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East: HIV At All-Time High In Former Soviet States

This week marks 20 years since the deadly AIDS disease was first reported. AIDS is now killing millions throughout the world, especially in Africa, where it is the leading cause of death. The countries of the former Soviet Union initially seemed to have escaped the global trend, but now experts say steep rates of infection by the HIV virus that causes AIDS are plaguing the region. RFE/RL correspondent Alexandra Poolos reports.

Prague, 6 June 2001 (RFE/RL) -- It all began 20 years ago when the U.S. Centers for Disease Control issued their weekly newsletter on outbreaks of illness and unusual deaths in the United States. In a short 500-word article, doctors reported that a rare parasitic lung infection -- Pneumocystis carinii pneumonia -- had shown up in five young men in Los Angeles. Three of the men tested had an inexplicable depression of their immune system.

Since that initial report, AIDS -- or Acquired Immune Deficiency Syndrome -- has become a household word, killing some 22 million people around the world. Across the globe, 36 million people have tested positive for HIV -- for Human Immuno-deficiency Virus, the virus that causes AIDS. AIDS is now the fourth leading cause of death globally.

HIV destroys the body's ability to fight infections and certain cancers by killing or damaging cells of the body's immune system. People diagnosed with AIDS may develop life-threatening diseases, causing what are called "opportunistic" infections.

Over the years, increased awareness of the disease and ways of preventing its transmission has led to a decline in AIDS deaths in North America and Western Europe. But experts report that AIDS is spreading faster in the countries of the former Soviet Union than anywhere else in the world.

Henning Mikkelsen, the Senior Liaison Officer for Europe at UNAIDS -- the UN coordinating agency for AIDS -- says that before the mid-1990s there were few reported cases of HIV in the countries of the former Soviet Union. But that has changed radically in recent years. Mikkelsen tells our correspondent that now the spread of HIV in the region is on a steep increase.

"From 1996 and outwards, the epidemic started to spread. First, there was an outbreak in a port city called Odessa in Ukraine. And from there on it started to spread rapidly across Ukraine and also in other countries like Belarus, Russia and Kazakhstan. Recently, the epidemic is moving extremely fast and it is happening almost everywhere."

Unlike the United States or West European nations, HIV is not usually transmitted sexually in Russia or Ukraine. Mikkelsen says that drug use is the predominant mode of transmission of the disease.

"It is closely linked to another development, namely that there has been a high increase in injecting drug use. So more than 80 percent of the reported HIV cases are found among injecting drug users. Of course, there is also sexual transmission going on, but it's mainly between injecting drug users and their partners."

Mikkelsen acknowledges that there are government initiatives to fight the disease in Russia, Belarus, and Ukraine. But he says that these countries are overwhelmed with the recent onslaught of HIV cases and are ill-equipped to do battle with its swift spread.

"But of course many of the countries have severe economic problems. They are still in the process of political transition. And clearly, also, it is just now that they are experiencing the problems of injecting drug use and HIV. It is new to them. It takes time before they are ready to invest substantially in this."

Murdo Bijl is the coordinator for research and development for Doctors Without Borders (Medicins Sans Frontiers) in Moscow. Bijl says that a major problem in Russia is that the disease is spreading among young drug users. He tells RFE/RL that while young people are aware of HIV and AIDS, many have no knowledge of how to protect themselves from contracting the disease.

"But despite the fact that people are aware, the ways of how to protect themselves is not generalized yet. So in other words, people know [that HIV and AIDS exist], but how to protect themselves is not clear for many people. And that's the challenge as well, for international organizations but also for the government of Russia and nongovernmental organizations, to really get this message across via a whole variety of activities."

Bijl says that the problem is even worse in Ukraine, where sexual transmission of HIV has been on the rise in recent years.

"The problem is certainly comparable in Ukraine -- in fact, Ukraine is one to two years ahead of the epidemic. So some lessons can be learned from Ukraine and implemented in the Russian Federation. [In Russia] you can see that unsafe injecting drug use did significantly contribute to the transmission of HIV throughout society. And in Ukraine you see now at the present time that sexual transmission is becoming more prevalent as well."

Both Mikkelsen and Bijl say that the AIDS epidemic is only beginning in the states of the former Soviet Union. But they say that these countries are in a unique position to study education initiatives in the United States and West European countries, where AIDS awareness is high. They say that educating young people on the dangers of both unsafe drug use and unprotected sexual practices will be the key to stemming the spread of HIV/AIDS in Ukraine and Russia.