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 You are in: Under Secretary for Political Affairs > Bureau of International Organization Affairs > Reports to Congress, U.S. Votes, Fact Sheets, Testimony > Fact Sheets > 2002
Fact Sheet
Prepared for the XIV International Conference on AIDS, July 7-12, 2002
Barcelona, Spain
July 2, 2002

HIV/AIDS in Eastern Europe and Central Asia

Released by the Joint United Nations Programme on HIV/AIDS (UNAIDS)

HIV/AIDS is rapidly spreading through countries of this region,
which is now experiencing the fastest-growing epidemic in the world.

Approximately one million people in Eastern Europe and Central Asia are living with HIV/AIDS (more than double the 420,000 at the end of 1999). An estimated 250,000 new HIV infections occurred in 2001. Given the high levels of other sexually transmitted infections, and the high rates of injecting drug use among young people, the epidemic looks set to grow considerably.

A sudden surge

As recently as 1994, no country in this region was reporting more than a few HIV infections. A year later, the first HIV outbreak occurred in Ukraine and Belarus. The epidemic then started to take off in other countries of the region -- Moldova in 1996 and the Russian Federation in 1998, followed by Latvia and then Kazakhstan.

The Russian Federation is at the forefront of this region's epidemic. New cases of HIV have been almost doubling annually for several years. The total number of HIV infections reported since the epidemic began now stands at more than 173,000 -- up from the 10,993 reported at the end of 1998. The estimated number of people now living with HIV/AIDS in the Russian Federation is thought to be around four times higher than these reported figures.

In Estonia, reported HIV infections soared from 12 in 1999 to 1,474 in 2001. Likewise, in Latvia, newly reported infections rose from 25 in 1997 to 807 in 2001 and, in Kazakhstan, 1,175 HIV infections were reported in 2001. HIV spread is now also evident in Azerbaijan, Georgia, Kyrgyzstan, Tajikistan and Uzbekistan.

Ukraine remains the most affected country in this region -- and, in fact, in all of Europe -- with an estimated adult HIV prevalence rate of 1%. (Approximately 250,000 people are living with HIV in this country of nearly 50 million.)

Fertile settings

Several factors provide a fertile setting for the epidemic. Mass unemployment and economic insecurity beset much of the region, while the rigid social control of the past has eroded, and new common norms and values are still flimsy. Unprecedented numbers of young people do not complete their secondary schooling. Public health and other services have deteriorated badly in some countries. Several countries have experienced setbacks in the human development index over the past two decades. (The index measures countries' average achievements in life expectancy, educational attainment and real gross domestic product per capita.)

The vast majority of reported HIV infections are among young people -- chiefly those who inject drugs. It is estimated that up to 1% of the population of countries in the Commonwealth of Independent States is injecting drugs, placing these people and their sexual partners at high risk of infection. Outbreaks of HIV-related injecting drug use are also being reported in several Central Asian republics, including Kyrgyzstan, Tajikistan and Uzbekistan.

Wider HIV spread

While injecting drug use is currently responsible for three-quarters of HIV infections in Ukraine, the proportion of sexually transmitted HIV infections is also increasing. More people (mostly women) appear to be contracting HIV through sexual transmission and more pregnant women are testing positive for HIV -- suggesting a shift of the epidemic into the wider population.

There is also evidence that young people in several countries are becoming sexually active at an earlier age and that premarital sex is increasing. A steady rise in premarital sex is being observed among Romanian adolescent girls (aged 15-19), for example. The percentage of reported premarital sexual relations in 1993 (9%) had more than doubled to 22% in 1999, while a 2000 report in Ukraine revealed that about 51% of women aged 15-24 had had a premarital sexual relationship.

In some Central Asian republics, awareness of HIV/AIDS is very low among vulnerable groups, such as teenage girls -- a mere 10% of whom in Tajikistan had ever heard of HIV/AIDS. In 2001, in Azerbaijan and Uzbekistan, fewer than 60% were aware of the disease. The proportion of young girls harbouring at least one major misconception about HIV/AIDS ranged from 94% to 98% in those countries. In Ukraine, which has the highest HIV prevalence rate in Europe, only 9% of adolescent girls were aware of HIV prevention methods. Although improving in some places, levels of condom use remain low.

Meanwhile, very high rates of sexually transmitted infections continue to be found in Eastern Europe and Central Asia, increasing the odds of HIV being transmitted through unprotected sex. In 2000, the number of newly reported cases of syphilis in the Russian Federation stood at 157 per 100,000 persons, dramatically higher than the 4.2 per 100,000 persons in 1987. Similar general trends are visible in the other countries of the Commonwealth of Independent States, in the Baltic States and in Romania.

In the psychological and socioeconomic aftermath of the Balkans conflicts, young people are now more vulnerable to HIV. A recent WHO/UNICEF study found high levels of drug injection in some countries, as well as frequent sharing of injecting equipment. The study also found a strong overlap between high-risk groups. In Serbia, for example, 20% of sex workers and 18% of men who have sex with men were found to inject drugs.

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