AIDS in Asia

Until the mid-1990s, most of the countries of the former Soviet Union appeared to have been spared the worst of the HIV epidemic. Mass screening of blood samples from people whose behaviour put them at risk of infection showed extremely low levels of HIV, right up to 1994. At that time the whole of Eastern Europe put together had around 30,000 infections among its 450 million people, Western Europe had over 15 times as many cases, while in sub-Saharan Africa over 400 times as many people were living with the virus.

The AIDS epidemic in Eastern Europe and Central Asia now shows no signs of declining. Some 210,000 people were infected with HIV in 2004, bringing the total number of people living with the virus to 1.4 million. AIDS claimed 60,000 lives in the past year.

Worst affected are the Russian Federation, Ukraine, and the Baltic states (Estonia, Latvia, and Lithuania), but HIV continues to spread in Belarus, Moldova and Kazakhstan, while more recent epidemics are now evident in Kyrgyzstan and Uzbekistan. It is estimated that around 860,000 people aged 15-49 were living with HIV in the Russian Federation at the end of 2003 (though estimates vary widely).

Driving these epidemics is widespread risky behaviour - injecting drug use and unsafe sex - among young people. Extraordinarily large numbers of young people regularly or irregularly engage in injecting drug use. This is reflected in increasing HIV prevalence among injecting drug users throughout the former Soviet Union.

In many countries of the former Soviet Union, such as the Russian Federation, Ukraine and Belarus, the fight against the epidemic is being waged against a complicated backdrop. Socio-economic instability in the region is fuelling drug use and commercial sex, and thus increasing the spread of HIV. On a more positive note, however, political and legal reforms are creating more effective avenues to HIV prevention. For instance, instead of relying on ineffective mass screening of the population to track and control HIV, most countries are using a range of channels to inform and educate their citizens about the virus. Also, the region is increasingly turning to proper HIV surveillance in sentinel populations, for example, in sex workers, pregnant women, injecting drug users, or people with a sexually transmitted infection.