DUBLIN, 22 February 2004 -- “HIV/AIDS has a young face and it is essential, therefore, for young people to be at the heart of a new and effective pan-European prevention effort,” said UNICEF Executive Director Carol Bellamy on the eve of the Irish EU Presidency Conference on HIV/AIDS: Breaking Barriers, Partnership to fight HIV/AIDS in Europe and Central Asia.
“HIV/AIDS thrives on the barriers we have built between countries and between individuals – barriers that can easily be torn down if we get honest, robust commitment. Such barriers make it easy to dismiss HIV/AIDS as ‘somebody else’s problem’ leading us to where we are today,” she said.
HIV infections are beginning to rise after a decade of progress in Western Europe and continue to spiral upwards in Eastern Europe and Central Asia. Overall numbers are low, but growing exponentially across the region. Young people face the highest risk of infection.
“The evidence shows that when serious and sustained prevention efforts target young people, HIV prevalence rates decline as they did among young people in Cambodia, Uganda and Brazil,” Bellamy said. “Young people are the solution, not the problem, and we are pleased that they will be part of this Dublin Conference.”
Recent trends in HIV infection among young people, 1996-2001.
In Eastern Europe and Central Asia, nearly all new reported HIV infections are among young people, especially young men, who make up the majority of injecting drug users. More than 80% of those living with HIV/AIDS are under age 30.
In Western Europe, the resurgence of other sexually transmitted infections points to a revival of high-risk sexual behaviour – especially among young people.
Europe faces stark truths:
A rise in the number of HIV infections in some western European countries, as prevention programmes slip down the agenda and fail to reach young people;
Soaring infections continue in Eastern Europe and Central Asia. In 2003, there were 230,000 officially registered new infections in the region, bringing the total number of people living with HIV/AIDS to around 1.5 million – a figure that is probably much lower than the actual numbers. The worst affected countries are Russian Federation, Ukraine and the Baltic States, but HIV continues to spread in Belarus, Moldova and Uzbekistan;
More than 80 per cent of those who are HIV positive in the East have not yet turned 30;
These same young people are the least likely to have access to the information and services they so urgently need. They also face poverty, unemployment levels that are three times higher than among the adult population, the trafficking of drugs and human beings, and many other challenges that fuel the spread of HIV/AIDS.
A rising number of HIV-positive infants in Eastern Europe and Central Asia, and of children abandoned by HIV positive mothers.
Bellamy said this picture could be changed by shoring up human rights – the right to information, to basic health services and to participation. Europe had more than a decade of painful lessons from other parts of the world to draw on and should learn from this experience – and learn fast. “I hope that the governments meeting here in Dublin will seize this opportunity to build strong and lasting partnerships with each other, with civil society and the media, and with young people, to defeat HIV/AIDS,” she said.
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Eastern Europe and Central Asia have the fastest growing HIV/AIDS epidemic – Worst-affected are the Russian Federation, Ukraine, and the Baltic States, while the most recent outbreaks are in Central Asia. In 2003, the region reported 30,000 AIDS-related deaths and 230,000 new infections. A million and a half people are living with HIV/AIDS.
Overall numbers are low, but growing exponentially across the region – Central Asia as a whole registered 5,458 cases in 2002, up from 88 in 1995. Estonia had 899 diagnosed cases of HIV in 2002; four years earlier there were 12. Lithuania registered a five-fold increase between 2001 and 2002.
Young people are at the epicenter of the epidemic – More than four out of five people living with HIV/AIDS in the region are under 30 years old, compared to Western Europe and the United States, where only 30% of HIV cases are among people under 29. In Russia, women account for a growing share of new infections; one consequence is a sharp rise in the number of new infections among infants.
Most of the reported infections are related to injecting drug use among young people – In the Russian Federation, four out of five HIV cases due to IDU are among people under 30. In Kyrgyzstan and Kazakhstan, more than two-thirds are under 30, and in Belarus, 60% are between 15 and 24. Overall, up to a quarter of those who inject drugs are under 20 years old.
Extremely limited access – Less than 5% of injecting drug users in the region have access to programmes and services to reduce their risk of HIV infection. There could be as many as 3 million injecting drug users in the Russian Federation alone, more than 600,000 in Ukraine and up to 200,000 in Kazakhstan. Condom use is also generally low.
AIDS mortality continues to drop, due to the widespread availability of antiretroviral treatment – In Western European countries that report HIV cases, heterosexual intercourse may now be the most common mode of HIV transmission, although sex between men and IDU remain important routes of infection in some countries.
The resurgence of other sexually transmitted infections points to a revival of high-risk sexual behaviour – especially among young people – France France rance, Ireland, the Netherlands and the United Kingdom have reported syphilis outbreaks among men who have sex with men. In England and Wales, diagnoses of gonorrhoea at STI clinics more than doubled in 1995-2000, with the steepest increases among teenagers aged 16-19. Reported gonorrhoea cases have also increased in the Netherlands, Sweden and Switzerland.
Movement of people – A large share of the increase in new HIV infections reported in Europe in 2002 is attributed to the significant number of persons believed to have been infected in countries with high HIV prevalence outside Europe. Most of these cases are in the United Kingdom, which saw a doubling in new HIV diagnoses between 1998 and 2002.