A new report released by the UNAIDS program says the rise of HIV/AIDS in the countries of Eastern Europe and Central Asia is putting an entire generation of young people at risk. RFE/RL looks into why HIV is spreading so rapidly and what is being done to combat it.
Prague, 26 November 2003 (RFE/RL) -- Some 1.5 million people living in Eastern Europe and Central Asia are infected with HIV, the virus that causes AIDS. And a report released yesterday by UNAIDS -- a partnership between the UN, the World Health Organization, and the World Bank -- says the epidemic shows no signs of abating in the region.
Russia, Ukraine, Estonia, and Latvia are most affected. The situations in Kazakhstan and Uzbekistan are also of great concern. The epidemic is spreading mostly among intravenous drug users and young people. This trend contrasts with most Western countries, where victims tend to be a bit older and transmit the disease sexually.
In Ukraine, 25 percent of those diagnosed with HIV are under the age of 20. In Belarus, 60 percent are aged 15 to 24. In Kazakhstan and Kyrgyzstan, more than 70 percent of those with HIV are under the age of 30. In fact, more than 80 percent of those diagnosed as HIV-positive in Central Asia and Eastern Europe have not yet celebrated their 30th birthdays.
Irina Savtchanko of UNAIDS spoke to RFE/RL about how the mode of transmission is changing. "In some regions, up to 90 percent of HIV-infected persons are injecting drug users," she said. "But during [the past few] years, the situation is changing a little bit and sexual way of transmission is playing more and more a role in the epidemic."
Over the past year, Savtchanko says, the number of those contracting AIDS through sex has risen from 12 percent to 17 percent. She says the rise can be attributed, in part, to young intravenous drug users and their unsafe sexual practices. "It's the law of developing the epidemic," she said. "If the epidemic is starting in injecting drug users, and the number of cases are accumulating in this group, later, the drug users, they serve like a bridge to the heterosexual population, because they are also sexually active and have sexual partners, and they transmit the virus to [the] heterosexual population."
The report states that extraordinarily large numbers of young people engage in intravenous drug use in the countries of the former Soviet Union. Condom use is also generally low among young people.
Young men are the greatest victims of the epidemic in the region. But now, a striking new pattern of infection is emerging among women as well. "At the beginning of the epidemic, the percentage of women was about 25 [percent] and now it's more than 30 percent. So women are more evolving first into injecting drug use and into sex with injecting drug users who have HIV infection and who transmit infection to them," Savtchanko said.
Many experts highlight the need for more vigorous governmental responses to the epidemic, including the addition of more programs aimed at prevention. Savtchanko says she hopes recent infusions of money from the United Nations to 12 countries in the region will make a difference.
She says Ukraine's HIV prevention program is a model for other nations to emulate. Ukrainian President Leonid Kuchma addressed the UN General Assembly on the topic in September. He reported his government is taking action to help those already infected and to prevent others from becoming infected. "Recently, a national program on HIV prevention has been implemented in Ukraine," Kuchma said. "Measures taken enable us to make substantial progress in combating the spread of the disease, particularly cases of the transfer of HIV infection from mother to child."
Savtchanko says other nations need to follow Ukraine's lead and devote more governmental attention to the problem. "Some governments, they do not understand the extent of the problem, or they don't want to understand the extent of this problem because, well, our countries are in the period of [transition] and countries, a lot of countries, are facing very serious problems -- economic and health problems and corruption and wars and all this," she said. "That's why some governments, they don't want to understand that in [the] future, HIV infection epidemic will be a real threat for the nations."
The report finds that the outbreak of the epidemic in the region, especially in Central Asia, is "very recent" and can still be halted if prevention efforts are targeted at those most at risk -- intravenous drug users, sex workers, and young people.
In some places, elementary efforts, such as screening blood donations for the disease, can still make a big difference.