east europe and central asia

trends

Abstracted from UNAIDS AIDS Epidemic Update: December 2003

At the end of 2003, the Eastern Europe and Central Asian regions were estimated to have 230,000 new HIV infections raising the number of people living with HIV/AIDS in the region to about 1.5 million. Over 30,000 people in the region lost their lives to AIDS in 2003.

Of all regions, the epidemic is spreading at an alarming rate in the Baltic States (Latvia , Estonia and Lithuania), the Russian Federation and Ukraine . The epidemic continues to ravish Belarus , Kazakhstan and Moldova . Kyrgyzstan and Uzbekistan were added to the list this year as areas of new concern. It is estimated that an average of about 1 million people are living with HIV/AIDS in the Russian Federation.

Driving the epidemic are persistently high levels of risky behavior - specifically injecting drugs and unsafe sex. Young people, mainly teenagers, engage in regular or intermittent injection of drugs. Estimates put the number of injecting drug users at 3 million or over in the Russian Federation , over 600, 000 in Ukraine and about 200, 000 in Kazakhstan . Estonia and Latvia also showed an increasing trend among adults injecting drugs : upto 1% of the population in Estonia and Latvia and about 2% in Kyrgyzstan are estimated to be injecting drugs regularly. Studies reveal that a majority of these drug users are male and an astonishing number of them are very young. A recent study in St. Petersburg, found that 30% of the drug users were under 19 years of age, while, in Ukraine, 20% were still in their teens. A survey of youth aged 15-18 in Moscow revealed that 12% of the males had injected drugs. Overall, up to 25% of injecting drug users are estimated to be less than 20 years of age across Eastern Europe and Central Asia . Rapid spread of HIV is promoted by the routine use of contaminated equipment and frequent sharing of drug injecting equipment. An alarming 60% of the affected population is estimated to be below the age of 25. In Ukraine, 25% of those diagnosed with HIV are younger than 20, in Belarus 60% of them are aged 15-24, while in Kazakhstan and Kyrgyzstan more than 70% of HIV-positive persons are under the age of 30. On the whole, more than 80% of people who are HIV positive in this region have not yet turned 30, in contrast to the situation in Western Europe and the United States of America , where only 30% of the reported cases are among people under 29 years of age.

The Russian Federation is the most affected area in this region. At the end of 2002, an estimated total of 229,000 people had been diagnosed with HIV. About 50,400 (a quarter of these cases) of that total were added in 2002 alone, indicating that the epidemic was growing quite rapidly. The young men in the region are the most affected; however, a recent trend indicates an increasing rate of infection among women and mother-to-child transmissions. New HIV infections among women had risen from24% a year ago to 33% in 2002. As many of these newly infected cases are among women of child bearing age, there has been a sharp rise in the transmission of the virus from mother to child. Kaliningrad and Krasnodar are two of the areas in the region where there is a rapid spread of the disease by mother to child transmissions.

Ukraine , Belarus and Moldova exhibit a similar pattern. More than 52,000 people in Ukraine were officially diagnosed with HIV by the end of 2002, 4,700 people in Belarus and about 1,700 cases in Moldova . Initially, the majority of HIV infections occurred among young people who inject drugs and their sexual partners, however, recent studies indicate that the epidemic is starting to spread beyond them.

Despite the rapid spread of the epidemic in the Russian Federation , the epidemic is considered to be in its early stages. The disease is spreading unevenly throughout the Federation, where the situation is more serious in some territories than others.

At 2,300 in 2002, the total number of HIV diagnoses in Latvia has risen five-fold since 1999. Just four years ago, Estonia reported 12 new HIV cases; in 2002, 899 people were newly diagnosed with the virus. Lithuania is on a similar path. There, the 72 new HIV cases detected in 2001 increased more than five-fold in 2002. Lithuania appears to be facing two distinct epidemics--one affecting mainly those injecting drugs in regions adjacent to Kaliningrad ( Russia ), and the other affecting homosexual and/or heterosexual men in Vilnius . Although overall numbers of infections remain low, HIV is spreading rapidly in the Baltic States .

HIV infections in Central Asia have grown exponentially from 88 in 1995 to 5,458 in 2002. Most of the new infections were recorded in Kazakhstan , Kyrgyzstan and Uzbekistan . HIV has now spread to all regions of Kazakhstan , while the majority of cases reported in Kyrgyzstan appear to be concentrated in the Osh region, which serves as a drug transit route for neighboring countries.

Newly reported HIV infections, further west, in Poland , Czech Republic , Hungary and Slovenia , have remained stable. It has been increasing roughly at a rate of 500-600 infections annually since the late 1990s.

The above data is only based on people who are currently tested for HIV. There are several groups of people who are currently not tested for HIV So the 'real' numbers of HIV infected individuals may be a lot higher than the current estimates.

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