Blame & Banishment - Médecins du Monde

Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia
A growing epidemic affecting young people…
Eastern Europe and Central Asia are the only parts of the world where the HIV epidemic
remains clearly on the rise. Increases of up to 700 per cent in HIV infection rates have been
found in some parts of the Russian Federation since 2006. 1 Over the past decade, there
have also been important increases in HIV incidence in Central Asia and in the Caucasus,
much of which remains under-reported.
The HIV epidemic in the region is driven by an explosive mix of injecting drug use and,
more recently, sexual transmission. Children and young people, including those living on
the streets, constitute a group whose risk of contracting HIV is particularly high. Today,
one third of new HIV infections in the region are among the 15–24 age group and more than
80 per cent of people living with HIV in the region are under 30 years old. 2
The region is home to 3.7 million people who inject drugs, representing almost one quarter of
the world total. Some 1.8 million of these live in the Russian Federation and close to 300,000
each in Azerbaijan and in Ukraine. 3 The highest prevalence of injecting drug use in the adult
population worldwide is now found in Azerbaijan (5.2 per cent), Georgia (4.2 per cent), Russian
Federation (1.8 per cent) and Ukraine (1.2 per cent). 4
The average age of injecting drug users (IDUs) in the region is very low, with the age of
initiating injecting still decreasing in a number of countries. In Moscow, Russian Federation,
in 2005 the average age of injection start-up was 16 years old. 5 A UNICEF assessment in
The former Yugoslav Republic of Macedonia found a growing number of 12- and 13-yearolds
already using drugs. 6 Some 80 per cent of sex workers in Central and Eastern Europe
are also young people, with female drug users often selling sex to support their drug use
and that of their male partners. 5
Women, who now account for some 40 per cent of new cases compared to just 24 per cent
under a decade ago, 7,8 are increasingly affected by HIV, as are children. The total number
of HIV-positive pregnancies has doubled during the past five years. Although rates of
mother-to-child transmission of HIV have declined significantly as a result of effective
implementation of national prevention of mother-to-child transmission (PMTCT) programmes,
HIV infection still remains a significant problem among drug-dependent pregnant women
and their newborns, who tend to be missed by services.
Since 2006, there have been new reports of children contracting HIV in health settings
due to unsafe injection practices, poor management of blood products and outdated clinical
2