As a general rule as per article 8 of the Federal Law on “On the Prevention of the Spread in the Russian Federation of Diseases Caused by HIV-Infection” medical testing shall be done voluntarily at request of a person being examined or with his or her consent. If requested by a person, medical examination shall be anonymous. Medical examination is done with pre- and post- testing counseling on prevention of HIV. Nationals of the Russian Federation receive free medical examination for HIV in all public healthcare institutions of the country.
There are certain population groups subject to mandatory examination for HIV. This obligation entails negative consequences for those refusing mandatory examination for HIV.
Individuals planning to be donors of blood, blood plasma, seminal fluid or other biological fluids, organs and tissue are subject to mandatory medical examination prior to each donor material drawing. Individuals who refuse mandatory medical examination may not be engaged as donors.
Medical examination for HIV is also mandatory for professional staff of certain occupations during the recruitment process and regular medical check-ups. The list of these occupations is established by the Resolution № 877 of September 4, 1995 of the Government of the Russian Federation and includes doctors, medical personnel of healthcare institutions working with HIV+ patients and delivering HIV testing and blood analysis, and research workers working with HIV materials. Representatives of the above occupations refusing examination for HIV are subject to disciplinary action, i.e. might be fired on an employer initiative.
HIV examination is also mandatory for foreign nationals and stateless persons planning to enter and reside on the territory of the Russian Federation for over three months with an exception applied to employees of diplomatic missions and consular offices of foreign states, employees of international intergovernmental organizations and their family members (article 10). When applying for entry visa, foreign nationals and stateless persons are requested to present medical certificate of a due form confirming their HIV-negative status. Entry visa will not be issued without such a certificate. Russian nationals returning back to the country after traveling abroad do not have to present such a certificate.
Mandatory examination for HIV also applies to people serving a sentence at institutions of confinement. Refusal to undergo mandatory medical examination is regarded as breach of conditions of the sentences and entails corresponding penalties. This requirement is secured in article 18 of the Criminal Correctional Code of the Russian Federation which provides that mandatory treatment shall be assigned to HIV+ inmates upon decision of a medical board.
There is a list of clinical indicators approved by the Public Health Ministry which are preconditions for examination for HIV. However, even if clinical indicators are observed, the examination shall not be done without a patient’s consent. A doctor shall recommend a patient undergo examination for HIV with explanation of its importance and possible outcomes. It is very important to ensure a patient undergoes examination consciously, on his own free will and feels prepared to accept possible HIV positive diagnosis.
Mandatory examination for HIV prior to entering a military service is secured in Regulation on Medical Evaluation for Military Service adopted by Resolution of the Government of Russian Federation No 123 of February 25, 2003. Such mandatory examination does not contradict current legislation as Federal Law on “Conscription and Military Service” provides that the procedure of medical examination of people subject to military duty/conscription shall be defined by the Regulation on Medical Evaluation for Military Service.
There are no other requirements for mandatory examination for HIV. Therefore, there should be no violation of rights of individuals refusing examination for HIV except the cases mentioned above.
Medical workers are obliged to inform a person about the results of medical examination. If a person diagnosed with HIV infection is a juvenile (under 18 years old) or duly recognized as legally incapable, the information shall be provided to parents or legal representatives as per article 13 of the Federal Law on HIV.