Central Asia: hotspot in the worldwide HIV epidemic

Illicit drugs in Central Asia: What we know, what we don’t know, and what we need to know

“…A number of reports and studies show that FWID in Central Asia face the same risk vulnerabilities for HIV as FWID in other countries (Thorne, Ferencic, Malyuta, Mimica, & Niemiec, 2010;UNAIDS, 2012). FWID are stigmatised, have low social status, are often victimised by their male sex partners, family members, community, and the police, and are sometimes perceived as deserving of abuse because of their drug use practices (El-Bassel, Terlikbaeva, & Pinkham, 2010;El-Bassel et al, 2014a, 2014bRhodes, Singer, Bourgois, Friedman, & Strathdee, 2005;UNAIDS, 2012).…”

“…As pointed out by many papers in this special issue, Central Asia represents a global HIV "hotspot" (Thorne et al, 2010), facing "the perfect storm" of high risk drug use, various blood borne infectious diseases (El-Bassel, Strathdee, et al, 2013) and other drug related harms, such as fatal overdoses (Kan et al, 2014;Mravcik et al, 2014). Such events of "disease clustering" (Knox, 1989) or "syndemics" (Singer & Clair, 2003) are more than just biological occurrences, but part of a process of social exclusion (March, Oviedo-Joekes, & Romero, 2006), linking multiple disparities (e.g., in personal, social, and economic conditions), which compounds the negative effects of drug use and vulnerability to infectious diseases and other harms (e.g., TB, overdose, viral hepatitis, STIs).…”

The Golden Crescent and HIV/AIDS in Central Asia: Deadly interactions

“…With a few important exceptions, there was clear evidence that the HIV epidemic had peaked in many 572 C. Beyrer regions, and the overall rate of HIV spread had markedly slowed, even in much of Africa, the most affected continent. One of the only regions where HIV spread was still marked by expanding epidemics, and where concern remains for the potential next waves of spread, is the vast Eastern Europe and Central Asian regions, including most of the states of the Former Soviet Union, and Iran, Afghanistan, Pakistan and the Muslim majority regions of Western China (Xinjiang Province) bordering Central Asia (Sanchez et al 2006, Eyzaguirre et al 2007, Beyrer et al 2009, Emmanual et al 2009, Kheirandish et al 2010, Thorne et al 2010. Across this greatly diverse region, the common thread of HIV epidemics is opiate injection usage.…”

Maternal Genital Tract Infection

“…Because most species of organisms responsible for STDs are not capable of survival outside the human host and must be transmitted by direct human contact, STDs are characteristically restricted to a sexually active population with a peak incidence between the ages of 15 and 34, and to newborns of women in this age group. Although the incidence of HIV/AIDS in many countries has decreased largely owing to alterations in high-risk behavior, HIV/AIDS continues to rise at an alarming rate in young men who have sex with men (MSM) in the United States and worldwide (Morris and Little, 2011) and in areas of escalating injection drug use, drug trafficking, and sex work (Thorne et al, 2010). Although these HIV positive individuals are not the only reservoir for STDs, they have become a major source.…”