Russia

OVERVIEW

In Russia, contraception is widely available and can be purchased without a prescription. Emergency contraception requires a prescription yet appears informally available without one. You can receive STI/STD tests at many facilities, though you should be aware that foreigners who apply for long-term residency are expected to be HIV-negative (reports on the enforcement of this policy vary). There are some international hospitals and clinics, such as European Medical Center (EMC), that are widely used by foreigners. Abortion is legal for the first 12 weeks of gestation in Russia, and Russia has the highest per capita rate of abortions in the world. While abortion services at public hospitals are notably cheaper (and often free), the private hospitals will be more closely aligned with current medical standards (as advocated by WHO) and operate in more efficient manners.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Russia, you can obtain birth control pills without a prescription. However, sex education remains very low in Russia, contributing to limited knowledge of contraceptive methods. Sex education is not compulsory in Russian public schools. It's estimated that only 5% of Russian teens have been educated on contraception and family planning.

Fortunately, contraception is becoming a more dominant method in Russian society. In 2003, the NYTimes reported, "For 50 years, Russian women relied on state-financed abortions as their main form of birth control. With pills, condoms and other contraceptives often in short supply, most women in Russia expected to face at least one and sometimes more than a dozen trips to the abortion clinic over their childbearing years. Now the Russian government is attempting to slow the abortion rate. It is an admirable goal, given the toll that multiple abortions have taken on the health and fertility of Russia's women."

What to Get & Where to Get It

• You can buy birth control pills at pharmacies ("apteka" in Russian). One brand, Jess, is approximately $30/month. But there are cheaper brands. You can also expect to see brands like Microlut, Ovidon, Microgynon, Minisiston and Rigevidon.
• You can buy condoms in many shops and markets, some of which are open 24 hours.
• For more recommendations, visit the city pages, like the Moscow page.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Russia, you technically need a prescription to obtain emergency contraception (also known as "the morning after pill"). However, it appears that you can purchase EC at many pharmacies without a prescription. As reported by the European Consortium for Emergency Contraception, "Although a prescription is mandatory in order to purchase LNG EC and all types of hormonal contraceptives, anecdotal data suggests that EC pills can often be obtained without a prescription from pharmacies and that UPA EC can be obtained from neighboring countries via the Internet."

What to Get & Where to Get It

• For assistance or information, you can contact the Russian Family Planning Association. Address: 18/20 Vadkovsky per., Moscow, 101479. Phone: +7 (499) 973 15 59 Email: info@rfpa.ru

Dedicated Emergency Contraception

Escapelle emergency contraception, purchased in Russia for 630 rubles

• In Russia, if you want dedicated emergency contraception that's anti-progestin, you'll find some of these pill brands. You should take 1 pill within 120 hours after unprotected sex. Here are the brands: Agesta, Gynepriston, Mifepristone 72 and Negele.
• If you want dedicated emergency contraception that's progestin only, you'll find some of these pill brands. You should take 1 pill within 120 hours after unprotected sex. Here are the brands: Escapelle, Escinor 1.5
• You can also find these progestin only brands. You should take 2 pills within 120 hours after unprotected sex. Here are the brands: Escinor 0.75, Postinor.

Oral Contraceptives Used as EC

• If you can't access dedicated emergency contraception, you can also use normal contraceptives (i.e. birth control pills) as replacement emergency contraception. To do this, you take progestin-only oral contraceptives. For these brands, take 50 pills within 120 hours after unprotected sex. Here are the brands: Microlut
• If you have progestin-estrogen combined pills, take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later. Note that only the first 21 pills can be used. Here are the brands: Ovidon
• For these brands, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later. Note that only the first 21 pills can be used: Microgynon, Minisiston, Rigevidon

Costs

You can expect to pay € 7 – 10 for dedicated emergency contraception. Escapelle is 630 rubles (about €10 as of February 2017).

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

On January 1 2017, President Vladmir Putin announced the establishment of a national HIV registry. The government claims that the registry is not mandatory, but people may need to be registered in order to receive their HIV treatment. Although other countries have some form of HIV registry, including the USA, activists in Russia worry about this registry falling into the wrong hands. Tor read more about the registry, click here and here.

