HIV/AIDS in Ukraine

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The HIV/AIDS epidemic in Ukraine is one of the fastest-growing epidemics in the world. [1] [2] [3] [4] [5] [6] Ukraine has one of the highest rates of increase of HIV/AIDS cases in Eastern Europe [7] and highest HIV prevalence outside Africa. [8] Experts estimated in August 2010 that 1.3 percent of the adult population of Ukraine was infected with HIV, the highest in all of Europe. [9] [10] Late 2011 Ukraine numbered 360,000 HIV-positive persons (increase in the rate close to zero compared with 2010). [10] Between 1987 and late 2012 27,800 Ukrainians died of AIDS. [1] In 2012 tests revealed 57 new cases of HIV positive Ukrainians each day and 11 daily AIDS-related deaths (on a population of roughly 45 million at the time). [1] [11]

Contents

Identified in the Ukrainian SSR in 1987, [1] HIV/AIDS appeared to be confined to a small population until the mid-1990s, when a sudden and explosive epidemic emerged among injecting drug users and prostitutes against the background of severe economic crisis and collapse of social healthcare system. [12] According to data reported in 2015 the epidemic is still on the rise, but it doesn't limit itself by a small group of drug users and appears to be accelerated within all parts of Ukrainian population with growing numbers of infected women. [13] Ukraine has one of the highest rates of increase of HIV/AIDS cases in Eastern Europe [7] and highest adult HIV prevalence outside Africa. [8]

Situation

Spread of AIDS

HIV officially reached the territory of the former Soviet Union in 1987, [1] about 5 years after the virus itself was discovered. Until 1995 there were only a few known cases of HIV infections in Ukraine. The country was therefore deemed to be “low risk” by the World Health Organisation (WHO) in terms of spread at that time. [14] Between 1987 and 1994, 183 infections were reported. [15]

In the mid-1990s, the transmission was primarily through injecting drug use.[ citation needed ] By 2001, however, the proportion of new cases of HIV/AIDS attributable to injecting drug use had declined to 57% from 84% in 1997.[ citation needed ] During that time, heterosexual transmission increased from 11% to 27%, and perinatal transmission increased from 2% to 13% as a proportion of total cases.[ citation needed ]

Registered HIV prevalence in Ukraine (late 2007) Registered HIV prevalence in Ukraine.jpg
Registered HIV prevalence in Ukraine (late 2007)

UNAIDS estimates that the number of people infected with HIV/AIDS in 2003 was 360,000 (range 180,000 to 590,000), representing an adult prevalence of 1.4%. According to the Ministry of Health—which estimates that by 2002 there were more than 500,000 people infected or nearly 2% of the adult population—the epidemic has now spread to every oblast in the country. Prevalence in the southern and eastern oblasts (Odesa, Mykolaiv, Dnipropetrovsk, and Donetsk) is about three times higher than rates in the rest of the country. [16] A major reason for this is the fact that the urbanized and industrialized regions in the East and South of Ukraine suffered most from the economic crisis in the 90s, which in turn led to the spread of unemployment, alcoholism, and drug abuse, thus setting the conditions for wider spread of the epidemic. [17]

From 1995 to 2007, the primary means of HIV transmission was through injection drug use, but by 2008, sexual contact outpaced injection drug use as the primary form of transmission. [16] By 2009, almost 44 percent of new infections occurred through sexual transmission, and 36 percent were through injecting drug use (according to USAID; according to CSIS in 2009 the proportion of new cases of HIV/AIDS attributable to injecting drug use was 60%). [18] [16]

In 2007 about 0.96 percent of Ukrainians, or about 440,000 citizens, were estimated to be living with HIV/AIDS, [19] down from 1.46 percent of the population in 2005, or 685,600 citizens, according to UNAIDS. [6] The number of HIV/AIDS cases in Ukraine reduced by 200 or 3.9% to 4,900 in the period of January–November 2008, compared with the corresponding period of last year. In 2007 the majority of those infected where under 30 years of age; with a full 25% of those affected still in their teens. [20]

