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. Last Updated: 07/27/2016

AIDS Now Ukraine's New Chernobyl

ODESSA, Ukraine -- Driving along the cobbled streets of Odessa, Stanislav Famyenko can spot a drug addict at 200 meters.


Even before he can see the telltale glaze in their eyes, Famyenko detects the jagged movements of the freshly injected as they propel themselves down the street with careful, concentrated deliberation.


"Sometimes there are girls standing out here at seven o'clock in the morning, and if one or two out of 15 girls are not drug addicts, I would be surprised," says the taxi driver, driving past a row of young prostitutes waiting for clients.


"It is obvious just from looking at them that they have AIDS and God only knows what other diseases."


It takes more than gazing into the eyes of local prostitutes to detect AIDS, but given the alarmingly fast rate diagnostic laboratory, AIDS is Ukraine's next Chernobyl, except that the disease has the potential for even greater devastation.


Delayed for at least a decade, the AIDS epidemic snuck up on Ukraine gradually from 1987 -- when the first case of HIV infection appeared -- until 1994. But in 1995, the situation exploded into a full-scale epidemic, with figures skyrocketing from 183 registered HIV patients Jan. 1 to 1,490 by year's end. According to national health officials, there are now an estimated 8,500 known HIV-positive cases in the country.


"The rapid rise of sexually transmitted diseases and intravenous drug use have made Ukraine, Russia and Belarus particularly vulnerable to AIDS," said Lev Khodakevich, Ukraine representative of UNAIDS, the joint United Nations program on HIV and AIDS. By contrast, he said, these two factors were considerably more stable in Western Europe when the AIDS virus first arrived on its shores.


"These changes in the former Soviet Union over the past several years have created very favorable conditions for the spread of AIDS," Khodakevich said. "Ukraine has started the epidemic, but it is only a matter of time before the other countries of the former Soviet Union will join it."


To combat the problem, UNAIDS and the Ukrainian national AIDS committee have coordinated efforts to develop what they call a harm reduction strategy.


With a $50,000 grant from the United Nations, AIDS specialists were charged with the task of developing a pilot program -- which was the subject of a recent seminar in Odessa -- that can be launched in this Black Sea town of 1.5 million and duplicated in other regions throughout Ukraine. Once support from the local government is secured, they hope to implement a coordinated system of Punkty Doveriya, or Trust Points, where drug addicts can go in for free condoms, needle exchanges and counseling.


A port city with a widespread drug problem, Odessa is at the epicenter of Ukraine's AIDS crisis, with 1,385 registered cases of HIV infection, about 40 percent of which appeared in the first six months of 1996. Other regions reporting high numbers of HIV cases include Nikolakyevsky with 751 registered cases, Donetsk with 534, and Crimea with 304. Ukraine's capital, Kiev, has only 135 cases of HIV infection.


These numbers are still small in comparison to the United States or most other countries, but the explosive rate of increase is causing great concern.


"Once the virus landed among Odessa's community of drug addicts, it started to spread very rapidly," said Lydia Andrushchak of the national AIDS committee, which recently co-sponsored a UNAIDS conference in Odessa. According to a report by the Ukrainian center for AIDS Prevention, 83 percent of the new cases of HIV infection registered in 1996 were caused by contaminated syringes, whereas unprotected sex accounted for 12 percent. In Odessa alone, more than 50 percent of the HIV-infected population are drug users.


If drugs used to be sold behind closed doors on the outskirts of the city, dealers have moved into the center of town over the past two years, trading in courtyards and side streets.


"There are at least six or seven spots right in town where people go to shoot up," said Famyenko, who has taxied many customers in search of a drug they call khimiya -- a brown liquid brewed from poppy seeds that, specialists say, is more potent than heroin.


One of the more popular spots is an apartment block on Ulitsa Srednaya, where a group of gypsy women sit outside munching on sunflower seeds and watermelon, their pockets filled with syringes ready for injection.


"They sit out here from morning until late at night," said Famyenko. "The police never hassle them. They just occasionally swing by to pick up bribe money."


On a recent sunny afternoon, a teenage girl hurried up to the cluster, handing over her money and snapping up the syringe held out to her. Without pausing she moved quickly past a row of dumpsters into the trash collection room of the apartment complex. At the door she passed a young man in baggy black jeans who was just emerging, his eyelids heavy. Seemingly oblivious to the new client, the freshly injected youth stumbled across the parking lot, taking a few tentative steps forward before he stopped to rock sleepily in his tracks.


Within a few minutes still others came to approach the table. Few looked more than 20 years old.


"There is a tremendous problem among adolescent drug users," said Tatyana Semikop, a policewoman who works with underage addicts. In the past month, Semikop registered five new cases of HIV infection among adolescents in her precinct alone, the youngest being 14.


A handful of dedicated health officials have sounded the alarm and are scurrying to find measures of coping with the epidemic, but for the majority of the population, AIDS is still a taboo subject.


"People think drug addicts are criminals," said Sasha, a former addict who works as a volunteer with AIDS prevention workers in Odessa. "They are afraid of them, so they just close their eyes to the problem."


Sasha's task is not only to try to lure drug addicts to come in for help, but to convince the community that addicts are not criminals, but sick people who need to be treated. Even if Sasha, who only kicked his six-year habit last November, does succeed in finding a way of reaching those in Odessa's shooting galleries, he will face an uphill battle convincing others that such people are deserving of help.


To a certain degree, their reticence to help is based on financial hardship.


"People will not want to spend money on free needle exchanges when there aren't enough syringes to go around in the hospital," said Khodakevich.


"But we must convince them that if we don't help drug users now, the whole population will suffer."