IN THE NEWLY INDEPENDENT STATES
characterized by very low prevalence, the region is now experiencing an
extremely steep increase in the number of people living with HIV/AIDS.
While the estimated number of people living with HIV/AIDS was 170,000
at the end of 1997, it is expected to climb to 700,000 by end-2000.
- Parallel epidemics
of HIV, injecting drug use and sexually transmitted infections are unfolding
in a social context of economic crisis, rapid social change,
increased poverty and unemployment, growing prostitution, and changes
in sexual norms.
- Most of the quarter
million adults who became infected this year are men, and most of them
are injecting drug users. The potential for further spread is
enormous: the Russian Federation, for example, has an estimated 1.5-2.5
million injecting drug users - or 2% of the population - compared with
130,000 people infected by end 1999. Clearly, hundreds of thousands
of drug users and their sex partners are at immediate risk of infection.
- During the year,
new epidemics in drug injectors emerged in Uzbekistan and in
Estonia, a country which reported far more HIV cases in 2000
than in any previous year.
- The skyrocketing
prevalence of sexually transmitted infections - with reported rates
of syphilis of more than 200 per 100,000 - is yet another warning sign
that transmission through sex may grow in importance.
- Judging from the
number of reports during the first nine months of the year, registered
new infections during the year 2000 may well reach 50,000. This is more
than the total number of infections registered in the country between
1987 and 1999.
- In Moscow
city and region, more than 7000 new HIV cases were reported during 1999,
and in Irkutsk, Siberia, more than 2200 new cases were reported
during the same period. Here, as in other newly independent states,
the actual number of new infections is higher than the number of officially
- In St Petersburg,
only 4 HIV-positive persons were identified among 1500 injecting drug
users tested in 1996-1997. In 1999, surveys among injecting drug users
found HIV prevalence rates of 12%, which rose six months later to 16%.
- Some uncertainty
surrounds the epidemic in Ukraine, still the most severely affected
country in the region. While the annual number of new cases registered
seems to have declined since 1997, the virus appears to be making inroads
into the general population, to judge from the evidence of HIV infection
recently found in pregnant women.
- In Ukraine the
annual number of diagnosed HIV infections jumped from virtually zero
before 1995 to around 20,000 a year from 1996 to 1999.
- As a result, the
estimated number of people living with HIV/AIDS has grown from 110,000
in 1997 to 240,000 at the end of 1999. Ukraine is now estimated to have
an HIV prevalence rate among adults (aged 15-49) of just under 1%, the
highest rate in the region.
- The proportion
of HIV diagnoses that are in injecting drug users seems to have decreased
from about 80% to 60%, indicating that an increasing number of Ukrainians
are becoming infected through unsafe sex.
- In Belarus, an
HIV prevention programme among drug users in Svetlogorsk, which
included education about safe injecting and safe sex and provided clean
syringes, seems to have led to far safer behaviour among drug users.
In 1997, before the prevention programme began, 92% of those surveyed
said they shared syringes. By 1999, this percentage had dropped to 35%.
While some people did continue to reuse syringes, the proportion that
cleaned them before using them again rose to 55%, from just 16% before
the prevention campaign.
- Between 1996 and
1999 there was a significant drop in the proportion of young people
aged 15-19 among those testing HIV-positive. During the same period,
HIV prevalence among army recruits dropped sharply, from 670
to 210 per 100,000 tested. This demonstrates the impact of a strong
national response in Belarus.
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