InterPress News Service (IPS) - May 22, 1998
IPS Correspondents

According to the National Committee for Drug Abuse and AIDS Prevention there were 26,000 officially registered HIV carriers out of a population of 50 million people at the end of 1997.

Some experts, however, believe the official figures are just the tip of the iceberg, and that the real number of cases could be up to ten times higher.

At present, HIV incidence is highest in the port city of Sevastopol in the Crimea, where the number of registered carriers has increased tenfold over the past year. However, rates of infection are increasing throughout the country. Kiev also saw a tenfold increase in the number of carriers last year and in Dnepropetrovsk the incidence of infection has risen almost 16 times.

At present the numbers are doubling or tripling every year. UNAIDS predicts that by 2001 Ukraine will have 20,000 AIDS cases, perhaps a quarter of a million cumulative HIV infections and 4,000 new AIDS cases a year after that.

Currently most HIV/AIDS cases are in the 20-39 age group but the number of infections in the 15-19 age group is increasing.

These are alarming numbers, considering that five years ago Ukraine registered just 52 HIV cases. "Imagine the impact on the health care system then," says epidemiologist Luis Loures of UNAIDS.

As it is, the health care system is cracking under the strain, and may even be contributing to the problem through inadequate blood-screening procedures. Ukrainian officials acknowledged last December that some HIV- infected blood had been used in medical procedures. The admission came after reports that two hospital patients, including one child, were infected with HIV after receiving blood transfusions.

Valery Ivasyuk, chairman of the National Committee for Drug Abuse and AIDS Prevention, says the patients received blood which had not been tested for HIV, a violation of medical regulations. He believes the blood donor programme is failing to screen out members of high-risk groups, such as intravenous drug users.

Other specialists and health officials say Ukrainian doctors routinely collect blood from nearby donors and transfuse it to patients immediately, without testing. They believe that freshly donated blood is better than frozen. In any case, the blood that is collected and frozen is tested only once, rather than twice as in the west, Health Ministry officials admit.

A second test would help to identify infected blood that passed initial tests during the virus's incubation period, but funding for this is not available. Ukraine has no outpatient AIDS clinics, but opening such clinics, along with reducing the time patients spend in hospital, would help to cut costs, says Yuri Dorofeev, chief sanitary physician for Crimea.

However, the main cause of the dramatic rise in infections, say Ukrainian doctors, is the use of contamintated needles by drug addicts, although sexual activity also plays a part in the spread. Of the 8,300 confirmed cases of HIV infection recorded up to 1 March 1997, 6,500 were intravenous drug addicts. Dr Alla Shcherbinskaya, director of both the Ukrainian Institute of Epidemiology and Infectious Diseases in Kiev and the Ukrainian AIDS Prevention Centre, says she is interested in starting a needle exchange programme.

"Our major task is to make drug users aware of HIV. We can't really stop drug abuse, but we can have education programmes about HIV," she explains. As yet, however, little is being done.

Prisons are one focus for the spread of the virus, and the government is currently considering isolating HIV-positive prisoners in separate facilities. HIV has spread rapidly among inmates over the past two years, for a variety of reasons. These include sexual activity (consensual and rape) and drug injection. Officials estimate that 2,100 inmates are infected, 70 percent of them male. The economic and social collapse that followed the break up of the USSR has provided a fertile breeding ground for drug addiction and promiscuity, both of which are fuelling the HIV epidemic.

Southern Ukraine, particularly Odessa and Crimea, has been hardest hit by HIV, primarily because it has become a centre for drug trafficking. In the early 1990s drugs were suddenly cheap and readily available and prostitution became a huge industry in the region.

The scale of the problem is increasing by the day. "This isn't just an explosion," says Dr Alla Soloviova, a Ukrainian working for UNICEF in Kiev. "This is an A-bomb." (END/IPS/AI/JMP/KG/AN/98)

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