Although HIV/AIDS had remained concentrated among marginalized and vulnerable populations, it was feared in 2008 it may be spreading to the general population. [17] According to the Ministry of Health, Ukraine has already surpassed the “optimistic” projections of an HIV/AIDS rate of 2% in 2010. [16]

According to the Health Ministry of Ukraine the HIV infection rate fell by 6.7% and mortality from AIDS was down by 7.9% in 2014. [21] HIV travel restrictions: WWW.PLHIV.ORG

Prisons

Between 1996 and 2001 about 26 percent in various prisons across Ukraine tested HIV- positive. In a January 2005 study between 15 and 30 percent of prisoners tested HIV- positive. [22]

Early 2005 rates of up to 95 percent of the prisoners were found Hepatitis C positive. [22]

Early 2010 there were over 147,000 people held at prisons and more than 38,000 at pre-trial detention facilities in Ukraine. [23]

Spread of AIDS among children

The number of children with AIDS in Ukraine is on the rise since the number of mothers with HIV grows by 20-30% annually. According to the United Nations, the number of pregnant women with HIV was 0.34% in 2007, which was the highest index in Europe. According to the United Nations, of nearly 18,000 children born by HIV-positive mothers in Ukraine, 10,200 children have not contracted HIV and another 5,500 children under eighteen months have yet to receive final results of an examination. In Ukraine, 1,877 children have been confirmed as HIV positive and 244 have died of AIDS. The United Nations notes that the program of preventing mother-to-child transmission of HIV in Ukraine has cut the share of such transmission from 27% of the number of HIV cases in 2000 to 7% in 2006. [7] According to the Health Ministry of Ukraine the HIV transmission from mother to a child was 4.28% in 2014 compared to 29% in 2004. [24]

The spread of HIV among the Ukrainian street children attracted a lot of special research interest due to their risky way of life [ citation needed ]. According to the obtained data around 15.5% of street minors in Ukraine used the injected drugs at least once, 9.8% of boys reported anal sex experience when only 36% of them acknowledged using condom during their most recent sexual encounter. [25]

Preventive measures

From 2001 till June 2015 HIV-positive Ukrainian citizens were barred from travelling abroad and HIV-positive foreigners were forbidden to enter Ukraine. [26]

Harm reduction programs

An ambulance in Kyiv An ambulance in Kiev.jpg
An ambulance in Kyiv

Since 2003, drug substitution programs have been introduced in Ukraine. By the end of September 2008, they were offered to about 2200 persons in 38 locations. [27] Mostly Buprenorphine (Trademark ‘Subutex‘) is dispensed, which is significantly more expensive than Methadone. It is also less frequently used and thoroughly researched worldwide. Buprenophin is more accepted by society and politicians, however, because it is seen as a painkiller. Methadone, in contrast, is viewed as a drug subscribed at public expense. [28]

In 2012 patients and advocacy groups complained of occasional supply shortages in Ukrainian AIDS clinics. [1] [29] In June 2012 advocacy groups accused Health Ministry officials of embezzling money that should be used to treat AIDS patients by buying AIDS drugs at hugely inflated prices and then receiving kickbacks. [29]

In the War in Donbass the separatist authorities of the Donetsk People's Republic and Luhansk People's Republic have banned methadone and substitution therapy and have taken a hard line on drug addiction and have banned most international medical organizations. [30] As a result people living with HIV/AIDS fled separatist-controlled areas. [30]

National response

The policy and legal environment in Ukraine is generally favorable for combating the spread of HIV/AIDS, but there is a gap between national-level policies and laws and local-level practices. The National AIDS Committee was established in 1992 but was dissolved in 1998 because of budget disputes. In 1999, the government created the National AIDS Control Coordinating Council under the Cabinet and mandated that all regions establish HIV prevention programs. In 2001, a national plan for combating HIV/AIDS was approved; its goals included preventing the further spread of HIV, developing the capacity to treat infected individuals, and providing social support and counseling for those living with HIV/AIDS. [16]

Although the HIV/AIDS law is one of the most progressive in the region, the government still treats HIV/AIDS primarily as a medical issue. Prevention activities have been largely funded by international organizations. Because HIV testing is limited to government facilities, those at greatest risk are not being reached, since marginalized populations are the least likely to use government facilities. Stigma by the medical profession against persons living with HIV/AIDS is a major barrier to accessing information and services. [16]

The first Ukrainian advocate group of/for Ukrainian AIDS patients was launched on December 10, 2010. [31]

Statistics

Note: all statistics till late 2007.

