HIV Epidemic Cuts Into Ukrainian Youth

KIEV Ч Don't use drugs, use condoms, lead a normal lifestyle. A simple motto aimed by AIDS campaigners at the youth of Ukraine, but the message is failing to get through.

Long the scourge of African countries, the United Nations estimates that Ukraine has the fastest-growing rate of HIV infection in Europe Ч and has said that 1.5 million of its 49 million people could be affected by the disease by 2010.

Since Ukraine's first HIV case was reported in 1987, the United Nations says "the virus has risen to near epidemic proportions mainly within the injecting drug-using community."

And aid workers believe it is not only the runaway rate at which the virus is spreading, but the fact that it is overwhelmingly attacking young people that is of mounting concern.

"Approximately 90 percent of infection [in Ukraine] occurs in the 15-24 age group," said Andrej Cima, Intercountry Program Advisor for the United Nations Joint Program on HIV/AIDS.

"In Ukraine, the epidemic is being driven by injecting drug users, and our experience is that when it gets into the drug-using community it spreads very fast," Cima said.

"We are now seeing an increase in non-drug users Е so we are seeing a spillover into the general community."

He said poppies growing in western Ukraine made access to drugs relatively cheap and easy, and the fact that surveys show a large percentage of drug users have casual sexual partners and practice unprotected sex was compounding the problem.

The explosion in sex workers in the post-communist era was also exposing more and more people to HIV/AIDS.

Cima said that according to sero-monitoring data, as of May 1, 2001 there were 67,844 reported cases of HIV in Ukraine and just 38,632 officially reported cases Ч 28,265 of those were injecting drug users.

The officially reported cases are those people who come back for treatment after testing positive for HIV.

And these are just the people who have come forward for testing. Experts believe the real number of Ukrainians affected could be as much as 10 times higher.

"Some people want to put it out of their minds as they know they can live for six to seven years without treatment," Cima said, explaining the discrepancy in the figures.

Between January and April this year, 2,032 new cases of HIV were reported.

Walid Harfouch, the UN goodwill ambassador to Ukraine, says the fact that there is not enough information available about HIV/AIDS and it is still a taboo topic in Ukraine are major contributing factors to its spread.

"One of the biggest problems is that people don't want to report [possible HIV] because they think they might be rejected by society, lose their jobs and so on," Harfouch said.

His campaign focuses on spreading awareness among young people through pop concerts, radio and television advertising, as well as supplying free condoms at special events. "Because I know that often young people, if they have the choice, will be more likely to spend their two hryvna (40 cents) on a beer rather than a condom," Harfouch said.

Cima also noted a lack of safe sex education in schools, which he said the government and aid groups were tackling.

Another issue that Ukrainians have to face is the high cost of treatment and its lack of availability for those who do come forward after testing HIV positive.

The Institute of Epidemiology and Infectious Diseases of the Academy of Medical Science of Ukraine Ч the country's first dedicated HIV/AIDS clinic Ч is based in the capital, Kiev, and has around 20 residential places, as well seeing a further 10-15 out-patients each day.

Housed in a beautiful old, if slightly shabby, building near the Pechersk Lavra monastery, the clinic is funded by the Ukrainian government and several nongovernmental organizations.

Igor Oleinik, a doctor at the clinic, says that the main problems they face in trying to combat HIV/AIDS are a lack of financing, the "terrible technical condition" of the ward and a lack of exact standards for diagnosis and treatment.

The UN's Harfouch said the treatment that was available was still very expensive.

"And it's not just treatment, there are also sometimes problems getting food to them three times a day or blankets," he said.

"Most of the people there are in the last stages of the disease because they can't get any treatment and because they have nowhere else to go."