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HIV/AIDS

UNICEF Romania/ Giacomo Pirozzi/ Aiming high: much remains to be done to prevent infection among young people in Romania and treat those carrying the virus
© UNICEF Romania/ Giacomo Pirozzi/ Aiming high: much remains to be done to prevent infection among young people in Romania and treat those carrying the virus

Background

At the end of 2011, 10,903 people were living with HIV/AIDS in Romania. The majority of cases, diagnosed when they were small children, have undergone more than 15 treatment schemes over the years. Most of the survivors are currently in the 19-24 age group and 47% are women.

The current trends which can be observed in HIV/AIDS transmission in Romania are:

  • A high rate of heterosexual transmission accounting for up to 61.7% of new cases between 2007 and 2011.
  • An increased rate of vertical transmission (mother to child) from 2% in 2007 to 5% in 2010.
  • An increased rate of HIV transmission amongst Most-At-Risk Populations (MARPs): men who have sex with men (MSMs) from 3.8% in 2007 to 14% of new cases in 2011, and injecting drug users (IDUs) from 0.8% in 2007 to 18.4% of new cases in 2011. 
  • Five time increase rate of needles and syringes sharing in 2010 comparing with 2009 due to intravenous use of new psychoactive substances which increase the risk of HIV transmission in IDUs group; 
  • An overall increase of people living with HIV/AIDS (PLHIV) who need specialised medical services and anti-retroviral ARV therapy, from 7,623 in 2005 to 9,428 in 2011. 
  • Frequent interruptions in treatment in 2010 for  65% of PLHIV  and ARV treatment adherence in 40% of PLHIV

Long term survivors have undergone multiple therapeutic schemes and problems of treatment adherence and social integration are common among them. According to a behavioural study survey  carried out in 2009 on PLHIV cohort , the mean age for sexual initiation is 17 years old. The same study showed that more than 79% of PLHIV in the sample with a stable seronegative partner or with unknown HIV status to which they did not reveal their status to their sexual partners, did not use a condom.

PLHIV from the long-term survivor cohort are now in their reproductive years and have started having children. An in-house 2010 study by the National Institute of Infectious Diseases on 310 children born to seropositive mothers found that 45% of mothers living with HIV are from the long-term survivors’ cohort. The same study found that 35% of sero-positive mothers did not receive treatment or prophylactic care increasing the risk of transmission to the infant.

Action

UNICEF’s work in HIV/AIDS has been largely in partnership with UN agencies which form the UN HIV/AIDS Theme Group, and with the National Institute for Infectious Diseases Dr. Matei Bals, Ministry of Health and The Romanian AIDS Centre. UNICEF also works closely with NGOs such as UNOPA which represents people living with HIV/AIDS and NGOs members of Romanian Harm Reduction Network (RHRN)  which delivers harm reduction and other services designed to stop transmission. Work in recent years has embraced the following:

Support to the new draft National HIV/AIDS Strategy which aims to strengthen the national response to the epidemic. In this context, the HIV/AIDS programme in Romania is being adapted in order to respond to new emerging situations: vertical transmission,  treatment adherence among long term survivors, HIV transmission among most at risk populations andadvocacy on the need to sustain budgetary allocations for programmes following the ending of funding from the Global Fund for AIDS, Tuberculosis and Malaria in 2010.

Support to programmes for most at-risk adolescents such as injecting drug users, men having sex with men and sex workers and helping them reduce risks of HIV transmission; 

Research on treatment interruptions and advocacy for corrective action in the areas of budgeting, drug procurement and distribution;  

Research on the use of New Synthetic Drugs (NSD) and especially their impact on children and young people. Advocacy for action including policies to address the supply and distribution of NSDs;

Advocacy for measures to prevent mother to child transmission, including full access to pre-natal screening, and medical guidelines for testing, treatment and counselling;

Results

A revised National AIDS Strategy has been developed which addresses the changing face of the epidemic.

Clear evidence of shortcomings which need to be urgently addressed has emerged from the research. These include interruptions in treatment and an increase in HIV transmission from injecting drugs, including NSDs. National capacity has been strengthened through support for the Romanian AIDS Centre.

Next Steps   

  • Step up advocacy for urgent action to fight HIV transmission among the most at risk populations. This includes MSM, IDUs, adolescents and HIV positive pregnant women who risk passing the virus to their infants. 
  • Increase advocacy for adequate budget allocations and management of funds for  the national HIV/AIDS strategy with particular emphasis on ensuring uninterrupted treatment for PLHIV and prevention programmes for most vulnerable populations.
  • Advocate for funding for NGOs involved in the fight against HIV/AIDS.   

 

 
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