Journal Logo

Research Article: Observational Study

Not an epidemic, but a global problem: the authorities’ construction of HIV/AIDS in Russia

Yasaveev, Iskender

Editor(s): Supervie., Virginie

Author Information
doi: 10.1097/MD.0000000000018945
  • Open

Abstract

1 Introduction

In Russia, there are different constructions of the social problem of HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome): statistical, governmental, expert, media, common ones. The Joint United Nations Programme on HIV and AIDS notes that Eastern Europe and Central Asia is the only region in the world where the HIV epidemic continues to rise rapidly, with more than 80% of the region's new HIV infections were in the Russian Federation.[1] There are official data about the significant and rapid increase of HIV infection in Russia since 2000. By 2000, about 31,000 HIV cases were registered among Russian citizens, by 2005 this number rose to 300,000, by 2010 to 530,000, by 2015 it exceeded 900,000.[2] By June 30, 2019, according to the Federal AIDS Center, 1,376,907 cases of HIV infection have been registered among Russian citizens, 335,867 people with HIV died. The number of people living with HIV who are aware of their diagnosis of “HIV infection” was 1,041,040 by the middle of 2019.[3] Coverage of antiretroviral therapy, according to the Federal AIDS Center, by June 30, 2019, was 44.8% of the number of people living with the diagnosis of “HIV infection”.[3] As stated earlier by the Federal AIDS Center, “the treatment coverage achieved in Russia does not play the role of a preventive measure and does not allow to reduce the spread of the disease radically”.[4]

The focus of this study is on the rhetoric of Russian authorities: what and how Russian authorities speak about HIV/AIDS in the period when official data indicate the significant rise of HIV prevalence in the country.

The study is based on the constructionist approach to social problems.[5–9] In constructionist terms, social problems are not “objectively existing” harmful, dangerous, threatening conditions, but claims-making, “the activities of individuals or groups making assertions of grievances and claims with respect to some putative conditions” (p. 75).[5]

Constructionism understands social problems as complex language games, in which different participants create different meanings. A strict version of the constructionist approach suggests that the researcher “never leaves language” (p. 64)[7] and refrains from making assumptions about “objective conditions,” regarding which the problematizing or de-problematizing rhetoric unfolds.

Ibarra and Kitsuse have developed a research program that focuses on rhetorical idioms that are definitional complexes through which the problematic status of a condition is elaborated, and counterrhetorics that are discursive strategies to counter the claims-making. Rhetorical idioms as ways of problematization provide participants with discursive materials “to structure and lend urgency to their claims” (p. 27).[7] The constructionists have formulated the following idioms: loss, entitlement, endangerment, unreason, and calamity. Each rhetorical idiom draws upon a cluster of images and has a specific vocabulary. The counterrhetorics, on the contrary, are discursive strategies to oppose the definition of the condition as a problem. These ways of de-problematization include the following strategies: naturalizing, representing the condition as natural and inevitable; the counterrhetoric of the costs involved in changing the condition; declaring impotence; perspectivizing, presenting the claim as just 1 of the possible “opinions”; tactical criticism, the critique of the tactics of constructing the problem; antipatterning, the presentation of a claim as characterizing not a full-scale social problem, but “isolated incidents”; the counterrhetoric of the “telling anecdote”, locating an instance, that “shows that the generality of the analysis offered by claimants is suspect”; the counterrhetoric of “insincerity” of those who construct the problem; and the counterrhetoric of their “hysteria” (pp. 33–38).[7]

Constructionists also studied the interests of the authorities in the processes of social problems. According to Lenoir, raising a situation to the rank of a “social problem” is of interest to the government either because this definition involves “solutions” that the state can implement, or because it is considered possible to comprehend and measure it with a fair degree of accuracy, creating an impression of being able to keep it under control (p. 139).[9]