If you are a tourist visiting Russia, there are no restrictions imposed based on your STI status. However, if you are applying to be long-term stay (i.e. over 3 months), and if you want a student or worker visa, you will probably be required to take some tests. If you test negative for HIV, you will be given an "HIV Certificate" that verifies that you're HIV-negative. If you test positive for HIV or TB, you may be expelled from the country. However, as reported by HIVTravel, "According to the feedback we received from a number of EU citizens, an HIV test is not required in order to apply for a work permit or a multy entry visa. We have no evidence that Russia has changed its policy. There might be a softening of requirements for citizens of specific countries."

In Russia, HIV is on the rise and inadequate sex education exacerbates the problem. The first reported HIV diagnosis in Russia (then the USSR) was in 1984, but the Soviet Union denied any diagnoses until 1987. Furthermore, the authorities denied the existence and rejected studies of at-risk groups, such as men who have sex with men (MSM), sex workers and injection drug users (IDU). In the early 2000s, Russia began collaborating with the World Bank to form join projects aimed at combating HIV/AIDS and tuberculosis. However, "Programs implemented largely through NGOs and funded by the Global Fund to Fight AIDS were terminated years ago, primarily because Russia sees itself as a global power who should be donating to other countries, not the recipient of help. The Russian government wants to present Russia as a strong, global leader, so it’s apparently willing to risk a few thousand extra deaths." In 2014, in excess of 85,252 new infections were reported. Globally, one of eight new HIV infections is in Russia. Unsafe sex practices are reportedly very common in Russia, and condoms are completely rejected by many sexually-active people. Other common unsafe practices include sharing needles and using dirty needles in unofficial tattoo parlors.

What to Get & Where to Get It

Testing Facilities

Visit the city pages, like the Moscow page, for local recommendations.

Support

• Federal AIDS Centre Moscow: Head: Prof W.W. Pokrowski, Phone: +7 (459) 366 0518, 365 3009
• Community of People Living with HIV: 11/22, 1st Neopalimovsky lane, Moscow, Russia, 119121, Phone/Fax: +7 (495) 246 4279, 246 7675
• AIDS Infoshare: American organization in Moscow providing support and information on HIV and AIDS (in English and Russian)
• Positive News (in Russian)
• E.V.A.: "NP E.V.A. is the first non-governmental network organization in Russian that was established to protect women who are affected by the HIV epidemic and other socially significant diseases. E.V.A.’s mission is to improve the quality of life of women who live with socially significant diseases." The group is also a member of the World Hepatitis Alliance. E.V.A.'s Helpline: +7 921 913 03 04. On weekdays, from 10.00 to 19.00. Email: office@evanetwork.ru

Medications & Vaccines

What to Get & Where to Get It

• Here's how you say "vaginal infection" in Russian: Вагинальная инфекция.
• If you have a yeast infection, you can ask the pharmacist for Fluconazole and they'll give you some version of the treatment.
• There is no HPV vaccination program in Russia. But you can probably access the HPV vaccine at clinics and hospitals.
• There are no PrEP programs in Russia (as of 2016).

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

In Russia, you can buy tampons or pads/panty-liners everywhere, especially in supermarkets. You'll be able to find tampons in bigger cities, typically a Tampax Compact (witha plastic applicator) and other brands that don't have applicators (like OB). If you're interested in menstrual cups, you won't generally find them in most stores but there are some Russian vendors. For DivaCup, contact Comfort Mama (Tel: +7 913 737 0577, Contact: Olesya Strizhova, info@comfortmama.ru). For LadyCup, check out Ekinol or Supercups.ru. For Lunette, check out the Russian Lunette website. We're not clear if MoonCup is sold in Russia. There's also a Russian menstrual cup brand called LilaCup.

Gynecological Exams

What to Get & Where to Get It

Visit the city pages, like the Moscow page, for local recommendations.

Pregnancy

What to Get & Where to Get It

Visit the city pages, like the Moscow page, for local recommendations.

