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Poster couple

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Science  15 Jun 2018:
Vol. 360, Issue 6394, pp. 1172
DOI: 10.1126/science.360.6394.1172

Showing the country that there's no need to fear HIV-infected people.

PHOTO: MISHA FRIEDMAN

Last year, on the streets of St. Petersburg, a poster appeared, featuring an attractive young man and woman looking into each other's eyes. “People with HIV are just like you and me,” it read. It was part of a provocative campaign to encourage HIV testing in a country where the infection is still highly stigmatized. In an extra twist, the woman, Tatiana Vinogradova, is the prominent deputy director of the city's AIDS center, and the man, Andrey Skvortsov, who is living with the virus, is her husband.

They decided to do the poster, says Skvortsov, who runs a nongovernmental organization called Patients in Control, “to do the maximum we could” for both the patient community and public health. “I try to motivate people, I'm an example,” says Skvortsov, who was diagnosed in 1997 with an HIV-ravaged immune system and today, thanks to antiretrovirals (ARVs), is healthy.

Vinogradova had another goal as well: to reduce bias and fear within the health care community. “I have a lot of friends who are doctors because we studied together at university, and they are still afraid of HIV patients,” says Vinogradova, whose mother once ran the city's AIDS center and whose grandmother diagnosed the city's first HIV case. “They're not afraid of TB [tuberculosis]. They're not afraid of hepatitis C. In the late '80s, AIDS was the plague of the 20th century and it's still in their heads.”

That stigma hit home 3 years ago, she says, when Skvortsov broke his collarbone in a bicycle accident. As a surgeon described the operation needed to repair his fracture, the couple told him that Skvortsov was living with HIV. Vinogradova offered to bring his medical records to show that he was on ARVs, that the virus was undetectable in his blood, and that his immune system was normal. The surgeon left the room, and when he came back, he said Skvortsov needed only a sling. They went to another hospital, where a surgeon had no concern about Skvortsov's HIV status and scheduled the operation for the next day.

Skvortsov and Vinogradova feel the situation is improving, if slowly, because the increasing severity of the epidemic has rattled complacent officials, and a new generation of doctors and activists understands the disease and what needs to be done. But they believe the situation will have to become bleaker before the epidemic receives the urgent, full-force response that's needed. “We have to be facing something terrible, and then there will be change,” Skvortsov says. “It's the Russian mentality.”

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