Most Russians see the truth all around them. Zoya’s story is repeated so often across the country’s nine time zones that the reality is hard to ignore. Even the government estimates there are 1.8 million heroin users; activists and doctors put the number closer to 3 million, and in a study last June, the United Nations put it at 2.34 million or 1.64 percent of Russia’s population. That’s the world’s third highest heroin abuse rate in per capita terms after Afghanistan and Iran. In absolute numbers, the UN says, Russia is number one.

Heroin was virtually unheard-of during the Soviet era, but is now easy to buy in any city in the country. In Tver, a medium-sized city with relatively little industry and few job prospects for the young, the detritus of addiction - used syringes, needles - litters the streets. Deals are a regular sight on street corners.

Russia’s anti-drugs tsar, Viktor Ivanov, who heads the Federal Drug Control Service - a powerful government body given to U.S.-style rhetoric about the ‘War on Drugs’- blames the country’s porous Central Asian borders for the heroin hunger.

“Unfortunately, in 1991 we suddenly found ourselves without borders,” Ivanov told reporters in December, referring to the collapse of the Soviet Union.

Ex-Soviet Tajikistan, which borders Afghanistan and is one of the world’s poorest countries, has long been a haven for drug smuggling out of Afghanistan, where the Tajiks have ethnic ties. From there the heroin flows through Kyrgyzstan and Kazakhstan and into Russia.

INTERTWINED WITH AIDS

The drug problem has now become an AIDS problem. Officially, Russia has 520,000 registered HIV-positive people. The UN and local NGOs say there are probably closer to a million, maybe even more. HIV/AIDS has spread rapidly over the past decade, especially among drug users who regularly share dirty needles. The government estimates around a third of all drug users in Russia are HIV-positive; and international and Russian health experts worry the disease is beginning to spread to the general population through heterosexual sex.

The biggest problem, say health experts, is the government’s refusal to address Russia’s drug addiction. The lack of official intervention is remarkable. There are currently just 70 needle exchange and distribution programs in Russia, reaching a mere 7 percent of heroin addicts according to the London-based International Harm Reduction Association (IHRA). In terms of needle exchanges, “Russia is not even scratching the surface,” says Rick Lines, executive director of the IHRA.

All the programs are run with foreign funding. Government support: nil. It’s not as if the government is powerless. In the one area of the HIV/AIDS epidemic where it is active - mother-to-child transmission - it has reduced transmission rates to almost zero.

HIGHWAY AIDS TEST

In the face of government inaction, grassroots groups have mushroomed across the country.

Outside Tver, Yuri Suring parks his beat-up black Toyota at a truck stop along the Moscow-Saint Petersburg highway every night. There, between 7 pm and 4 am, he surreptitiously doles out clean needles and condoms to prostitutes, many of whom work to support their drug addictions. “If I were not here, where would these girls go? Who would help them? No one,” Surin says as a trio of prostitutes in knee-high boots and bomber jackets approaches the car.

Surin’s organization, We And AIDS, consists of himself, a second outreach worker and a driver. The supplies he hands out every night and the kits he uses to test women come, he says, from sympathetic doctors and western groups who want to help.

On a cold night in November, 20-year-old prostitute Olga slips into Surin’s car for an AIDS test. Surin rubs a two-inch indicator on her gums and inserts it into a small plastic tray while Olga nervously smokes a cigarette and shakes her black-bobbed head from side to side in anger at her fate, her gold leaf-shaped earrings swaying.

After studying the result - negative - the prostitute flings the indicator out of the car window and then hops across the gravel into a truck cabin where customers - two large middle-aged truckers - are waiting.

DEEMED SUFFICIENT