World Bank Group, DC
March 29 2005

Young and at Risk : Living With HIV

March 28, 2005 – The 1990s ushered in many positive changes in Eastern
Europe and Central Asia, but rapid social change also exposed these
transition countries to problems that tight borders previously held
at bay-drug and sex trafficking and the onset of HIV/AIDS.

Sharing needles and injecting drugs is driving the spread of the
HIV/AIDS in this region, particularly among youth.

Between 1.5 and 3 million Russians are believed to inject drugs.
Ukraine has more than 800,000 injecting drug users, while Kazakhstan
some 200,000.

Economic hardship has been especially difficult on young people, who
are increasingly poor and jobless. An increasing number aren’t
completing secondary school and are exposed to trafficked drugs and a
burgeoning sex trade.

All of this makes youth more vulnerable to drug use, and,
consequently, to HIV/AIDS. As a result of this risky behavior, the
number of new infections has skyrocketed over a short period of time.

While the number of actual infections (prevalence rate) in the region
remains low-0.8%-the number of those infected reached some 1.4
million people by the end of 2004, which represents more than a
nine-fold increase in less than 10 years, according to UNAIDS
estimates.

The Russian Federation has the largest number of infections in the
region – 860,000. HIV is thought to have gained a foothold among
high-risk groups – injecting drug users and commercial sex workers —
in Southeastern Europe.

Under 30 at the Epicenter

More than 80% of those living with HIV are under the age of 30.

Young men are at the greatest risk. Drug use often lands them in
prison for possession, where they continue injecting and sharing
needles, spreading HIV to other inmates and becoming susceptible to
tuberculosis, which easily attacks those whose immune systems are
weakened by HIV.

Tuberculosis has emerged as a parallel epidemic to HIV/AIDS and is
considered to be “critical” in Armenia, Azerbaijan, Belarus, Estonia,
Georgia, Kazakhstan, the Kyrgyz Republic, Latvia, Lithuania, Moldova,
Romania, the Russian Federation, Tajikistan, Turkmenistan, Ukraine,
and Uzbekistan, according to the World Health Organization (WHO).

Sexual transmission of HIV is increasing as well, particularly in
Estonia, Russia, and Ukraine, the region’s most seriously-affected
countries, allowing the epidemic to gain a foothold in the wider
population.

Difficult socio-economic circumstances are forcing young women and
girls to engage in commercial sex work, which also fuels the spread
of HIV.

Demographic Decline Fueled Further

Unless its spread is contained, HIV/AIDS will have grave economic and
social consequences.

In Russia, where prevalence is estimated at around 1.1%, AIDS is
accelerating a pre-existing demographic crisis- further reducing life
expectancy as well as overall population.

If current trends continue, Russia’s GDP could drop by 4.15% by 2010,
and without any intervention the GDP could fall by 10.5% by 2020,
according to a 2002 World Bank study.

The uninhibited spread of HIV would diminish the economy’s long-term
growth rate, taking off half a percentage point annually by 2010 and
a full percentage point annually by 2020.

Stemming the HIV Tide

The HIV/AIDS pandemic in Eastern Europe and Central Asia started
relatively late compared to other places in the world.

In many countries the epidemic is still in its early stages-largely
contained within high risk groups- providing a window of opportunity
to contain its spread.

Increasing awareness about HIV/AIDS and establishing effective
prevention, care and treatment services are crucial to tackle the
epidemics. Country governments, civil society, the private sector and
international agencies must work together for these interventions to
succeed.

Two examples of such joint action are taking place this week in
Moscow – a Russian Business Summit on HIV/AIDS being supported by the
World Bank Group and other partners, and a CIS ministerial meeting
from March 31-April 1, organized by UNAIDS and its co-sponsors.

Mobilizing Resources

In addition to helping mobilize resources to fight HIV/AIDS in
Eastern Europe and Central Asia, the World Bank has conducted
extensive research and analysis of the issue to support policy design
and project planning.

In a regional strategy laid out in 2003, Averting AIDS Crises in ECA,
the Bank estimated that the region will need US$1.5 billion in
resources by 2007 to stem the spread of HIV.

International assistance for fighting HIV/AIDS in the region has
risen twelve-fold over the past four years -from US$52 million in
2001 to more than US$600 million by the end of 2004-through the
Global Fund to Fight AIDS, TB, and Malaria (GFATM), the World Bank,
and major bilateral donors.

From: Emil Lazarian | Ararat NewsPress