Eastern European Health Officials Meet to Discuss Spread of HIV in the Region
Health officials from 27 Eastern European countries met recently in Debe, Poland, to discuss strategies to curb the spread of HIV in the region, where intravenous drug use has helped fuel a steep rise in HIV cases over the past three years, the New York Times reports. The problem is particularly acute in countries that were once a part of the Soviet Union, where HIV is now spreading at one of the fastest rates worldwide. In addition, Eastern Europe is the "only place" where intravenous drug use has become the "major route of infection." Health officials noted that the collapse of Communism brought changes that "created conditions ripe for the spread" of HIV -- "Borders opened, burrowing out nearby trade routes from the major supplier of heroin, Afghanistan." In addition, economic "troubles" that came with the transition "have left many young people without jobs." Dr. Karl Dehne, UNAIDS program coordinator for Central and Eastern Europe, noted, "It looks much more like a regional pattern. All regions in Ukraine are affected. Most regions in Russia. The Baltics are affected. Now the first outbreaks are happening in Central Asia. In intensity and geographic spread, it's evolving." Russia experienced a threefold rise in HIV cases between 1999 and 2000, and Ukraine saw reported HIV cases rise from less than 300 in 1995 to the current 38,000 citizens registered as HIV-positive.
Officials Discuss 'Harm Reduction'
Health officials at the conference noted that the "limited scope" of HIV's spread has made it difficult to contain the virus, as the "problem is perceived to be confined to small groups of social outcasts like drug users." HIV rates also have been climbing among prostitutes in the region. Robin Montgomery, an official with AIDS Infoshare, an organization in Russia that works with prostitutes and other groups, said, "Intravenous drug users and commercial sex workers are blamed for spreading the epidemic, so there is a backlash." Health officials at the conference discussed ways to target these groups using "harm reduction" strategies, which aim "less at law enforcement than at finding ways to improve the health of people who use drugs or are HIV-positive." But officials disagree on strategies such as needle-exchange programs or methadone treatment to curb the spread of HIV among drug users. Kasia Malinowska-Sempruch, director of the International Harm Reduction Development Program, part of the Soros Foundations Networks' Open Society Institute, which helped sponsor the conference, said, "It's not about needles. Needles are part of a bigger package to help incredibly mistreated, marginalized drug users" (Fisher, New York Times, 6/13).