The HIV/AIDS epidemic in eastern Europe: recent patterns and trends and their implications for policy-making

Abstract

Our data confirm that HIV must have been rapidly spreading among IDU in several countries of the former Soviet Union, whereas central and southeast Europe have so far escaped a more extensive spread of HIV. Factors that might have fuelled a massive spread among IDU include changes in drug demand and supply, migration and specific local drug production and consumption patterns. High rates of syphilis reported in the countries of the former Soviet Union highlight that subregion's increased vulnerability with regards to a further spread of the epidemic, via heterosexual intercourse, into the general population.

Prostitution and the Invisibility of Harm

“…The invisibility of women's HIV risk, as compared to men's risk, has resulted in a lack of attention to early HIV infection in women (Allen et al, 1993;Schoenbaum and Webber, 1993). Allen et al (1993) (Dehne, Khodakevich,Hamers & Schwartlander, 1999). In the city of Kaliningrad, one in three people infected with HIV was a woman, and 80% of the infected women were in prostitution (Smolskaya, Momot, Tahkinova & Kotova 1998) It is likely that this massive increase in HIV resulted from an extremely high rate of violence against women in Russia ( Hamers, Downs, Infuso & Brunet, 1998).…”

HIV/AIDS-Related Knowledge, Attitudes And Sexual Behaviors as Predictors of Condom Use Among Young Adults in Croatia

“…The possible score was 6-30; the median was 13. The scale was dichotomized into values equal to or lesser than the median (0) and values greater than the median (1).…”

“…and "In your opinion, what are the odds of your getting infected with some other sexually transmitted disease?" Response options ranged from "the odds are infinitely small" (1) to "the odds are very high" (10). The two items, moderately strongly correlated (r=0.8, p<0.001), were collapsed into a new variable whose score was calculated as the mean of the two individual items.…”

Editors' Reply

“…In eastern Europe, over 50% of HIV infections are among users of injection drugs [9]; in Pakistan, people receive on average eight injections per year compared with about one in subSaharan Africa [10]. Our fi ndings apply to Manicaland and may be relevant for similar epidemic patterns in southern Africa.…”