See also

Related Research Articles

<span class="mw-page-title-main">HIV/AIDS in Africa</span> HIV/AIDS in Africa

HIV/AIDS originated in Africa during early 20th century and is a major public health concern and cause of death in many African countries. AIDS rates varies significantly between countries, though the majority of cases are concentrated in Southern Africa. Although the continent is home to about 15.2 percent of the world's population, more than two-thirds of the total infected worldwide – some 35 million people – were Africans, of whom 15 million have already died. Eastern and Southern Africa alone accounted for an estimate of 60 percent of all people living with HIV and 70 percent of all AIDS deaths in 2011. The countries of Eastern and Southern Africa are most affected, AIDS has raised death rates and lowered life expectancy among adults between the ages of 20 and 49 by about twenty years. Furthermore, the life expectancy in many parts of Africa is declining, largely as a result of the HIV/AIDS epidemic with life-expectancy in some countries reaching as low as thirty-nine years.

<span class="mw-page-title-main">Epidemiology of HIV/AIDS</span> Epidemic of human immunodeficiency virus

The global epidemic of HIV/AIDS began in 1981, and is an ongoing worldwide public health issue. According to the World Health Organization (WHO), as of 2021, HIV/AIDS has killed approximately 40.1 million people, and approximately 38.4 million people are infected with HIV globally. Of these 38.4 million people, 75% are receiving antiretroviral treatment. There were about 770,000 deaths from HIV/AIDS in 2018, and 650,000 deaths in 2021. The 2015 Global Burden of Disease Study estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year. Incidence of HIV has continued to fall, decreasing by 23% from 2010 to 2020, with progress dominated by decreases in Eastern Africa and Southern Africa. As of 2020, there are approximately 1.5 million new infections of HIV per year globally.

<span class="mw-page-title-main">HIV/AIDS in Taiwan</span> Overview of (typically) sexually transmitted disease in Taiwan

Taiwan's epidemic of HIV/AIDS began with the first case reported in December 1984. On 17 December 1990 the government promulgated the AIDS Prevention and Control Act. On 11 July 2007, the AIDS Prevention and Control Act was renamed the HIV Infection Control and Patient Rights Protection Act.

<span class="mw-page-title-main">HIV/AIDS in Asia</span>

In 2008, 4.7 million people in Asia were living with human immunodeficiency virus (HIV). Asia's epidemic peaked in the mid-1990s, and annual HIV incidence has declined since then by more than half. Regionally, the epidemic has remained somewhat stable since 2000.

The Caribbean is the second-most affected region in the world in terms of HIV prevalence rates. Based on 2009 data, about 1.0 percent of the adult population is living with the disease, which is higher than any other region except Sub-Saharan Africa. Several factors influence this epidemic, including poverty, gender, sex tourism, and stigma. HIV incidence in the Caribbean declined 49% between 2001 and 2012. Different countries have employed a variety of responses to the disease, with a range of challenges and successes.

<span class="mw-page-title-main">HIV/AIDS in Europe</span>

In Western Europe, the routes of transmission of HIV are diverse, including paid sex, sex between men, intravenous drugs, mother to child transmission, and heterosexual sex. However, many new infections in this region occur through contact with HIV-infected individuals from other regions. In some areas of Europe, such as the Baltic countries, the most common route of HIV transmission is through injecting drug use and heterosexual sex, including paid sex.

