‘Branding people with a stigma’ HIV and hepatitis are spreading rapidly in the Russian army. What does that mean for the soldiers living with these diagnoses?
Viral hepatitis and HIV are spreading quickly in the Russian army, according to both pro-war bloggers and researchers. In September 2025, reports surfaced that soldiers with these diagnoses were being placed in their own separate units. Meduza spoke with Alexey Lakhov, an international consultant on HIV and hepatitis, about how militaries worldwide handle such cases, what’s happening inside the Russian army, and how an influx of veterans with these conditions might affect the stigma faced by people in Russia living with HIV and hepatitis.
— Let’s say it’s peacetime, and someone diagnosed with viral hepatitis or HIV wants to enlist. What’s the current practice, globally? Is that allowed?
— Take the U.S. military, for example. For many years, there was a blanket ban on enlisting people with HIV — they were excluded even if they were in good health. Some countries had similar restrictions for hepatitis B and C. In fact, the U.S. Department of Defense still officially bars people with chronic hepatitis B from serving, even though all recruits there have been vaccinated against hepatitis B since 2002.
The modern trend is to revise these rules in light of advances in treatment. Many countries now treat HIV as a manageable chronic condition as long as patients are on drug therapy. In June 2022, the U.K. lifted restrictions for HIV-positive personnel: they can now enlist [and continue] serving if their viral load is suppressed by treatment. Similarly, in the U.S., court rulings have forced the military to change its policies. Between 2022 and 2024, federal judges struck down the ban on HIV-positive recruits, calling it baseless and discriminatory. Under the rulings, the Pentagon must allow people with HIV to serve if they are asymptomatic and have an undetectable viral load. The judge described the old ban as “irrational and arbitrary,” noting that it only reinforced stigmas and actually harmed the military’s own interests by limiting recruitment.
Other countries are changing their approach as well. In Israel, where military service is mandatory, HIV-positive draftees were long deemed unfit and automatically exempted. But in 2015, Israel announced it would begin drafting them, assigning a restricted medical profile that excludes combat roles but allows service in most other capacities. The condition is that health and treatment criteria are met; for instance, HIV-positive soldiers in Israel are not placed in jobs with a high risk of bleeding, meaning they are kept out of combat units.
Russia, until recently, maintained strict restrictions. HIV was listed among conditions that led to a Category D classification (completely unfit) or Category B (fit with limitations), which effectively barred service in peacetime. HIV-positive people were not officially accepted into either conscription or contract service. The same applied to chronic hepatitis — diagnoses of hepatitis B or C were grounds for refusal of a contract or assignment of a limited fitness category. In practice, the standard peacetime policy in Russia was to deny military service to people with HIV or hepatitis, or to discharge them immediately if they were diagnosed with the condition.
— And now that’s definitely changed.
— Yes. In Russia, the law still allows discharge for “socially significant diseases,” but in practice — especially since the [full-scale] war began — soldiers are often not dismissed. Many even hide their diagnoses themselves to avoid losing benefits and payments. So while discharge is technically possible, in reality many continue serving as long as their health allows. From all appearances, there are now quite a few soldiers with these infections at the front. If someone contracts hepatitis during the war, they may tire more easily, lose their appetite, or experience dizziness.
— In other countries, during wartime, would an infection still mean discharge?
— In the past, yes, it usually meant being discharged. In the U.S. military, for example, service members with HIV were barred from overseas deployments or combat zones, which effectively ended their prospects. The justification was the difficulty of providing medications abroad and the restrictions imposed by host countries. If an HIV-positive soldier stayed in service, they were often assigned to domestic roles — in headquarters, training units, and so on — to minimize the risk of being without medical care. Since 2022, however, it’s no longer permitted to discharge someone solely for being HIV-positive if they’re on treatment and fit for duty. In the U.K. and other NATO countries, the trend is also to keep soldiers in service, sometimes reassigning them to lower-risk positions. And if a British or American service member deploys to a combat zone, the command now guarantees they’ll have enough medication for the entire mission and access to medical support.
— There are reports that in Russia, special units will be formed consisting only of soldiers with viral hepatitis and HIV, who would have to wear distinctive armbands. That doesn’t sound very ethical or legal.
— Right. The official justification was concern for fellow soldiers — so that “healthy ones wouldn’t be afraid to serve alongside them.” But medically, it makes no sense. HIV and hepatitis are not transmitted through everyday contact; what’s actually needed are universal precautions when handling blood. Segregation and labeling, on the other hand, only deepen stigma and violate basic rights. International organizations and medical associations explicitly call such practices discriminatory and unethical. It’s more about branding people with a stigma — like “a mark on the forehead” — than about real safety (much like the notorious red triangles on the medical records of people with HIV).
— How are these viruses usually transmitted in the military?
— The main sources are the same as in civilian life: unprotected sex (for example, with sex workers, through sexual violence against civilians, or homosexual contact) and drug use with shared needles. In armies that recruit prisoners or people from so-called marginalized groups, the percentage of those already infected is higher to begin with. For instance, HIV and hepatitis rates in Russian prisons are much higher than average.
Transmission can also occur through medical procedures or injuries in combat conditions. There are several factors here.