The Russian authoritiesrhetoric concerning HIV/AIDS has been studied in different perspectives. According to Burke, a notion of cementing traditional family values promoted by Russian authorities forces drug users, men who have sex with men, and sex workers vulnerable to HIV to the margins of society.[10] Colborne emphasizes that while HIV infection rates in Russia continue to climb, the Kremlin persists in rejecting preventive harm-reduction approaches, such as needle exchanges, methadone replacement therapy, and promoting condom use, which could help curb the epidemic.[11] Russian president's rhetoric on HIV/AIDS has been analyzed as the securitizing move[12] and the security threat framing.[13] Pape concludes that “Russia has thus far failed to confront HIV, as the government is not prepared to fully acknowledge the underlying causes of the epidemic or introduce necessary policies” and that the main problem in addressing HIV in the country is the lack of political will.[14] Brown points out that there is a high price paid for President Putin's procrastination on HIV in the form of continuing ignorance about the virus among the general population.[15]

The constructionist approach to social problems can add 1 more dimension to the study of the rhetoric of Russian authorities about HIV/AIDS: an analysis of the ways of problematization and de-problematization. The research question is in what discursive ways HIV/AIDS is problematized and de-problematized by Russian authorities?

2 Methods

The chronological frameworks of the study are based on presidential terms of Vladimir Putin (2000–2004, 2004–2008, 2012–2018, and the current one from 2018) and Dmitry Medvedev (2008–2012). The statistical construction of HIV/AIDS in Russia includes data about a significant increase in the prevalence of HIV infection since 2000. From the same year, the official website of the president has existed.

A search on the Kremlin website, used as the source of Russian authoritiesrhetoric on HIV/AIDS, by the keywords “HIV” and “AIDS” revealed 93 texts published from July 2000 till December 2018. Thirty-two texts from this amount include statements on HIV/AIDS by presidents Putin and Medvedev.

The rhetoric of the authorities, found through the study of official speeches, was sorted with the vocabularies of rhetorical idioms and counterrhetorics for revealing the ways used to problematize and de-problematize HIV/AIDS.

The ethical approval of this research was not necessary because it did not involve human participants, the data are not sensitive, and there were no risks of harm.

3 Data and discussion

A study of Vladimir Putin's statements on HIV/AIDS since 2000 shows that during his first presidential term and the first half of the second one, this theme regularly appeared on his agenda. Putin reported his intention to work closely with the USA in solving the problem of HIV infection,[16] made decision about Russia's participation in the Global Fund to Fight AIDS, Tuberculosis and Malaria, noted the high incidence of AIDS in Kaliningrad Region[17] and the Siberian Federal District,[18] spoke about HIV/AIDS during TV “direct lines”[19,20] and in annual addresses to the Federal Assembly.[21,22]

Most of Putin's statements about HIV/AIDS during his first presidential terms were caused by international events and had a global context. He called AIDS and tuberculosis “the most serious and worrisome diseases of mankind”,[23] spoke about “uniting efforts in the international arena”[24] and “international solidarity in the fight against the spread of AIDS”.[25] Russia in these statements was presented mainly not as a country in which the HIV epidemic takes place, but as a participant in global efforts to combat HIV/AIDS, including humanitarian programs.

At the same time, Putin problematized the spread of the disease in Russia. The terms used by the president correspond to the vocabulary of the rhetorical idiom of endangerment: “an avalanche-like spread of AIDS”,[26] “AIDS epidemic”,[19] “deadly AIDS virus”,[27] “threat”,[22] “a very acute problem”,[20] “a very actual” problem,[24] “extremely dangerous disease”.[28]

Putin, during this period, declared the responsibility of the authorities: “We are obliged to reduce the prevalence of infectious diseases, including HIV infection, significantly”.[29] In the mid-2000s, he reported about an increase of 20 to 30 times of the financing of treating people with HIV[20] and promised cautiously: “If the planned programs are implemented, we will provide access to medicines for all who need it and for all carriers of HIV infection by 2010”.[30]