<span class="mw-page-title-main">HIV/AIDS in Russia</span>

The situation with the spread of HIV/AIDS in Russia is described by some researchers as an epidemic. The first cases of human immunodeficiency virus infection were recorded in the USSR in 1985-1987. Patient zero is officially considered to be a military interpreter who worked in Tanzania in the early 1980s and was infected by a local man during sexual contact. After 1988—1989 Elista HIV outbreak, the disease became known to the general public and the first AIDS centers were established. In 1995-1996, the virus spread among injecting drug users (IDUs) and soon expanded throughout the country. By 2006, HIV had spread beyond the vulnerable IDU group, endangering their heterosexual partners and potentially the entire population.

Since the first HIV/AIDS case in the Lao People's Democratic Republic (PDR) was identified in 1990, the number of infections has continued to grow. In 2005, UNAIDS estimated that 3,700 people in Lao PDR were living with HIV.

Kenya has a severe, generalized HIV epidemic, but in recent years, the country has experienced a notable decline in HIV prevalence, attributed in part to significant behavioral change and increased access to ARV. Adult HIV prevalence is estimated to have fallen from 10 percent in the late 1990s to about 4.8 percent in 2017. Women face considerably higher risk of HIV infection than men but have longer life expectancies than men when on ART. The 7th edition of AIDS in Kenya reports an HIV prevalence rate of eight percent in adult women and four percent in adult men. Populations in Kenya that are especially at risk include injecting drug users and people in prostitution, whose prevalence rates are estimated at 53 percent and 27 percent, respectively. Men who have sex with men (MSM) are also at risk at a prevalence of 18.2%. Other groups also include discordant couples however successful ARV-treatment will prevent transmission. Other groups at risk are prison communities, uniformed forces, and truck drivers.

UNAIDS has said that HIV/AIDS in Indonesia is one of Asia's fastest growing epidemics. In 2010, it is expected that 5 million Indonesians will have HIV/AIDS. In 2007, Indonesia was ranked 99th in the world by prevalence rate, but because of low understanding of the symptoms of the disease and high social stigma attached to it, only 5-10% of HIV/AIDS sufferers actually get diagnosed and treated. According to the a census conducted in 2019, it is counted that 640,443 people in the country are living with HIV. The adult prevalence for HIV/ AIDS in the country is 0.4%. Indonesia is the country is Southeast Asia to have the most number of recorded people living with HIV while Thailand has the highest adult prevalence.

<span class="mw-page-title-main">HIV/AIDS in Nepal</span>

The first HIV/AIDS cases in Nepal were reported in 1988. The HIV epidemic is largely attributed to sexual transmissions and account for more than 85% of the total new HIV infections. Coinciding with the outbreak of civil unrest, there was a drastic increase in the new cases in 1996. The infection rate of HIV/AIDS in Nepal among the adult population is estimated to be below the 1 percent threshold which is considered "generalized and severe". However, the prevalence rate masks a concentrated epidemic among at-risk populations such as female sex workers (FSWs), male sex workers (MSWs), injecting drug users (IDUs), men who have sex with men (MSM), Transgender Groups (TG), migrants and male labor migrants (MLMs) as well as their spouses. Socio-Cultural taboos and stigmas that pose an issue for open discussion concerning sex education and sex habits to practice has manifest crucial role in spread of HIV/AIDS in Nepal. With this, factors such as poverty, illiteracy, political instability combined with gender inequality make the tasks challenging.

HIV/AIDS infection in the Philippines might be low but growing fast. The Philippines has one of the lowest rates of infection, yet has one of the fastest growing number of cases worldwide. The Philippines is one of seven countries with growth in number of cases of over 25%, from 2001 to 2009.

Since HIV/AIDS was first reported in Thailand in 1984, 1,115,415 adults had been infected as of 2008, with 585,830 having died since 1984. 532,522 Thais were living with HIV/AIDS in 2008. In 2009 the adult prevalence of HIV was 1.3%. As of 2016, Thailand had the highest prevalence of HIV in Southeast Asia at 1.1 percent, the 40th highest prevalence of 109 nations.

HIV/AIDS in Bolivia has a less than 1 percent prevalence of Bolivia's adult population estimated to be HIV-positive. Bolivia has one of the lowest HIV prevalence rates in the Latin America and Caribbean region.