First, blood transfusions and wound treatment in the field. With massive blood loss at the front, emergency transfusions may be needed. If there’s a shortage of disposable equipment or rapid testing devices, mistakes can happen — for example, transfusing blood from a donor who is unknowingly infected. In field hospitals, they may even resort to direct “vein-to-vein” transfusions from fellow soldiers. If the donor isn’t properly screened, the risk of transmission is enormous. In this way, military medicine itself, when overstrained and poorly equipped, can unintentionally spread infection.
Second, the shortage of sterile instruments and supplies plays a big role. Under such conditions, syringes, scalpels, or catheters may be reused without proper sterilization. If one wounded soldier is infected and the needle isn’t disinfected correctly, the next patient may receive the virus. Any inadequately sterile medical care — from dressing wounds to surgery — can transmit hepatitis B, hepatitis C, or HIV.
Third, there’s blood-to-blood contact on the battlefield. In the chaos of combat or when giving first aid, a soldier may get another’s blood on open wounds or mucous membranes — for example, while carrying an injured comrade without gloves or while bandaging wounds. If one soldier’s blood enters another’s wound, transmission is theoretically possible (especially for hepatitis, which is more contagious). The probability isn’t especially high, but given the chaos of battle, it can’t be ruled out.
There’s also the factor of barracks life. If soldiers neglect hygiene — say, several men share the same razor and one is infected with hepatitis B or C — others can become infected. Bloody encounters during fights or hazing — if the same blade is used, or blood gets mixed — carry some risk as well. Hepatitis B, for example, can be transmitted by microscopic amounts of blood and the virus remains viable on surfaces for a long time.
— And ideally, how should things be organized to minimize these risks?
— Vaccinating everyone [against hepatitis B] is the best solution. That’s what the U.S. military does. The vaccination requires three doses, so it can take some time, but even a single shot begins to build immunity.
It’s also crucial to identify [infections] early and provide treatment to suppress viral load and reduce the risk [of transmission] to virtually zero.
— Russia has always struggled with access to treatment for viral hepatitis and HIV. Now that the Defense Ministry is responsible for some of these patients, has the situation changed?
— If a military unit lacks the right specialists or equipment and can’t send a soldier to a specialized hospital, Russian service members can still be treated at regional AIDS centers. The decision to begin antiretroviral therapy (ART) is made by a medical commission at the AIDS Center; even if another institution administers the treatment, the Center remains the supervisory authority.
In practice, cooperation between AIDS centers and infectious disease units in military medical facilities varies by region and in many cases remains inadequate. For example, data from the federal registry of people living with HIV is still only available through a personalized written request. Another difficulty is ensuring continuous ART medication for patients between the time they’re discharged from a clinic and when they report to the AIDS Center in their home region after leaving military service. Still, within military medical institutions such as the Kirov Military Medical Academy in St. Petersburg, treatment is carried out with modern drugs.
— In Russia today, the number of people living with viral hepatitis and HIV is growing, partly due to those returning from the war. These are people who come back from the “special military operation” and are widely glorified. Do you think the existence of this new, “elite” category of patients could help reduce the stigma around such infections?
— Most likely, neither the authorities nor the veterans themselves will make their status public. If someone is decorated, the press release isn’t going to say, “he has hepatitis C, contracted at the front.” The topic of HIV and hepatitis will remain in the shadows.
So far, everything suggests that the system doesn’t take pride in these people but isolates and marks them instead (with armbands, separate units). That only reinforces the idea that they are “different, dangerous.” Fellow soldiers may fear or despise those who are infected, blaming them personally or viewing them as “dirty.” If these attitudes persist, then even after the war society may regard such veterans with suspicion. Not as a “hero with HIV,” but, crudely put, as “that AIDS soldier.” Destigmatization depends on how these people are integrated into society. If they’re granted equal rights and honored without reference to their illnesses, then yes, it could break down stereotypes. But if they’re quietly pushed aside or looked down on, then no.
So far, official rhetoric in Russia shows no sign of using this moment to combat stigma. On the contrary, HIV continues to be framed as a “socially dangerous disease,” with emphasis on danger, epidemic, even blame. Take Anastasia Kashevarova’s words: “those who’ve long been sick and worsened it with drugs or alcohol should serve separately — that’s only fair.” The implication is to fault the patients themselves. In such an atmosphere, it’s unlikely that tolerance will suddenly be promoted. More likely, the authorities will avoid drawing attention to the fact that “heroes” returned with HIV. The subject may be hushed up, or spun negatively: “they pose a threat, they need treatment or they’ll infect the population.” That kind of messaging can actually heighten public fear.
Perhaps years from now, when this wave of veterans with such diagnoses starts turning up in civilian hospitals, doctors and social services will have no choice but to treat them with respect — as veterans. That, indirectly, could improve how all patients with HIV or hepatitis are treated. For example, if an HIV-positive veteran shows up at a clinic, they can no longer be denied dental care just because of their diagnosis (as has sometimes happened with ordinary HIV patients). A veteran comes with status, with veteran laws behind him. In that sense, yes, the rising number of people in society living with these conditions could gradually erode stigma: the illness will no longer seem rare, people will see that their neighbor — a “war hero” — lives with HIV, and that challenges entrenched stereotypes.
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