In first terms of his presidency (2000–2004, 2004–2008), Putin problematized not only the spread of AIDS, but also the stigmatization of people living with HIV: “There is an extremely acute problem of people infected with HIV and other dangerous diseases which in fact become outcasts and have to cope both with their disease and the difficulties of adapting to a full life in a society”.[28]

From 2000 till 2020, the President of Russia delivered only 1 speech about HIV/AIDS, exactly in this “early” period. It was delivered as the opening remarks at the State Council Presidium meeting on April, 23, 2006 to April 21, 2006.[31] The president's speech included recognition of the significance of the problem:

Both elements of usual authorities’ game in social problems[9] were present in the president's rhetoric about HIV/AIDS: the possibility of a “solution” and “exact knowledge” of the problem, creating an impression of control. Putin endowed the HIV/AIDS with the status of the problem, while at the same time presented the “solutions” implemented by governmental agencies:

Putin also emphasized the “knowledge” of the state about the problem:

In his speech, Putin initiated an appeal to moral values in statements about HIV/AIDS: “Our common task is to promote a healthy way of life and raise awareness of the importance of moral values”.[31] Previously, this rhetoric was not used by the president regarding HIV/AIDS. Unlike earlier statements, he used the term “carriers of HIV infection” and mixed the terms “HIV” and “AIDS”: “people infected with AIDS,” “the birth of AIDS-infected children.

Since 2007, the theme of HIV/AIDS was not an item on the public agenda of Russian presidents (Putin and Medvedev). Dmitry Medvedev, when he was the President of Russia (from 2008 to 2012), spoke only twice about HIV/AIDS, both times answering questions from citizens of Western countries. Medvedev called HIV a “big” and “very severe problem”.[32,33] Putin did not publicly touch on the theme of HIV during his third presidential term (2012–2018) and only in April 2018 mentioned HIV, at a meeting with the acting governor of the Kemerovo Region Sergey Tsivilev.[34] The excluding of HIV/AIDS from the presidential public agenda coincided with a change in rhetoric regarding the USA and West European countries and deterioration of the relations with them since a speech delivered by Putin in February 2007 in Munich.

Presidents Putin (during his first terms) and Medvedev also de-problematized HIV/AIDS in Russia, using the strategy of naturalizing that presents the phenomenon as natural and inevitable. The variety of this strategy is the widening of phenomenon frameworks and defining it not as national, but as a global problem. Putin, in the cases of critical questions about corruption, violations of human rights and freedoms, brutal suppression of peaceful protests, the annexation of Crimea, full control of the authorities over TV channels, dismissals and murders of journalists in Russia, begins his answers by presenting these conditions as existing not only in Russia but also in other countries, primarily western ones. Putin and Medvedev used the same strategy in their statements about HIV/AIDS:

The constant emphasis on HIV/AIDS as a “common threat,” global problem and challenge, removes part of the responsibility for the problem from Russian authorities.

As to the term “epidemic,” Putin used it several times referring to HIV/AIDS in Russia in the first half of the 2000s, but in 2005 he said: “The problem is very acute, but still it does not have the nature of epidemic”.[20] Later, neither Putin nor Medvedev used this term concerning HIV/AIDS in Russia. In December 2016, the Russian Minister of Health Veronika Skvortsova said: “There are no single criteria for defining HIV as an epidemic... No epidemic has been announced yet in our country”.[36]

One of the motifs of the Russian authoritiesrhetoric at present is “traditional values.” During his third and fourth presidential terms (2012–2018, from 2018 onward), Vladimir Putin used the expression “traditional values” dozens of times:

The protecting of the “traditional values” by the authorities embodied in legislation contributes to sexual prejudices and prevents sexual education in schools, dissemination of safe sex practices (use of condoms), harm reduction programs for drug users, introduction of substitution therapy for drug addicts. In Russian secondary schools, the discussion of condoms use is in fact forbidden due to Federal Law No. 436, “On protecting children from information that is harmful to their health and development.” The same law contains the provision prohibiting the dissemination among children of the information that “denies the family values and propagandizes non-traditional sexual relationships.”

