Courtesy of AIDS Action Europe
The needMartine de Schutter, AIDS Action Europe, on the HIV epidemic in Eastern Europe and Central Asia
Europe does not have a homogenous HIV epidemic. Relatively speaking, most Western European countries have had limited exposure to HIV – though none has been untouched by the epidemic. In Eastern Europe and Central Asia; however, several countries (Russia, Ukraine, Latvia and Estonia) have adult HIV prevalence of nearly 1% or higher (this is compared to several countries in Western Europe – such as Norway, the Netherlands, Germany and Ireland – which have adult HIV prevalence of 0.3% or lower.i) The countries with the highest prevalence rates are often those least supportive of community and non-governmental organisations and some of the interventions they propose.
We formed, in large part, to create links between organisations in the West and their counterparts in the East, and thereby to create new opportunities for exchanging knowledge and expertise, and for working together to pursue common policies and advocacy initiatives.
Although we see much variation within this region, it is the only region in the world where the epidemic is still growing and where new infections are on the increaseii – compelling evidence, in my opinion, that there is a significant need for a better and highly coordinated response to HIV in Europe and Central Asia. Let me give you some examples of where the need is greatest and why:
- Across the region people living with HIV/AIDS (PLWHA) and other key populations (such as sex workers, gay men and other MSM, people who inject drugs and migrants, among others) are subject to stigma and discrimination and the barriers this poses to effective prevention, treatment and care. There’s a tremendous need for advocacy work and lobbying efforts to call attention to stigma and discrimination and to combat it. So, this is one important cornerstone of our work.
- Related to this is the need to better inform people about their rights. When PLWHA are discriminated against in the workplace, or when they are denied medical interventions, they need to be aware of the national and international laws that are in place to protect them.
- Improved access to treatment is another vital need, though here again we see significant variation within the region. Relatively speaking, I think the response in Western Europe is fairly well organised, whereas access to treatment is one of the biggest every day challenges for PLWHA in Eastern Europe and Central Asia.
- Treatment interruptions also need to be addressed – increasingly we’re seeing that there’s not enough stock to fill the demand.
- I think another day-to-day challenge for PLWHA who also have used drugs is thatacross much of our region there are no good harm reduction programmes –we need to provide access to needle exchange and opiate-substitution treatment programmes in order to successfully address the epidemic.
- We must foster more awareness of how the epidemic is increasingly affecting young women, particularly in Eastern Europe and Central Asia.
- Lastly, given the economic crisis in Europe, there’s a significant and growing need for sustainable funding. Unfortunately, in the current environment, many effective programmes in the region are being scaled back or cut altogether.
i Adult HIV/AIDS Prevalence Percent (Aged 15-49) – reflects 2011 estimates from UNAIDS. Kaiser Family Foundation. Accessed on 11.15.12. (Link expired)