During the early 1990s, the  breakup of the Soviet Union and Russian economic collapse brought about economic and social disarray in the region. Suddenly, inexpensive, low-quality heroin from Afghanistan created new drug markets, and its use, almost always by injection, was taken up by a large proportion of adolescents and young adults.  As effective drug treatment programs are generally unavailable in Russia and drug substitution therapy (such as methadone) is prohibited, those who become addicted generally continue injecting heroin.  Although syringes are legally available, access to clean syringes is limited, thus needle sharing has historically been common among people injecting drugs. These factors have led to the prevalence of HIV and hepatitis among injectors in some Russian and other post-Soviet cities to reach levels among the highest in the world, with alarmingly high incidence of new infections.  A research team in EMD headed by Professor Robert Heimer works in close collaboration with colleagues from academic, governmental and non-governmental organizations in host countries in the region to study the epidemiology, sociology, and biology of blood-borne pathogens in this population. The team takes into consideration injectors and their drug and sexual networks and other drug-related health aspects of the syndemic such as overdose and incarceration to address public policy around matters such as the treatment of drug addiction and HIV infection. 

Current Projects

Alcohol and HIV Risk Reduction in St. Petersburg, Russian Federation, Nadia Abdala, D.V.M, PhD.

Developing an Evaluation Platform for UNFRA's Y-PEER Projects, Robert Heimer, Ph.D.

Influences on HIV Prevalence and Service Access among IDUs in Russia and Estonia, Robert Heimer, Ph.D.

International Feasibility Study of Pharmacy-Based HIV Prevention: St. Petersburg, Robert Heimer, Ph.D.

Potential for HIV Transmisison in Relationships of Drug-using Women in Russia, Linda Niccolai, Ph.D.

TB-AIDS Clinical Training and Research Unit, Russia, Robert Heimer, Ph.D.

Training and Research in HIV Prevention in Russia, Robert Dubrow, M.D., Ph.D.


Fogarty Training Program

YSPH faculty with scientists who are here from St. Petersburg to study HIV/AIDS as part of a Fogarty Training Grant. This program, established in 1998, develops talent among behavioral and medical scientists to participate in interdisciplinary HIV research. Front row, left to right: Rashad Abyshev, Anton Pashchenko. Back row, left to right: Stanislav Toropov, Marina Vetrova, Olga Alexandrova, Ted White, Linda Niccolai, Robert Heimer.

The Russian Federation is experiencing the fastest growing HIV/AIDS pandemic in the world. In less than a decade, the reported number of HIV infections across Russia's 89 administrative territories grew by a factor of 300, from less than 200 in 1994 to over 50,000 in 2002. In 1998, the Center for Interdisciplinary Research on AIDS (CIRA) at Yale University, in collaboration with the Biomedical Center and St. Petersburg State University (SPSU) in St. Petersburg, began an AIDS International Training and Research Program (AITRP) focused on HIV prevention and covering a wide range of public health-related disciplines. Now in its sixth year, the Yale University AITRP has provided mentorship, research support, and lasting partnerships to 27 Russian trainees primarily in biology, medicine, sociology, and psychology, and enabled them to apply their knowledge in research and teaching positions upon their return home. This program is supporting the training of a cadre of researchers in a broader spectrum of biological, quantitative, social, behavioral, and political sciences to build capacity in Russian institutions to address many important researchable issues that need resolution to mount a multi-faceted response to the expanding HIV/AIDS epidemic. Mounting an effective response to the HIV/AIDS epidemic in Russia also requires a well-functioning health system that provides effective preventive and care services to diverse populations in different regions. There is no school of public health in Russia to provide this training and no institution that offers a Master of Public Health (MPH) degree. This program has also continued building an MPH program at SPSU, a collaborative effort begun in 2002 and led by the Yale AITRP, as a critical step in preparing a new generation of Russian leaders who will spearhead local, regional and national efforts for the protection and improvement of public health, including those required for prevention and care of HIV infection.


Biomedical Center and St. Petersburg State University

SPIIRAS (St. Petersburg Institute for Informatics and Automation of the Russian Academy of Sciences)

St.Petersburg V.M.Bekhterev Psychoneurological Research Institute


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Russia's Epidemic

HIV has spread quickly in St. Petersburg and other major cities and the problem threatens to get worse..  Article starts on page 22 of the Spring 2014 edition of Yale Public Health magazine.