Rates of HIV incidence are climbing in the region, with a 250% increase in the number of people living with HIV (410,000) in 2001 compared to 2010 (1.5 million). AIDS-related deaths also continue to rise in this part of the world according to the report, which has been published ahead of World Aids Day on 1 December.
The Russian Federation and Ukraine account for nearly 90% of HIV/AIDS cases in Eastern Europe and Central Asia. In these countries, injecting drug use remains the major cause of HIV infection, with transmission also occurring to the partners of people who inject drugs. Studies in the region have shown that many drug users avoid seeking medical help out of fear they will be reported to law enforcement authorities. This makes it is harder to contain the epidemic, since infected individuals are not identified to receive antiretroviral treatment or provided with counselling on how to reduce sexual transmission.
Experience from around the world has shown that harm reduction programmes need to be targeted among people who inject drugs. When such prevention programmes do not take place, the consequences can be severe. For example, in St Petersburg, HIV prevalence has doubled in the past five years and estimates suggest nearly two-thirds of people who inject drugs now have HIV. 181 million dollars was invested in HIV-related programmes in the Russian Federation during 2008. However, only 8 million of this amount went into HIV-prevention programmes.
The UNAIDS report suggests a shift in strategy is needed in the Russian Federation, so that more money is targeted towards harm-reduction programmes among drugs users. This reprioritization is already starting to happen in the Ukraine, where more of the AIDS prevention budget is being focused towards key affected populations. The authors of the report believe that this more focused approach is required to cut new HIV infections in the Russian Federation.
Young people account for a significant number of new HIV infections among drug users. To slow the spread of HIV, the 2011 Political Declaration adopted at the United Nations General Assembly meeting in June, calls on countries to encourage and support the active involvement of young people in fighting the disease. This means ensuring the young participate on AIDS-related bodies, as well as involving young people in community, family, school, recreation centre and workplace initiatives. The Declaration also pledges countries into taking specific steps to engage young people living with the disease. An HIV Young Leaders Fund has been set up to provide support for leadership among young people most affected by HIV. Since 2010, this Fund has provided 23 grants to projects in 19 countries for youth-lead initiatives and peer-based services in the community.