The terms “moral values,” “risk groups,” “marginal groups” in the authoritiesrhetoric on HIV/AIDS put HIV and deviance in 1 context and contribute to stigmatization and self-stigmatization of people living with HIV. The research results get by Balabanova, Coker, Atun and Drobniewski show that the perception that HIV is associated with immoral behavior underpins stigma,[39] while Pape highlights that HIV-related stigma is an obstacle to responding adequately to the epidemic, creating a culture of neglect and avoidance.[14,10,40]

In October 2016, the Russian government approved the “State strategy to combat the spread of HIV in Russia through 2020 and beyond”. The strategy does not include the term “epidemic” but includes the traditionalist moral rhetoric: “to strengthen traditional family and moral values.” It has neither statements on harm reduction programs for drug users, sex education and promoting condom use, nor any financial dimension.[41,42]

4 Conclusion

The HIV/AIDS disappeared from the agenda of the Russian president since 2007, at a time when the statistical construction of the HIV/AIDS problem presented a significant increase in HIV prevalence. This silence points out the pragmatic game of the authorities in the problem of HIV/AIDS: it was used by Russian authorities to represent Russia as a full participant in the international coalition to fight the challenges of our time, but the Russian president stopped to construct this problem after the deterioration of relations with Western countries.

There are parallels found between Putin's governance and former South African President Mbeki anti-science AIDS denialism.[43,44] At the same time Putin's public inattention to HIV/AIDS is similar to Ronald Reagan's one during the first years of HIV epidemic in the United States[45] but the difference is in the vector: not from silence to late definition of HIV/AIDS as a problem but vice versa, from defining it as a global problem to a silence.

Meanwhile, people living with HIV in Russia talk about fear, violence, rupture of relationships, labeling in health care institutions by the medical code “B20,” denials in medical care caused by their HIV status.[46] The explanation of why the Russian authorities have silenced the topic of HIV/AIDS in official discourses goes beyond the constructionist framework of this study. But the significant differences between the authorities’ construction of the HIV/AIDS problem and the utterances of people living with HIV clarify the factors that contribute to a further HIV spread in Russia. The Russian president's traditionalism, de-problematization and silence concerning HIV/AIDS lead to the absence of the HIV/AIDS issues in media agenda, the agenda of local authorities, and consequently the personal agendas of Russian citizens. The consequences are ignorance, fears, stigmatization of people living with HIV, semi-legal status of needle and syringe programs for intravenous drug users, low antiretroviral therapy coverage, and the continuing HIV epidemic.

Acknowledgments

The author is thankful to HIV activists, Svetlana Isambaeva's foundation, Timur Islamov's foundation, the public organization “Prophylaxy and Initiative” (the low-threshold center “Island”) for openness and help during research; Nadya Nartova, Anastasiya Shilova, and Yana Krupets for cooperation in the framework of the research project; and 2 anonymous reviewers for very valuable comments.

Author contributions

Conceptualization: Iskender Yasaveev.

Investigation: Iskender Yasaveev.

Methodology: Iskender Yasaveev.

Resources: Iskender Yasaveev.

Writing – original draft: Iskender Yasaveev.

Writing – review & editing: Iskender Yasaveev.

