Ukraine’s HIV epidemic:What progress has been made?

Ukraine is home to the largest and most rapidly growing HIV epidemic in Europe. According to Ministry of Health September 2011 statistics, 197,083 Ukrainians are infected with the virus, which equates to 0.9 percent of the population. This number accounts for those individuals who are registered as HIV positive, but the actual percentage is set at approximately 1.3 percent of Ukraine’s population.

According to Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Ukraine is “the only region of the world where the AIDS epidemic is still growing”.

So what is being done to curb the rate of HIV transmission? The Global Fund is allocating $86 million to Ukraine in 2012-2013 to aid the HIV prevention and treatment efforts. Since condoms are considered “a simple, low-cost prevention method that works” the AHF (AIDS Healthcare Foundation) is distributing one million free condoms around the world on International Condom Day, February 13th. The AHF will also conduct up to 10,000 HIV tests. Seven thousand condoms will be distributed in Odessa and Kiev as part of the initiative.

On December 1, 2011, The Elena Pinchuk ANTIAIDS Foundation in collaboration with Ukraine Google affiliate launched an interactive map and news service which will provide easy access to locations of the nearest HIV testing sites and condom vending machines.

The United States Congress has cut the President’s Emergency Plan for AIDS relief (PEPFAR) by 2 percent, and has mandated that none of the funds be spent on needle exchange programs, which will undoubtedly prove inefficient in places like Ukraine, where intravenous drug use accounts for a majority of HIV infections.

Related to the discussion on HIV/AIDS, here is a link to And the Band Played On, a wonderful film that documents the discovery of the HIV virus, the important research that was conducted in the 80’s which led to the discovery, and the inaction of the US government in the crucial early years of the disease’s spread. The film emphasizes the government’s views of HIV/AIDS as a “gay” disease. It seems that linking AIDS to homosexuality, promiscuity, and drug use offered (and offers) justification for limited access to ARV’s and other drugs or programs which should be readily attainable by HIV positive populations as well as those at risk.

  1. For the U.S. to refuse to allow its AIDS-directed foreign aid funding — called PEPFAR — to be used for needle- and syringe-exchange programs is a big deal. Syringe exchange doesn’t attract as much attention in the U.S. as condom distribution. But it’s important in Ukraine and other countries where drug injection is the main means of transmission of HIV.

    I went to Ukraine at the very beginning of the country’s HIV outbreak (mid-1990s), met with drug users and suppliers, and observed drug-use practices. It was very obvious how HIV was transmitted. Even then, users knew what the dangers were and knew that they needed clean syringes in order to protect themselves.

    Last year, a friend of mine produced a really insightful documentary on HIV and drug injection in Ukraine, called Balka. You can watch it here:

  2. Access to sterile injection equipment is indispensable for preventing transmission of HIV and other bloodborne viral infections (hepatitis B and C, notably). Marina points out here that, even though sharing of drug injection equipment is a main aspect of Ukraine’s HIV epidemic, the US’s foreign-aid-for-AIDS program, called PEPFAR, will not fund needle and syringe exchanges.

    Is access to sterile injecting equipment one of the health necessities to which all people are entitled, as a matter of human rights? Or, since only a minority of the population injects illegal drugs, is this not really a universal right?

  3. marinaerlikh said:

    Condoms are in some sense analogous to sterile syringes; both are effective methods NOT of preventing the activity (sex, drug use) but of lessening the risk of disease transmission from person to person. Condoms are being freely distributed because it is understood that this is the only way, short of abstinence, to prevent transmission of HIV and other viruses/diseases. It seems that it is not yet widely accepted that intravenous drug use will continue to be a global problem irregardless of access to clean needles- but if we understand that making these supplies available can reduce spread of infections, then why is access limited, and why does PEPFAR exclude syringe exchange programs from the funding?

    Even though only a minority of the population injects illegal drugs, access to sterile syringes and needles is a universal right because the drug-using population interacts with the non-drug-using population and all of these individuals have the right to access to preventative equipment. Also, such programs cost nothing in comparison to how much it would cost taxpayers to finance already infected peoples’ healthcare.

  4. noakrawczyk said:

    Although access to sterile injecting equipment may not be seen as a health necessity to which people are entitled, the right to prevent disease definitely is. Drug users who become infected with Hepatitis B or C or HIV are not only at risk of infecting other drug users, but can infect non-drug users as well. Therefore, even though some may be opposed to “supporting” or “funding” drug users, the neglect to provide sterile injection equipment generates a greater risk for the population as a whole. It is truly inconceivable that PEPFAR still excludes syringe exchange programs from their funding despite the myriad of evidence that these programs significantly curb HIV spread. This reflects the US policy of criminalizing drug users and argument that allowing access to injecting equipment is encouraging drug use. However, the US is not the only government which objects to this form of prevention: Apparently, the 2009 Political Declaration of the UN Commission on Narcotics Drugs, a document which outlines international cooperation on drug strategy for the next ten years, doesn’t even refer to this issue even though the UN General Assembly, UNAIDS, the UN Office on Drugs and Crime, and World Health Organization openly support such harm reduction measures.

    A very informative website on this topic is on

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