HIV in the CIS.

• Author: Sethi, Sanjay
• Position: HealthWatch

The AIDS epidemic is spreading rapidly across Eastern Europe and Central Asia, with countries of the Commonwealth of Independent States (CIS) experiencing the world's fastest-growing infection rate. Approximately I million people in the region are living with HIV/AIDS--more than double the 420,000 infected at the end of 1999. An estimated 250,000 new HIV infections occurred in 2001. With both high levels of other sexually transmitted infections (STI) and high rates of intravenous drug users among young people, the epidemic seems set to continue its rapid growth.

Before 1994, no country in the region was reporting more than a few HIV infections. A year later, the first reported HIV outbreak occurred in Ukraine and Belarus. The epidemic then started to expand into other neighbouring countries. Moldova had its first outbreak in 1996 and the Russian Federation in 1998. Similar outbreaks were reported in Latvia and Kazakhstan shortly thereafter.

The major mode of HIV-transmission in Eastern Europe is through intravenous drug use. Up to 1 per cent of the population of the CIS countries may be injecting drugs, placing themselves and their sexual partners at high risk of infection. Outbreaks of HIV-related intravenous drug use are also being reported in several Central Asian republics, including Kyrgyzstan, Tajikistan and Uzbekistan.

The best available data suggests that drug use by injection is responsible for more than 60 per cent of all new HIV transmissions in Eastern Europe. Unsafe sexual practices have also contributed to the spread of AIDS there, and with the increasing number of sex workers, this will likely continue to be a problem in the near future.

Ukraine is the hardest-hit country in all of Europe. According to its Ministry of Health, an estimated quarter million of its citizens are currently infected with the virus--approximately I per cent of the adult population. Helen Petrozolla of the United Nations Development Programme (UNDP) Country Office, an expert on HIV infection in Ukraine, suggests that the figures of those infected are vastly underestimated due to a lack of effective surveillance mechanisms; instead, it is probably five to six times that number. Historically, countries of the former Soviet Union were slow in responding to the advancing threat of AIDS. This was due largely to the stigma attached to the disease. In the past, HIV testing was imposed only on populations that were considered at risk of contracting the...