References

[1]. UNAIDS. Prevention Gap Report. 2016. http://www.unaids.org/sites/default/files/media_asset/2016-prevention-gap-report_en.pdf. Accessed November 20, 2018.
[2]. Pokrovsky VV, Ladnaya NN, Tushina OI, Buravtsova EV. VICh-infekciya. Informacionnyj byulleten no 40 [HIV infection. Information Bulletin no 40]. Moscow, 2015.
[3]. Rospotrebnadzor. Spravka “VICh-infekciya v Rossijskoj Federacii v pervom polugodii 2019 g.” [HIV infection in the Russian Federation in the first half of 2019]. Moscow, 2019.
[4]. Rospotrebnadzor. Spravka “VICh-infekciya v Rossijskoj Federacii v 2017 godu” [HIV Infection in the Russian Federation in 2017]. Moscow, 2018.
[5]. Spector M, Kitsuse JI. Cummings, Constructing Social Problems. Menlo Park, CA: 1977.
[6]. Holstein JA, Miller G. Aldine de Gruyter, Challenges and Choices: Constructionist Perspectives on Social Problems. Hawthorne, NY: 2003.
[7]. Ibarra PR, Kitsuse JI. Holstein JA, Miller G. Claims-making discourse and vernacular resources. Challenges and Choices: Constructionist Perspectives on Social Problems.. Hawthorne, NY: Aldine de Gruyter; 2003. 17–50.
[8]. Ibarra PR, Adorjan M. Treviño AJ. Social constructionism. The Cambridge Handbook of Social Problems. Vol. 1.. Cambridge: Cambridge University Press; 2018. 279–300.
[9]. Lenoir R. Predmet sociologii i social’naya problema [The subject of sociology and the social problem]. in: Lenoir R, Merllié D, Pinto L, Champagne P. Nachala prakticheskoj sociologii [The beginnings of practical sociology]. Moscow: Institute of Experimental Sociology; Saint-Petersburg: Aletheia; 2001:77–144.
[10]. Burki T. Stigmatisation undermining Russia's HIV control efforts. Lancet Infect Dis 2015;15:881–2.
[11]. Colborne M. Russia's HIV rate continues to rise with reactionary policies. Can Med Assoc J 2016;188:299–300.
[12]. Sjöstedt R. Exploring the construction of threats: the securitization of HIV/AIDS in Russia. Secur Dialogue 2008;39:7–29.
[13]. Pape U. Framing the epidemic: NGOs and the fight against HIV/AIDS in Russia. Russ Polit 2018;3:486–512.
[14]. Pape, U. (2019). HIV/AIDS in Eastern Europe and Central Asia. In: Oxford Research Encyclopedia of Politics. Oxford University Press. DOI: https://dx.doi.org/10.1093/acrefore/9780190228637.013.1314. Accessed October 10, 2019.
[15]. Brown H. Russia's blossoming civil society holds the key to HIV. Lancet 2006;368:437–40.
[16]. Putin VV. Poslanie Prezidentu SShA Dzhordzhu Bushu [Message to US President George W. Bush]. 2001. http://www.kremlin.ru/events/president/news/41416. Accessed November 20, 2018.
[17]. Putin VV. Vstupitel’noe slovo na zasedanii Soveta Bezopasnosti po voprosam zhizneobespecheniya i perspektivam razvitiya Kaliningradskoj oblasti v preddverii predstoyashchego rasshireniya Evropejskogo soyuza [Opening remarks at a meeting of the security council on the issues of life support and development prospects for the Kaliningrad region on the threshold of the forthcoming enlargement of the European Union]. 2001. http://www.kremlin.ru/events/president/transcripts/21299. Accessed November 20, 2018.
[18]. Putin VV. Vystuplenie na zasedanii Soveta Bezopasnosti po voprosam obespecheniya nacional’noj bezopasnosti v Sibirskom federal’nom okruge [Speech at a Security Council meeting on national security in the Siberian federal district]. 2003. http://www.kremlin.ru/events/president/transcripts/22029. Accessed November 20, 2018.
