InterPress News Service (IPS) - May 22, 1998
Katya Gorchinskaya

"Me and my husband wanted to have lots of children, but now we can't. Now I try to keep happy just watching other peopel get on with their lives, because my own life is ruined," sighs Oksana.

Her story is a simple one: her older brother had been intravenous drug user for many years, and she and her friends also had an occasional intravenous shot of 'shyrka', a liquid drug made from poppy straw. Often, she says, they would share a syringe.

Oksana said she knew that dealers often dilute the drugs they sell with water from syringes they have used themselves. "I realise only now that all my friends who use drugs are infected," she added.

People like Oksana and her friends account for 70 to 85 percent of the Ukrainians who carry the human immunodeficiency virus which causes AIDS. Ukraine is now facing an epidemic of the disease: the number of known cases of HIV infection has skyrocketed, from 384 in 1995 to 36,000 by the beginning of 1998. UNAIDS, however, estimates that the real figure is closer to 180,000.

About 1,500 new cases are registered every month, mostly among people under 25, but the cash-strapped government is doing little either to prevent the spread or to help those already infected.

Non-governmental programmes, like syringe exchange centres for drug users, face opposition from law enforcement officials who say such centres attract drug dealers. They insist that money spent on needles should go to treat drug addicts and people already infected with HIV instead.

State hospitals still frequently use blood which has not been screened for HIV. Last year two people, a nine-year-old boy with leukaemia and a father of seven, were found to have contracted the virus through blood transfusions in two different parts of the country, raising fears that there might be more such cases to come.

Little effort is being made to screen people for the virus. HIV tests are only compulsory for those who donate blood in special clinics and for pregnant women.

Alexey, a 28 year old from Kiev, says a friend of his died last summer after developing a variety of different symptoms. First he got a cold. That developed into pneumonia, and then further complications set in. He spent months being treated at different hospitals, but even though he was a regular drug user, doctors never tested him for HIV.

Alexei then started to develop similar symptoms himself. But after the Hospital for Infectious Diseases in Kiev tested him for HIV, he was prescribed a course of retro-viral drugs and antibiotics. The treatment saved his life.

Since then, he has been going to the hospital whenever he starts to feel ill, but says he stops taking the medicines when he checks out.

"Why should I take anything if I'm feeling fine?" he asks.

Alexey, like many other people with HIV, does not know how his disease should be treated. Unlike patients in the West, who take retro-viral drugs continually to slow the progress of the virus, in Ukraine these drugs are only available at later stages of the disease.

This is because neither the state, nor most patients, can afford such treatment, according to Alla Vovk, head of the HIV and hepatitis departments at the Hospital for Infectious Diseases. As a result, the patient's life-expectancy is just five years -- half of that for AIDS sufferers in the West.

To make matters worse, there is little or no public education to explain the nature of the disease and the risks of intravenous drug use or unsafe sex. Oksana says she never thought she could be infected, even though she used drugs. The Crimean peninsula, where Oksana lives, has one of the highest rates of HIV infection in Ukraine, with as many as ten per cent of the population carrying the virus.

"We always thought this wouldn't get to us. We heard rumors that someone got infected in Sevastopol, but it was all very abstract and far away," she says. Tatyana, a 30-year old AIDS patient in Kiev, says that when her aunt visited her in hospital, she did not know how to behave in front of her, and was scared of getting infected herself.

"She was afraid to sit next to me, and she nearly died of shock when she saw a nurse bringing me food in rubber gloves," Tatyana laughs.

"She asked me why I was sick, and I said I had tuberculosis of the spine. Then she asked me what I was doing in the AIDS department. I asked her what AIDS is, and she couldn't tell me anything except that it's the plague of the 20th century."

A recent UNAIDS report warns that with such high levels of ignorance about the disease, Ukraine's AIDS epidemic is likely to continue for tens of years, with tremendous social and financial costs.

"If the worst-case scenario develops, Ukraine may face 1.8 million cumulative deaths from AIDS by 2016," the report says. The consequences of this epidemic are going to be felt for several generations, placing a huge burden on the welfare system. For instance, the report estimates that the number of children orphaned through AIDS could reach 317,000 by 2016.

For a single mother like Tatyana, the problem is an immediate one. She only has a few years to live and her 12-year-old son is mentally handicapped. When she dies, he will be left without any means of support. (END/IPS/KG/AN/98)

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