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Russia, abortion is fully legal for women over 16 years old. If women are under 16 years old, they must receive parental permission. In the first twelve weeks of gestation, all reasons for abortions are accepted, including to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, risk of fetal impairment, economic or social reasons or upon general request. To obtain an abortion, the patient must first give "informed consent," meaning she must formally consent to the abortion at least 48 before the procedure. The abortion must be performed by a licensed physician in a hospital or another recognized institution. Note that a doctor is allowed to refuse giving abortion services, unless it's medically necessary to save the life of a woman. If you get an abortion at a public hospital, you need a referral from a doctor. If you get it at a private hospital, you don't need a referral.

After 12 weeks of gestation, abortion is sometimes permitted. You can receive an abortion within 28 weeks from conception, but this only under special circumstances, such as risk to a woman's life if the pregnancy continues, and the patient must receive special authorization from a committee of local physicians.

After an abortion, a woman is entitled to 3 days of sick leave. They will also be directed to visit a family planning center to learn about contraceptive methods.

Historically, Russia was the first European country to grant abortions upon request in 1920 (then under the Soviet Union). At that time, abortions were free of charge and so in demand that hospitals became congested with abortion patients. As a result, special clinics for abortion procedures opened up. From 1936-1955, abortion was made illegal in the Soviet Union. Following Stalin's death in 1955, it was once again made legal, and it was estimated in the 1950s and 1960s that the Soviet Union had some of the highest abortion rates in the world. After the fall of the Soviet Union, abortion remained very common in the country. This was also due to the closure of condom and IUD factories, making contraceptive options less available for many women. However, with the legalization of sterilization in 1993, abortion rates did begin to go down. In Russia today, abortion still remains incredibly common, and many women still appear to not regularly take contraceptives and have multiple abortions performed on them. While China has the most abortions in the world, Russia was found to have the most abortions per capita. In the last few years, there have been some legal and political challenges to the abortion law, such as the 2015 proposed fine if women obtained abortions outside state clinics and mandatory ultrasounds.

However, public opinion remains generally pro-choice. As reported by AngloInfo, "In general, public opinion is that the woman has the right to choose between abortion and giving birth. Recently though, some thinking is that fathers should also have some right to take part in the decision making process. Most people support abortions being kept legal and the procedure should not be made complicated. However, there are some who believe it should be taken out of insurance packages for free medical care and should be a paid procedure."

What to Get & Where to Get It

If you go to a state hospital, you'll need to be referred to a hospital. The abortion will generally be free (but you'll have to pay for anesthetic). You're more likely to get the dilation and curettage (75 percent in 2011) procedure. This procedure is not recommended by the World Health Organization and there are greater risks, particularly to fertility. The procedure requires anesthetic. You can also choose to vacuum aspiration or medical abortion (i.e. "the abortion pill") but these procedures are not free.

If you go to a private hospital, you won't need a referral. There's a generally higher-level of care than at public facilities, and the abortion procedures comply with WHO guidelines. However, private hospitals are also more expensive.

Advocacy & Counseling

What to Get & Where to Get It

• Center Anna: "Regional Public Organization for Assisting Women and Children in Crisis Situations “Informational Methodological Center “ANNA” (ROO Center «ANNA») was founded in 1993 in Moscow, Russia. The purpose of the organization was to bring attention to the issue of violence against women as well as to establish the first helpline and services for female survivors of domestic violence in Russia. ANNA provides free psychological and legal aid to victims of violence against women." Address: Of. 25, 5/1 Verkhnyaya Radishchevskaya Str., 109240 Moscow, Russia. Telephone (admin): +7 499 225 08 72; +7 926 212 14 42. Telephone (support): 8 800 700 06 00. Email: annaruss93@gmail.com.
• HRO Soprotivlenie (Victim Support Russia) / Межрегиональная правозащитная общественная организация - Сопротивление: "Soprotivlenie is a non-governmental, non-profit organization, founded in 2005 in Moscow, Russia. Soprotilenie provides free legal aid to victims and witnesses of crime (HRO Soprotivlenie provides free legal advice to victims of crime, punishable under the Criminal Code, be it violence, rape, fraud, etc. We do welcome female survivors of sexual violence to enlist our service." Address: 14 Bolshoy Vlasyevsky pereulok, 119002 Moscow, Russia

List of Additional Resources

• Amnesty International Russia: Email: msk@amnesty.org.