[19]. Putin VV. Stenogramma pryamogo tele-i radioefira (“Pryamaya liniya s Prezidentom Rossii”) [Transcript of live TV and radio broadcasts (“hot line with the president of Russia”)]. 2001. http://www.kremlin.ru/events/president/transcripts/21457. Accessed November 20, 2018.
[20]. Putin VV. Stenogramma pryamogo tele-i radioefira (“Pryamaya liniya s Prezidentom Rossii”) [Transcript of live TV and radio broadcasts (“hot line with the president of Russia”)]. 2005. http://www.kremlin.ru/events/president/transcripts/23190. Accessed November 20, 2018.
[21]. Putin VV. Poslanie Federal’nomu Sobraniyu Rossijskoj Federacii [Annual address to the federal assembly of the Russian Federation]. 2003. http://www.kremlin.ru/events/president/transcripts/21998. Accessed November 20, 2018.
[22]. Putin VV. Poslanie Federal’nomu Sobraniyu Rossijskoj Federacii [Annual address to the federal assembly of the Russian Federation]. 2005. http://www.kremlin.ru/events/president/transcripts/22931. Accessed November 20, 2018.
[23]. Putin VV. Vstupitel’noe slovo na neformal’noj vstreche glav gosudarstv SNG [Opening remarks at the informal meeting of the CIS leaders]. 2001. http://www.kremlin.ru/events/president/transcripts/21302. Accessed November 20, 2018.
[24]. Putin VV. Vystuplenie i otvety na voprosy na vstreche s prepodavatelyami i studentami Kolumbijskogo universiteta [Speech and answers to questions at Columbia University]. 2003. http://www.kremlin.ru/events/president/transcripts/22129. Accessed November 20, 2018.
[25]. Putin VV. Vystuplenie na 58-j sessii General’noj Assamblei OON [Speech at the 58th session of the General Assembly of the United Nations]. 2003. http://www.kremlin.ru/events/president/transcripts/22128. Accessed November 20, 2018.
[26]. Putin VV. Vystuplenie na zasedanii Soveta Bezopasnosti Rossii po probleme sovershenstvovaniya gosudarstvennoj politiki v sfere bor’by s nezakonnym oborotom narkotikov i rasprostraneniya narkomanii [Speech at Russian Security Council meeting on the problem of improving state policy in the fight against drug trafficking and the spread of drug addiction]. 2001. http://www.kremlin.ru/events/president/transcripts/21344. Accessed November 20, 2018.
[27]. Putin VV. Vstupitel’noe slovo na Vtorom sammite gosudarstv - chlenov Soveshchaniya po vzaimodejstviyu i meram doveriya v Azii (SVMDA) [Opening address at the second summit of the conference on interaction and confidence-building measures in Asia (CICA)]. 2006. http://www.kremlin.ru/events/president/transcripts/23650. Accessed November 20, 2018.
[28]. Putin VV. “Gruppa vos’mi” na puti k sammitu v Sankt-Peterburge: vyzovy, vozmozhnosti, otvetstvennost’ [The upcoming G8 Summit in St. Petersburg: challenges, opportunities, and responsibility]. 2006. http://www.kremlin.ru/events/president/transcripts/23462. Accessed November 20, 2018.
[29]. Putin VV. Vystuplenie na vstreche s chlenami Pravitel'stva, rukovodstvom Federal’nogo Sobraniya i chlenami prezidiuma Gosudarstvennogo soveta [Speech at the meeting with the cabinet members, the heads of the Federal Assembly, and State Council members]. 2005. http://www.kremlin.ru/events/president/transcripts/23157. Accessed November 20, 2018.
[30]. Putin VV. Vstrecha liderov “Gruppy vos’mi” s predstavitelyami “yunosheskoj vos’merki” [The meeting of G8 leaders with members of the Junior G8]. 2006. http://www.kremlin.ru/events/president/transcripts/23712. Accessed November 20, 2018.
