InterPress News Service (IPS); Thursday, 28 November 1996.
Dipankar De Sarkar

The report by the Joint United Nations Programme on HIV/AIDS (UNAIDS) tracks rising HIV infection rates not only among previously unaffected communities in Central and Eastern Europe, but also among new sectors such as women and children.

"The HIV epidemic is far from over, and in fact, continues to strengthen its grip on the world's most vulnerable populations," said UNAIDS Executive Director Peter Piot.

"Amidst all the optimism about new treatments [such as the prohibitively expensive combination therapy], we must remember that 90 percent of people living with HIV/AIDS are in developing countries with little access to health care.

"The only true hope for the entire world is prevention -- education, new forms of protection and development of a vaccine."

Acquired Immunodeficiency Syndrome (AIDS) was first recognised in 1981 and Human Immunodeficiency Virus (HIV) -- the virus that causes AIDS -- was identified two years later. Extensive spread HIV is thought to have begun in the late 1970s and early 1980s.

In Thursday's report, the most startling example of the spread of the epidemic came from the former republics of the former Soviet Union.

Ukraine recently reported a dramatic increase in newly infected injecting drug users in cities bordering the Black Sea, said the report published to mark World AIDS Day on Monday, Dec. 1.

In a particularly stark example, the percentage of HIV-infected people among those injecting drugs in the Black Sea town of Nikolayev exploded from 1.7 percent in January last year to 56.5 percent just eleven months later.

To the north the Russian Federation may experience similar progression, UNAIDS warns. Since January this year, the reported number of people infected with HIV in the Russian city of Kaliningrad has increased 18-fold -- from 21 to 387.

And following a trend notice elsewhere, the male-female ratio among HIV-positive people in Russia has begun to equalise. Men now outnumber infected women by 2:1 instead of 6:1 previously.

"There has been a skyrocketing of infections in Eastern Europe," Piot told journalists Thursday.

"Its a bit of a deja-vu," he added, in reference to early HIV infection among drug users in the East Coast of the United States and in Thailand.

Piot pointed out that the spread in Eastern Europe was occurring in a "context of profound social change, to use a euphemism."

The change meant that "unfortunately, there is no longer the infrastructure for providing essential services and prevention programmes" in countries of Eastern Europe.

Apart from high-risk injecting behaviour, such as sharing needles, the most worrisome indication of an imminent risk of HIV spread through sexual intercourse comes from recent surveillance findings on sexually transmitted diseases (STDs) in the republics of the former Soviet Union, UNAIDS reports.

Between 1994 and 1995, syphilis incidence rates per 100,000 population rose from 81.7 to 172 in Russia; from 72.1 to 147 in Belarus; from 116.6 to 173.6 in Moldova; and from 32.6 to 123 in Kazakhstan.

And there are signs the disease is spreading across Russia's borders: most of the new syphilis cases diagnosed in Finland last year were found to be in the south east area near the Russian border. In addition, a cluster of 30 STD cases, discovered in central Finland, originated in infections acquired through 'unsafe' male-to-male sex in Russia.

UNAIDS also reports a steep increase in STDs and AIDS cases stemming from male-to-male sex , saying "there is a serious potential in these countries for the further spread of HIV among men who have sex with men."

In Russia, for example, male-to-male sex was considered to be the mode of transmission in 53 percent of the 587 HIV/AIDS cases reported among adult males up to December 1994.

Apart from Central and Eastern Europe, the report notes a growth in new HIV epidemics in Asia. According to estimates by the Chinese Academy of Preventive Medicine, there were 10,000 HIV-infected persons in China by the end of 1993, and 100,000 by the end of 1995.

HIV is spreading explosively in parts of India too. In Bombay, for example HIV prevalence has reached 50 percent in sex workers, 36 percent in STD patients, and 2.5 percent in pregnant women attending clinics for ante natal care.

Other alarming new facts in the UNAIDS report included: There were 3.1 million HIV infections in 1996, bringing the total number of people living with HIV/AIDS worldwide to 22.6 million; Of the 2.7 million newly infected adults worldwide, the majority are under 25 years of age and nearly 50 percent women; There were 400,000 new infections among children this year, bringing the total number of children living with HIV/AIDS to 830,000.

Nearly one-quarter of the 6.4 million total HIV/AIDS associated deaths occurred in just the past year as the disease enters the mortality phase.

"As more and more mothers die of AIDS. the number of orphans will rise exponentially," Piot said. "The millions of people contracting HIV today will leave millions more children behind in the coming years." (END/IPS/DDS/RJ/96)

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