By Richard Galpin
BBC News, Moscow
Syringes used by addicts are often contaminated
A top international HIV/Aids expert has told the BBC that the epidemic in Russia is now out of control.
Robin Gorna, head of the International Aids Society, urged Russia to do much more to prevent the spread of HIV among an estimated two million drug users.
Ms Gorna was speaking ahead of a major international conference on Aids which is taking place in Moscow.
It is believed there are now at least a million people infected with HIV in Russia.
This represents a dramatic increase over the past decade.
The vast majority are people under the age of 30. Most were infected because they share needles for injecting heroin.
According to some estimates, there are almost two million intravenous drug users in the country - the result of the large quantities of heroin flowing from Afghanistan into Russia.
Wider epidemic fears
International experts have raised concerns over Russian laws which they say hamper efforts to slow down the HIV infection rate.
It is illegal to give drug addicts substances such as methadone as an alternative to injecting heroin.
As the conference opened on Wednesday, Russia's chief medical official acknowledged the scale of the epidemic, but insisted there would be no change of policy on methadone.
Gennady Onishchenko said that HIV infections in Eastern Europe and Central Asia were "a highly important problem for all of us, not only for medical but also for social reasons".
"The danger is that the epidemic will cross over from a concentrated one to a general one," he said.
But he added that methadone would remain illegal.
"Russia speaks out categorically against this component in prevention programmes," he said.
The Russian government also does not fund any needle exchange programmes.
There is particular concern because until now international donors have financed the major prevention programmes in Russia.
But they are having to stop their funding because Russia is now considered to be a middle-income country and does not want to receive financial aid from abroad.