[31]. Putin VV. Vstupitel’noe slovo na zasedanii prezidiuma Gosudarstvennogo soveta “O neotlozhnyh merah po bor’be s rasprostraneniem VICh-infekcii v Rossijskoj Federacii” [Opening remarks at State Council Presidium meeting on urgent measures to combat the spread of HIV/AIDS in the Russian Federation]. 2006. http://kremlin.ru/events/president/transcripts/23547. Accessed November 20, 2018.
[32]. Medvedev DA. Kremnievaya dolina vpechatlyaet i vdohnovlyaet [Silicon Valley is impressive and inspiring]. 2010. http://www.kremlin.ru/events/president/news/8160. Accessed November 21, 2018.
[33]. Medvedev DA. Vstrecha s liderom irlandskoj gruppy “U2” Bono [Meeting with the leader of the Irish Group “U2” Bono]. 2010. http://www.kremlin.ru/events/president/news/8731. Accessed November 21, 2018.
[34]. Putin VV. Vstrecha s vrio gubernatora Kemerovskoj oblasti Sergeem Tsivilevym [Meeting with acting governor of Kemerovo Region Sergei Tsivilev]. 2018. http://www.kremlin.ru/events/president/news/57209. Accessed November 21, 2018.
[35]. Putin VV. Stenograficheskij otchet o vstreche s rukovoditelyami vedushchih informacionnyh agentstv stran “Gruppy vos’m” [Transcript of meeting with the leaders of the news agencies of G8 Member countries]. 2006. http://www.kremlin.ru/events/president/transcripts/23613. Accessed November 21, 2018.
[36]. TASS. Skvortsova: epidemiyu VICh v Rossii nikto ne ob’yavlyal [Skvortsova: nobody declared the HIV epidemic in Russia]. 2016. https://tass.ru/obschestvo/3830277. Accessed November 21, 2018.
[37]. Putin VV. Vstrecha s ispolnyayushhim obyazannosti gubernatora Ryazanskoj oblasti Olegom Kovalyovym [Meeting with acting governor of Ryazan Region]. 2012. http://kremlin.ru/events/president/news/16545. Accessed December 2, 2019.
[38]. Putin VV. Poslanie Federal’nomu Sobraniyu Rossijskoj Federacii [Annual address to the Federal Assembly of the Russian Federation]. 2014. http://kremlin.ru/events/president/news/47173. Accessed December 2, 2019.
[39]. Balabanova Y, Coker R, Atun R, et al. Stigma and HIV infection in Russia. AIDS Care 2006;18:846–52.
[40]. Zvonovskii V. VICh i stigma [HIV and stigma]. Zhurnal Issledovanii Sotsial’noi Politiki [J Soc Pol Stud] 2008;6:505–21.
[41]. Russian Government. Gosudarstvennaya strategiya protivodejstviya rasprostraneniyu VICh-infekcii v RF na period do 2020 goda i dal’nejshuyu perspektivu [State strategy to combat the spread of HIV in Russia through 2020 and beyond]. 2016. http://government.ru/docs/24983/. Accessed November 21, 2018.
[42]. Clark F. Gaps remain in Russia's response to HIV/AIDS. Lancet 2016;388:857–8.
[43]. Kalichman SC. Pence, Putin, Mbeki and their HIV/AIDS-related crimes against humanity: call for social justice and behavioral science advocacy. AIDS Behav 2017;21:963–7.
[44]. Kravtsov V. University of Georgia Press, Norm diffusion and HIV/AIDS governance in Putin's Russia and Mbeki's South Africa. Athens, GA: 2015.
[45]. Gamson J. Silence, death, and the invisible enemy: AIDS activism and social movement “newness”. Soc Probl 1989;36:351–67.
[46]. Yasaveev I. VICh/SPID v Rossii: vlastnaya i aktivistskaya konstruktsii sotsial’noy problemy [HIV/AIDS in Russia: governmental and activist constructions of the social problem]. Russ Sociol Review 2019;18:49–76.
Keywords:

authorities; human immunodeficiency virus/acquired immune deficiency syndrome power; problematization; rhetoric; Russia; social problem

Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.