Download AIDS epidemic in Eastern Europe and Central Asia

Fact sheet
UNDER EMBARGO UNTIL 6 JULY 2004, 11.00 GMT
AIDS epidemic in Eastern Europe and Central Asia
In Eastern Europe and Central Asia, diverse epidemics are under way, and they show no
signs of abating. In 2003, some 360,000 people were newly infected with HIV, bringing the
number of people living with the virus to 1.3 million (range: 860 000–1.9 million). In the past
year, AIDS claimed an estimated 49 000 lives.
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In Eastern Europe, Estonia, Latvia, the Russian Federation and Ukraine are the worstaffected countries in this region. However, HIV continues to spread in Belarus,
Kazakhstan and Moldova.
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Injecting drug use is the driving force behind this region’s epidemic—an activity that has
spread explosively in the turbulent years since the Soviet regime’s demise. In the
Russian Federation alone, there are an estimated 3 million injecting drug users. The
Ukraine has more than 600 000 and Kazakhstan has up to 200 000. In Latvia and
Estonia, an estimated 1% of the adult population injects drugs. Most of these drug users
are male.
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The epidemic’s most striking feature is the age of those infected—more than 80% are
under 30. Condom use is also generally low among this population. By contrast, in North
America and Western Europe, only 30% of infected people are under 30.
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The Russian Federation remains saddled with the region’s worst epidemic, with an
estimated 860 000 people living with HIV. More than half the reported cases come from
just 10 of the 89 administrative territories. The number of new cases registered in 2000
(56,630) was almost twice that of 1987. Although the number of reported cases dropped
by 50% over the past two years, possibly due to changing testing patterns, the overall
number of HIV-positive people continues to rise in Russia.
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Women account for an increasing share of newly diagnosed HIV infections in the
Russian Federation—up from one-in-four in 2001, to one-in-three just one year later. The
trend is most obvious in areas where the epidemic is oldest; this suggests sexual
intercourse plays an increasing role in transmission or that women are increasingly
involved in injecting drug use. From 1998 to 2002, infection levels among pregnant
women increased from less than 0.01% to 0.1%—a 10-fold increase.
In the Baltic States, overall infection numbers remain low, but HIV spread continues at
an alarming pace. In Latvia, the number of HIV diagnoses has risen five-fold since 1999.
In 2000, Estonia reported 12 new HIV cases; in 2002, it reported 899. Lithuania is on a
similar path. In 2001, 72 new HIV cases were detected. The following year, this
increased more than five-fold. Lithuania appears to be facing two distinct epidemics. In
regions adjacent to Kaliningrad (Russia), HIV is affecting mainly injecting drug users; in
Vilnius, it is spreading among men who have sex with men.
In Poland, since the mid-1990s, newly reported HIV infections have remained stable (at
roughly 500–600 annually). In parts of south-eastern Europe (especially in countries
emerging from conflict and difficult transitions), drug injecting and risky sexual behaviour
appears to be on the increase. This raises the prospect of possible HIV outbreaks unless
preventive steps are swiftly introduced.
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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.
Several Central Asian countries—notably Kazakhstan, Kyrgyzstan and Uzbekistan—
have reported growing numbers of HIV infections, most of them among injecting drug
users. Central Asia is at the crossroads of the main drug-trafficking routes between East
and West. In some places, heroin is said to be cheaper than alcohol.
Throughout the region, estimates and trends are based on case reporting by the health
services and the police, since there is little money or infrastructure for systemic
surveillance. This raises concerns that HIV may be spreading among people who rarely
come into contact with the authorities or testing services.
For example, in the Czech Republic, Hungary, Slovenia and the Slovak Republic, sex
between men is clearly the predominant mode of HIV transmission. Yet, men who have
sex with men are widely stigmatized, so very little is known about how the epidemic
affects this population.
These epidemics are recent. They can be halted if targeted prevention efforts address
higher-risk populations, such as injecting drug users, sex workers, men who have sex
with men and young people.
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For more information, please contact Dominique De Santis, UNAIDS, Geneva, tel. +41 22
791 4509 or mobile (+41 79) 254 6803, or Abby Spring, UNAIDS, Geneva, tel. +41 22 791
4577 or mobile (+41 79) 308 9861. For more information about UNAIDS, visit
www.unaids.org.