Eastern Europe and Central Asia are the only parts of the world where the HIV epidemic remains clearly on the rise, a new UNICEF report states.
The report, released Monday, found increases of up to 700 percent in HIV infection rates in some parts of the Russian Federation since 2006. The under-reported and largely underground epidemic has been fueled by injection drug use and high-risk sexual behavior.
More than 80 percent of people living with HIV in Eastern Europe and Central Asia are under 30 years old.
"Here in Vienna, we are right next door to the only region were HIV infection rates continue to rise," said Marine Adamyan, director for Health and HIV in the Eastern Europe/Central Asia/Middle East Region at World Vision International. "Because they have long been ranked as low-prevalence, many Eastern Europe and Central Asian countries have been falling under the HIV response radar, but unless higher-risk communities and groups are adequately reached, the epidemic will soon expand in a much larger way in the general population."
Titled "Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia," the report was released at the 18th International AIDS Conference in Vienna. The July 18-23 event has drawn world leaders, professionals and scientists, and various faith groups with the aim of keeping HIV on the front burner.
This year's conference is also coinciding with a major push for expanded access to HIV prevention, treatment, care and support. A United Nations General Assembly resolution adopted in 2005 had made 2010 the deadline for universal access to treatment.
Despite notable progress in responding to the epidemic, HIV infections continue to rise at an alarming rate in Eastern Europe and Central Asia and access to antiretroviral treatment is still among the lowest in the world, the UNICEF report states.
More than one million children and young people live or work on the streets of the region and many engage in HIV risk behaviors. A recent study of 15- to 19-year-old street children in St. Petersburg, involving 313 participants, found that almost 40 percent of them were HIV-positive.
"Today, street children in the region are dying of AIDS and drug use in much the same way as they died of cold, famine and typhoid in the twentieth century," the report states.
One of the largest contributors to HIV transmission is injecting drug use. According to the report, 3.7 million people in the region inject drugs. Up to 30 percent of young users started injecting before they were 15 years old.
Engaging in multiple unprotected sexual partnerships has also placed many adolescents at risk of HIV. In Ukraine, 20 percent of female sex workers are aged 10-19. In 2006, 19 percent of female sex workers aged 15-19 were infected with HIV.
The total number of HIV-positive pregnancies has doubled during the past five years throughout Eastern Europe and Central Asia. In the Russian Federation and Ukraine, about 6 to 10 percent of children born to HIV-positive mothers are abandoned in maternity wards, pediatric hospitals and residential institutions.
Adamyan of World Vision – a Christian organization which has been responding to HIV and AIDS in Romania since 1990, expanding through Eastern Europe and Central Asia since then – said the extent of the risks and the toll HIV is taking on young lives have not been truly reflected in hard facts and statistics until now.
"This report is bringing those realities to light, and our hope is that it will awaken people to action against what is now the world's fastest-growing HIV epidemic," Adamyan commented.
To break the trajectory of the epidemic, UNICEF has called for the establishment of nonjudgmental, friendly services among medical and civil authorities that address the needs of marginalized adolescents.
Lamenting that some youth living with HIV are denied access to school or even criminally prosecuted when seeking treatment and information, UNICEF executive director Anthony Lake said the adolescents need access to health and social welfare services, rather than "a harsh dose of disapproval."
"This report is a call to protect the rights and dignity of all people living with or at risk of exposure to HIV, but especially vulnerable children and young people," Lake said in a statement. "We need to build an environment of trust and care, not one of judgment and exclusion."