Russia, the largest country on earth, which emerged from the post-Soviet economic and political chaos to reassert itself, is facing an HIV/Aids epidemic.

The current rate of HIV is less than one percent of Russia's population of 143 million. It's far lower than many other countries, such as South Africa which stands at 12.2 percent, that have been battling HIV epidemics.

I don't know how many more people need to get infected with HIV and die before something changes in this country.

Maksim Malyshev, social worker in Moscow

Russia has one of the fastest-growing rates of HIV/Aids in the world. At the beginning of this year, the number of registered HIV-positive people surpassed one million. The number of Russians living with HIV has almost doubled in the last five years.

The 2016 UNAIDS Prevention Gap Report pointed to Eastern Europe and Central Asia as "the only region in the world where the HIV epidemic continued to rise rapidly".

Russian activists say the government's reluctance to introduce internationally-accepted prevention methods is behind this epidemic. Potential solutions such as sex education, the distribution of condoms to sex workers, methadone therapy and the availability of clean needles to drug addicts are strongly opposed by religious leaders and other conservatives. 

It is estimated that over 50 percent of HIV cases in Russia are the result of intravenous drug use. Methadone therapy, however, was made illegal by President Vladimir Putin's government, despite being classified as "the most promising method of reducing drug dependency" by the World Health Organization.

Talk to Al Jazeera travels to St Petersburg and Moscow to meet people living with HIV and the activists doing all they can to help.

In St Petersburg, we meet Aleksandr Romanov, 47, who discovered that he was HIV-positive six years ago. He grew up in Kazakhstan, then part of the Soviet Union. He says his infection can be traced back to the post-Soviet effects on society - dramatic changes, which included widespread drug use.

Maria Yakovleva, also known as Masha, is part of Svecha, or Candle Foundation, an organisation which provides support, guidance, education, and hope to those living with HIV. She herself is HIV-positive. Changes need to come from the top, she says. 

"There are plenty of things [people need to know], but there is no information [from the government]," Yakovleva says.

Maksim Malyshev works as a social worker with a local NGO in Moscow, which promotes humane drug policies. He worries about the negative impact that the government's approach has on Russians living with HIV. He can't understand whether Russia's leadership simply doesn't care or is just incompetent.

"In my view, the problem of HIV infection in Russia exists because the people whose job it is to find ways of preventing HIV in Russia are doing a crap job. They are living in some kind of fantasy world of their own, and they have no desire to listen about science-based methods and to the specialists who are working on this problem," he says.

"Either these people are hypocrites who don't care about the thousands of people who get infected with HIV and die, or they are simply too stupid to research the HIV prevention information in order to ascertain what is and isn't working and to resolve this problem."

The government needs to wake up to a problem that has long been urgent, he believes.

"I think we are already long past the point when something should have been done."

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Source: Al Jazeera