Cases of HIV/AIDS in Peru are considered to have reached the level of a concentrated epidemic.

In 2016, the prevalence rate of HIV/AIDS in adults aged 15–49 was 0.3%, relatively low for a developing country. This low prevalence has been maintained, as in 2006, the HIV prevalence in Mexico was estimated at around 0.3% as well. The infected population is remains mainly concentrated among high risk populations, men who have sex with other men, intravenous drug users, and commercial sex workers. This low national prevalence is not reflected in the high-risk populations. The prison population in Mexico, faces a fairly similar low rate of around 0.7%. Among the population of prisoners, around 2% are known to be infected with HIV. Sex workers, male and female, face an HIV prevalence of around 7%. Identifying gay men and men who have sex with other men have a prevalence of 17.4%. The highest risk-factor group is identifying transgender people; about 17.4% of this population is known to be infected with HIV. Around 90% of new infections occur by sex-related methods of transmission. Of these known infected populations, around 60% of living infected people are known to be on anti-retroviral therapy (ART).

With less than 1 percent of the population estimated to be HIV-positive, Egypt is a low-HIV-prevalence country. However, between the years 2006 and 2011, HIV prevalence rates in Egypt increased tenfold. Until 2011, the average number of new cases of HIV in Egypt was 400 per year. But, in 2012 and 2013 it increased to about 600 new cases and in 2014 it reached 880 new cases per year. According to UNAIDS 2016 statistics, there are about 11,000 people currently living with HIV in Egypt. The Ministry of Health and Population reported in 2020 over 13,000 Egyptians are living with HIV/AIDS. However, unsafe behaviors among most-at-risk populations and limited condom usage among the general population place Egypt at risk of a broader epidemic.

With 1.28 percent of the adult population estimated by UNAIDS to be HIV-positive in 2006, Papua New Guinea has one of the most serious HIV/AIDS epidemics in the Asia-Pacific subregion. Although this new prevalence rate is significantly lower than the 2005 UNAIDS estimate of 1.8 percent, it is considered to reflect improvements in surveillance rather than a shrinking epidemic. Papua New Guinea accounts for 70 percent of the subregion's HIV cases and is the fourth country after Thailand, Cambodia, and Burma to be classified as having a generalized HIV epidemic.

<span class="mw-page-title-main">HIV/AIDS in Haiti</span>

With an estimated 150,000 people living with HIV/AIDS in 2016, Haiti has the most overall cases of HIV/AIDS in the Caribbean and its HIV prevalence rates among the highest percentage-wise in the region. There are many risk-factor groups for HIV infection in Haiti, with the most common ones including lower socioeconomic status, lower educational levels, risky behavior, and lower levels of awareness regarding HIV and its transmission.

Vietnam faces a concentrated HIV epidemic.

