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Eastern Europe and Central Asia
   Last updated: 18.06.04
 
There are an estimated 1.2 million people living with HIV/AIDS in Eastern Europe and Central Asia, as of December 2002. This is estimated to be 0.6% of the adult population. UNAIDS considers this to be the fastest-growing series of epidemics in the world, mainly driven by increasing rates of injecting drug use. In 2002 there were an estimated 250,000 new infections.
AIDS claimed the lives of 25,000 people in this region during 2002.

Whilst the number of cases reported in people infected heterosexually has risen, largely due to sexual contact with injecting drug users, rates of HIV among gay and bisexual men in this region have remained very low.

Newly diagnosed people tend to be much younger in Eastern Europe. 65% of new infections, reported in adults/ adolescents in 1997-1999 occurred in people less than 30 years old. It is estimated that up to 1% of the population in these regions is injecting drugs. Those injecting drugs can be very young. One study among Moscow secondary-school students revealed that 4% had injected drugs.

Urgent measures are needed to limit transmission among injecting drug users and prevent the wider diffusion of HIV into the sexually active population.

In the Russian Federation, and in many of the Central Asian Republics, the wave of injecting drug use is closely correlated with socioeconomic upheavals that have sent the living standards of tens of millions of people plummeting, amid rising unemployment and poverty levels. Another factor has been the four-fold increase in world production of heroin in the past decade, along with the opening of new trafficking routes across Central Asia.

In Romania, cases in children who were infected around 1990 through blood transfusion and multiple injections with improperly sterilised needles account for around 70% of all infections (5,000 of an estimated 7,000).

High rates of sexually transmitted infections continue to be found in Eastern Europoe and Central Asia, suggesting widespread unsafe sex and increased risk of HIV infection. In the Russian Federation between 200,000 and 400,000 cases of syphilis are reported annually.

There may be cause for moderate optimism in Central Europe, where countries continue to hold the epidemic at bay; HIV incidence overall remained exceptionally low in 2001 (7–10 reported infections per million persons). Prevalence remains low in countries such as the Czech Republic, Hungary, Poland and Slovenia, where well-designed national HIV/AIDS programmes are also in operation.

The worst affected countries are;

Ukraine
With an estimated adult prevalence rate of 1%, the Ukraine is the most affected country in the region.

Ukraine, with an estimated adult HIV prevalence rate of 1%, is the most affected country in the region (and, indeed, in all of Europe). New diagnoses of HIV in persons infected through heterosexual intercourse accounted for 28% of all new cases reported in the first six months of 2002—up from 15% in 1998.

Russian Federation
130,000 people living with HIV/AIDS, or 0.18% of the adult population. In the Russian Federation, there are an estimated 2.5 million drug users. With such a large pool of potential candidates for infection, it is likely that infection rates among injecting drug users will continue to rise, and may also begin to infiltrate other parts of the population. Injecting drug use is still the main route of transmission in the countries that make up the former Soviet Union. Rates of infection remain low, but the speed of transmission has been astounding. New infections in Russia during the first half of 2000 increased by 305% compared to 1999, with a total of 22,068 cases being reported during the first six months of the year, and overcumulative infections had been reported by this time.

HIV epidemics have been discovered in morethan 30 cities and 86 or the country's 89 regions. Up to 90% of the registered infections have been attibuted to injecting drug use.

Belarus
14,000 people living with HIV/AIDS, or 0.28% of the adult population.

In Belarus, about 27% of new registered infections in 2001 were attributed to heterosexual transmission. Although many of these infections may occur in sexual partners of injecting drug users, the trend may also indicate spread into the wider population of these countries.

Republic of Moldova
4,500 people living with HIV/AIDS, or 0.20% of the adult population.

Estonia
Reported infections soared from 12 in 1999 to 1474 in 2001. (Relative to population size, Estonia now has the highest rate of new HIV infections in this region—50% higher than the Russian rate.)

Latvia
A burgeoning epidemic is visible in Latvia, where new reported infections rose from 25 in 1997 to 807 in 2001, and where a further 308 new HIV cases had been registered by the end of June 2002.

Lithuania
Lithuania, is experiencing a major HIV outbreak in one of its prisons, where 284 inmates (15% of the total) were diagnosed HIV-positive between May and August 2002. This confirms the important, though often overlooked, role of prisons in the spread of HIV in many countries of the region.