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Southeastern Europe: Cases Of HIV And AIDS On The Rise

By Stephanie Wells & Kacy Zuchowski

A recent World Bank report indicates that Southeastern Europe is experiencing alarming increases in infection rates for HIV and AIDS. And the report notes that many of those infected don't have access to adequate health care.

Washington, 18 July 2003 (RFE/RL) -- A new World Bank report finds that HIV and AIDS are spreading in Southeastern Europe.

The report outlines the current situation regarding AIDS and HIV, the virus that causes AIDS, in three countries. The study says Romania has almost 13,000 cases of HIV/AIDS, with Bulgaria and Croatia at around 350 cases each. Health experts say that, due to lack of testing, these figures are probably much higher and that many people are unknowingly spreading the disease.

The World Bank found the three countries share the problems of high unemployment and poverty, the effects of rapid social change, and poor health and education services. Other factors contributing to the problem include high population mobility, increased substance abuse, and prostitution.

Although the epidemic in the region began among intravenous drug users, the World Bank is expressing concern that HIV/AIDS will soon spread to the general population, mainly through heterosexual intercourse. That means these countries will no longer be able to target a specific social group to educate or provide treatment. The World Bank says educating and treating an entire population presents a great challenge to the underfunded health systems of Southeast European countries.

Dominic Haazen is one of the authors of the report and a senior health specialist at the World Bank. He expressed concern to RFE/RL about the accessibility and affordability of effective treatments in these countries.

"The antiretroviral [AIDS] drugs are fairly expensive, even with the better prices that some of the countries are getting, and the level of spending on health in the countries [is also a concern]," Haazen said.

Haazen also noted that the economies of these countries will suffer as more of the population becomes unable to hold jobs and maintain productivity. "People that would be affected most, or that are affected most by HIV/AIDS, are younger people, so there would be an impact on decreased economic growth."

According to the World Bank, outreach to high-risk groups in the region is a problem due to stigmas against certain segments of the population. The report says prostitutes, intravenous drug users, and ethnic minorities do not have the same access to health care and HIV/AIDS information as the general population.

Henning Mikkelsen is the European regional coordinator for UNAIDS, the United Nations global advocacy initiative on HIV/AIDS. He told RFE/RL that although Africa has more infected people and deserves the international attention it is now receiving, Southeastern Europe could be the site of the world's next HIV/AIDS crisis.

Mikkelsen said a combination of care for those already infected and prevention education directed toward youth is the best way to combat the spread of HIV/AIDS in Southeastern Europe. "We need to do something to reduce the vulnerability of young people, so we need to do something to improve the social situation of young people, to provide them the life skills and education which can [teach] them how to deal with the problems of HIV and AIDS," he said.

Mikkelsen also said young people need to have access to health-care facilities that provide treatment for sexually transmitted diseases and which can educate them about condoms and other preventative measures.

"Young people are living in a very uncertain situation. In some of the countries, we have an aftermath of the whole armed conflict situation there, which creates a very difficult psychological and social situation for young people. And as a result of that, they are increasingly turning to injecting drug use and they are also engaging in high-risk sexual behavior," Mikkelsen said.

The report says 1.2 million people living in Eastern Europe and Central Asia are infected with HIV or AIDS, with an estimated 250,000 new infections last year alone. Romania, Croatia, and Bulgaria may have comparatively small numbers of infections, but the cases are increasing at alarming rates, which will soon rival the rates in Russia and Ukraine.

A study released on 16 July at an international AIDS conference in Paris finds that about 10 percent of all new AIDS patients in Europe are infected with drug-resistant strains, making the search for new AIDS drugs particularly critical.