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Untitled May 17, 2008 
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  • Untitled Global overview
  • Untitled Sub-Saharan Africa
  • Untitled Middle East and North Africa
  • Untitled Eastern Europe, Russia and Central Asia
  • Untitled Asia and the Pacific
  • Untitled Latin America and the Caribbean
  • Untitled More Developed Countries (MDCs)

    Untitled Eastern Europe, Russia and Central Asia
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    Diverse Untitled HIV epidemics are under way in Eastern Europe and Central Asia. About 1.3 million people (range: 860 000–1.9 million) were living with Untitled HIV at the end of 2003, compared with about 160 000 in 1995. During 2003, an estimated 360 000 people (range: 160 000–900 000) in the region became newly infected, while 49 000 (range: 32 000–71 000) died of Untitled AIDS . Among young people aged 15–24, 0.6% of women (range: 0.4–0.8%) and 1.3% of men (range: 0.9–1.8%) were living with Untitled HIV by the end of 2003.

    Estonia, Latvia, the Russian Federation and Ukraine are the worst-affected countries in this region, but Untitled HIV continues to spread in Belarus, Kazakhstan and Moldova (see Fig. 1). For example, in Russia, the number of new cases registered in 2000 (56 630) was almost twice the cumulative number of cases registered since 1987 (French, 2004). However, the number of reported cases was down in 2002 and 2003, possibly due to testing saturation among injecting drug users, and changes in testing patterns.

    Newly diagnosed HIV infections per million population in Eastern European and Central Asian countries, 1996‚2003

    Figure 1



    The main driving force behind epidemics across the region is injecting drug use—an activity that has spread explosively in the years of turbulent change since the demise of the Soviet regime. A striking feature is the low age of those infected. More than 80% of Untitled HIV -positive people in this region are under 30 years of age. By contrast, in North America and Western Europe, only 30% of infected people are under 30.

    The Russian Federation has the largest number of people living with Untitled HIV in the region, estimated at 860 000 (range: 420 000–1.4 million). The picture is uneven; well over half of all reportedcasesof Untitled HIV infectioncome from just 10 of the 89 administrativeterritories. Most drug users in Russia are male. But the proportionoffemales among new Untitled HIV cases is growing fast—up from one in four in 2001, to one in three just a year later. The trend is most obvious in parts of Russia where the epidemic is oldest, and this suggests that sexual intercourse has been playing an increasing role in transmission. From 1998 to 2002, Untitled HIV infection levels among pregnant women in Russia increased from less than 0.01% to 0.1%—a 10-fold increase. However, in St Petersburg, Untitled HIV seroprevalence increased from 0.013% in 1998 to 1.3% in 2002—a 100-fold increase.

    In Ukraine, drug injecting remains the principal mode of transmission, but sexual transmission is becoming increasingly common, especially among injecting drug users and their partners. However, an increasing proportion of those who become infected through unsafe sex have no direct relationship with drug users.

    Recently, several Central Asian countries—notably, Kazakhstan, Kyrgyzstan and Uzbekistan—have reported growing numbers of people diagnosed with Untitled HIV , most of them injecting drug users. Central Asia is at the crossroads of the main drug-trafficking routes between East and West and, in some places, heroin is said to be cheaper than alcohol.

    Throughout the region, estimates and trends are based almost exclusively on case reporting by the health services and the police, since there is little money or infrastructure for systematic surveillance. This raises concerns that Untitled HIV may be spreading among people who rarely come into contact with the authorities or testing services. For example, very little is known about how the epidemic affects men who have sex with men, since sex between men is widely stigmatized and rarely acknowledged. However, in Central Europe, sex between men is clearly the predominant mode of Untitled HIV transmission in the Czech Republic, Hungary, Slovenia and the Slovak Republic.
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    The excerpted text and figures integrated herein were mainly from the: unless indicated, otherwise.
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