NEWS AND VIEWS: Ukraine's HIV/AIDS epidemic focus of Columbia presentations (06/11/06)

NEWS AND VIEWS

Ukraine's HIV/AIDS epidemic focus of Columbia presentations

by Diana Howansky

Ukraine has one of the fastest-growing HIV/AIDS epidemics in the world, but social stigma and ineffectual officials hamper adequate treatment, said speakers at two events organized by the Columbia University Ukrainian Studies Program.

With 25 years having passed since the AIDS virus was first reported in 1981, the Ukrainian Studies Program focused attention on Ukraine's HIV/AIDS crisis by organizing a panel discussion and then a roundtable during the 2005-2006 academic year.

These events featured representatives from such institutions as the Permanent Mission of Ukraine to the United Nations, Transatlantic Partners Against AIDS, American International Health Alliance, the Children of Chornobyl Relief and Development Fund and Human Rights Watch.

HIV/AIDS is being transmitted at such a high rate in Ukraine - which is populated by approximately 47 million people - that the country's approximately 260,000 cases of people living with HIV/AIDS could grow to almost 1.4 million cases and over 450,000 AIDS deaths by the end of 2010, said Stephen Massey, vice-president of Transatlantic Partners Against AIDS. This would mean that Ukraine's prevalence rate, or number of infected, would grow from over 1 percent to approximately 8 percent of Ukraine's adult population (compared to over 40 percent in some sub-Saharan countries).

Ukraine's epidemic, moreover, hits a young and productive segment of its population, as 80 percent of Ukrainians living with HIV/AIDS are individuals between the ages of 20 and 39, Mr. Massey added.

The country's crisis can also be viewed as part of a regional epidemic that is also affecting Ukraine's neighbors, such as Russia, as HIV is being transmitted at higher rates per capita in the so-called Eurasia region than any other region of the world, Mr. Massey explained

The factors that contributed to the growth of HIV/AIDS in Ukraine, particularly after the fall of the Soviet Union, include economic decline, which lured people into drug use and the sex trade, the erosion of Church and moral authority, and general chauvinism that perpetuates unprotected sexual intercourse, stated Alex Kuzma, executive director of Children of Chornobyl Relief and Development Fund.

"All the ingredients were there. It was just a matter of time before the current problem exploded," Mr. Kuzma said, illustrating that the number of Ukrainians at risk from HIV/AIDS rivals the mass number of demonstrators who packed into the maidan, the main square of Ukraine's capital, during the height of the 2004 Orange Revolution.

Statistics show that most Ukrainians living with HIV/AIDS acquired the disease from non-sterilized syringes during drug use. And because people with or at high risk of HIV/AIDS are most often marginalized groups like injection drug users, sex workers, men who have sex with men or prisoners, human rights abuses against them occur, said Rebecca Schleifer, a researcher at Human Rights Watch.

Drug and law enforcement officials discriminate against those with or at risk for HIV/AIDS by subjecting them to violence and mistreatment, and preventing them from receiving services, like clean needles, according to recent Human Rights Watch reports. Such drugs as methadone can also be used to treat dependence on opiates, which are injected through needles, but law enforcement officials argue that this practice helps drug users.

People know how to stop the growing HIV/AIDS epidemic in Ukraine, Ms. Schleifer stated. "Ukraine should be instituting a major substitution therapy program," she said.

Additional barriers to treatment, however, include Ukraine's economy and insufficient budgetary allocations for AIDS centers by policy-makers who consider it a lower priority than democracy-building, terrorism or other issues.

In fact, as a result of under-funding, an estimated 45,000 out of 47,000 Ukrainians will have been denied life-saving treatment in 2005, said Mr. Massey of Transatlantic Partners Against AIDS.

The HIV/AIDS epidemic in Ukraine is also becoming more critical because it has reached the general population. The number of children with HIV/AIDS is rising steadily in Ukraine, and two-thirds of all children born to HIV-positive mothers in the region are born in Ukraine, said Kate Schecter, a program officer at the American International Health Alliance.

Prenatal programs targeting "prevention of mother-to-child transmission" may be a more palatable way for Ukrainian authorities to begin tackling the epidemic, though, and such a pilot program at the Odesa Oblast Hospital has shown a 75 percent decrease in the number of HIV-infected babies born to HIV-positive mothers there, Ms. Schecter stated.

The HIV/AIDS epidemic is going to require a massive response from the new Ukrainian government, the speakers at the Columbia Ukrainian Studies Program's events agreed.

The HIV/AIDS crisis is a national security issue for Ukraine, which must be fought not only by government, but also by mass media and other organizations that can help educate the public, said Andriy Nikitov, a counselor at the Permanent Mission of Ukraine to the United Nations.

President Viktor Yushchenko has only begun taking steps to combat the HIV/AIDS crisis, such as reforming health care to coordinate AIDS and tuberculosis hospitals, said Ms. Schleifer of Human Rights Watch.

Ukraine's Ministry of Health also signed a deal in November 2005 with former President Bill Clinton and the William J. Clinton Foundation, which promises training for Ukrainian medical professionals who treat HIV patients, as well as help for Ukrainians in getting HIV medications at reduced prices. Ukraine has the opportunity to become a leader in HIV/AIDS prevention and treatment in the region, Ms. Schleifer added.

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For more information about the Ukrainian Studies Program at Columbia University, readers may contact Diana Howansky at [email protected] or 212-854-4697.

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