References

  1. 1 2 3 4 5 6 "HIV prevention, AIDS treatment still lag in Ukraine". Kyiv Post . 30 November 2012. Retrieved 1 December 2012.
  2. ↑ "HIV/AIDS menaces progress in Ukraine". UNICEF. 11 May 2004. Archived from the original on 11 February 2009. Retrieved 30 January 2009.
  3. ↑ "Ukraine: End Human Rights Abuses Fueling HIV/AIDS". Human Rights Watch. 23 October 2006. Retrieved 30 January 2009.
  4. ↑ "Elton John gives AIDS charity concert in Ukraine". The Independent . 18 June 2007. Retrieved 30 January 2009.
  5. ↑ "Ukraine Launches Information Campaign Against AIDS". World Bank. 27 September 2005. Retrieved 30 January 2009.
  6. 1 2 "Ukraine losing HIV/AIDS fight". Kyiv Post . 7 May 2008. Retrieved 2 December 2008.
  7. 1 2 3 "United Nations Registers More Children With AIDS In Ukraine". Ukrainian News Agency. 1 December 2008. Archived from the original on February 29, 2012. Retrieved 2 December 2008.
  8. 1 2 Kerrigan, Deanna (2013). "Ukraine". The Global HIV Epidemics among Sex Workers. p. 134. ISBN   978-1-4648-0388-8.
  9. ↑ "HIV infection rate, lack of spending worry Ukraine public health professionals". Kyiv Post . 10 August 2010. Retrieved 10 August 2010.
  10. 1 2 On World AIDS Day, a dose of good news, Kyiv Post (1 December 2011)
  11. ↑ Ukraine, CIA Factbook (page last updated on November 14, 2012)
  12. ↑ HIV/AIDS : global frontiers in prevention/intervention. Pope, Cynthia., White, Renée T., Malow, Robert. New York: Routledge. 2009. ISBN   9780415953825. OCLC   190751460.{{cite book}}: CS1 maint: others (link)
  13. ↑ Platt, Lucy (2015). "Case Study: United Kingdom and Ukraine". HIV Epidemics in the European Region: Vulnerability and Response. pp. 35–36. ISBN   978-1-4648-0388-8.
  14. ↑ L. Burruano und J. Seydel Die Ausbreitung von HIV/AIDS in der Ukraine. Gesundheitswesen 2006;68, 8-9, 571-574, Georg Thieme Verlag, Stuttgart. ISSN 0941-3790
  15. ↑ Sexually Transmitted Diseases (4th ed.). McGraw-Hill Professional. 2007. ISBN   978-0071417488.
  16. 1 2 3 4 5 6 "Health Profile: Ukraine". United States Agency for International Development (December 2004). Retrieved 7 September 2008. PD-icon.svg This article incorporates text from this source, which is in the public domain .
  17. 1 2 Vulnerability Assessment of People Living With HIV (PLHIV) in Ukraine Archived 2011-07-24 at the Wayback Machine United Nations Development Programme, page 24 - Retrieved on 8 December 2009.
  18. ↑ Injecting Drug Use in Ukraine, Center for Strategic and International Studies (March 2012)
  19. ↑ "Interactive map: Towards universal access". www.unaids.org. Archived from the original on August 31, 2009.
  20. ↑ World Youth Report 2007:Young People's Transition to Adulthood. United Nations. 2007. p. 185. ISBN   978-92-1-130257-8.
  21. ↑ Number of HIV infection cases in Ukraine down by almost 7% since early 2014, says health ministry, Interfax-Ukraine (3 December 2014)
  22. 1 2 HIV/AIDS and hepatitis C in prisons: the facts Archived 2016-01-25 at the Wayback Machine , AIDSLEX (2006) Retrieved 1 April 2010.
  23. ↑ "Number of inmates in Ukraine rises for first time in 7 years". Kyiv Post . 26 March 2009. Archived from the original on 31 January 2011. Retrieved 1 April 2010.
  24. ↑ "Number of HIV infection cases in Ukraine down by almost 7% since early 2014, says health ministry". Interfax-Ukraine. 3 December 2014. Retrieved 3 December 2014.
  25. ↑ Pace, Garrett (2012). "Street children in Ukraine: Homelessness and other associated risks". Journal of Global Awareness. 12: 65–71.
  26. ↑ "Ukraine lifts ban on HIV-positive visitors". UNIAN. 6 August 2015. Archived from the original on 23 August 2015. Retrieved 6 August 2015.
  27. ↑ "Alliance. International HIV and AIDS Alliance, Kiew". Archived from the original on 6 September 2009. Retrieved 1 December 2012.
  28. ↑ C. Weber Assessment 2007 in Donetsk. http://www.aids-ukraine.org.
  29. 1 2 Ukraine:Corruption blamed for AIDS non-treatment Archived 2014-03-10 at the Wayback Machine , Associated Press (29 June 2012)
  30. 1 2 "HIV: East Ukraine's Silent Crisis". Radio Free Europe. 22 July 2016.
  31. ↑ "All-Ukrainian Network of people living with HIV: Association of patients established in Ukraine". Kyiv Post . 18 December 2010. Retrieved 6 January 2016.
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