognize the cultural, historical and political idiosyncrasies that influence educational methodology. Ideally, international partnerships might serve as a means of finding an effective, nationally tailored equilibrium between the willfully blind official piety that currently pervades, and comparatively amoral Western model programs. In the context of the impending demographic crisis and its ineluctable global impact, it seems that there is little choice as to the incumbent nature of such cooperation.
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