(October 2002) HIV prevalence is rising faster in Eastern Europe and Central Asia than anywhere else in the world. The epidemic took hold only in the early 1990s and was concentrated among injecting drug users. There were just 5,000 people living with HIV/AIDS in Eastern Europe and Central Asia in 1990, but by 2001, there were an estimated 1 million.

Russia has the region’s largest number of people living with HIV/AIDS, while Ukraine has the highest percentage with the disease. An estimated 700,000 Russians were living with HIV/AIDS at the end of 2001, and experts fear that increased sexual activity and injecting drug use among adolescents and young adults, mass unemployment, and economic insecurity all favor another surge in HIV infections in the region. At the same time, deteriorating public health services are ill-equipped to deal with the epidemic. In Ukraine, an estimated 1 percent of young women and 2 percent of young men were infected with HIV in 2001.

In central Europe, strong prevention efforts may have stymied the rise of HIV infections, and prevalence has remained relatively low. The Polish government successfully contained the epidemic among drug users and prevented it from spreading into the general population. But there is still a threat of spillover from eastern Europe, where HIV infections continue to proliferate.

In western and southern European countries, adult prevalence is below 0.5 percent, except in Portugal, Spain, and Switzerland. HIV transmission has been concentrated among gay men and injecting drug users, but HIV is slowly spreading into the general population as well. Recently, STIs among gay men have increased in some European cities, indicating a return to the unsafe sex practiced before the AIDS epidemic. New HIV infections among gay or bisexual men in Madrid rose from just over 1 percent to more than 2 percent between 1996 and 2000.

Peter Lamptey is president of the Family Health International (FHI) Institute for HIV/AIDS. Merywen Wigley is an associate technical officer at the FHI Institute for HIV/AIDS. Dara Carr is a technical director for health communication at PRB. Yvette Collymore is senior editor at PRB.

For More Information

Read the “Report on the Global HIV/AIDS Epidemic” from UNAIDS: http://www.unaids.org/en/

Excerpted from PRB’s Population Bulletin “Facing the HIV/AIDS Pandemic” (PDF: 786KB).