In most countries in Western Europe, AIDS cases have fallen to levels not seen since the original outbreak; many attribute this trend to aggressive educational campaigns, screening of blood transfusions and increased use of condoms. Also, the death rate from AIDS in Western Europe has fallen sharply, as new AIDS therapies have proven to be an effective means of suppressing HIV.
In this area, the routes of transmission of HIV are diverse, including paid sex, sex between men, intravenous drugs, mother to child transmission and heterosexual sex. However, many new infections in this region occur through contact with HIV-infected individuals from other regions. The adult (15-49) prevalence in this region is 0.3% with between 570,000 and 890,000 people currently living with HIV. Due to the availability of antiretroviral therapy, AIDS deaths have stayed low since the lows of the late 1990s. The Economist reported in January 2000 that almost 40% of AIDS sufferers are intravenous drug users.[1]
Regarding the social effects of the HIV/AIDS pandemic, there has been since the 1980s a "profound re-medicalization of sexuality".[2][3]
As part of the global AIDS pandemic, there is also growing concern about a rapidly growing epidemic in Eastern Europe and Central Asia, where an estimated 0.99-2.3 million people were infected in September 2006, though the adult (15-49) prevalence rate is low (0.9%). The rate of HIV infections began to grow rapidly from the mid-1990s, due to social and economic collapse, increased levels of intravenous drug use and increased numbers of prostitutes.
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AIDS emerged as an issue in Poland later than in the West—partly because of communist suppression of statistics, partly because the epidemic apparently reached Poland later. In 1991 the government officially estimated that 2,000 Poles had been infected with the human immunodeficiency virus (HIV), whereas an independent health expert put the figure at 100,000. This statistical discrepancy reflected Poland's late start in testing the groups at highest risk of infection. Narcotics addicts were endangered particularly because the drug in widest use in Poland was administered and distributed by syringe, one of the most potent means of HIV transmission.
Early efforts to control the spread of HIV were hampered by public ignorance and superstition; in 1992 about 70 percent of Poles believed they could not be infected, while many believed that water and mosquitoes were carriers. The total lack of sex education programs in the schools (the Polish Catholic Church forced their removal after the communist era) and the disinclination of political and religious leaders to address the issue publicly further hindered prevention efforts.
Twice in 1991, World Health Organization (WHO) teams evaluated the Polish situation and proposed a program to combat the spread of AIDS. The teams advised that, to prevent the disease from spreading from high-risk groups to society at large, information on the epidemic be given maximum dissemination to certain less visible groups that were likely victims of the second phase of the disease. The most urgent target groups were the prostitute community—whose numbers in 1992 were estimated to be as high as 180,000—and their potential customers.
At that point, however, a comprehensive information program was impossible because the country lacked trained workers and money for training programs. Other obstacles were lack of modern diagnostic technology and poor hygiene in public health facilities. In 1991 WHO allocated a small fund for a three-year education and prevention program in Poland.
As of late 2006, a total of 10 555 HIV infections have been officially registered in Poland.[4] It is estimated that the total number of people with HIV in Poland is 20 000, with adult HIV prevalence rate 0.1% (2007).[5]
By 2004 the number of reported cases in Russia was over 257,000, according to the World Health Organization, up from 15,000 in 1995 and 190,000 in 2002; some estimates claim the real number is up to five times higher, over 1 million. There are predictions that the infection rate in Russia will continue to rise quickly, since prevention measures may not be sufficient.
Ukraine and Estonia also had growing numbers of infected people, with estimates of 500,000 and 3,700 respectively in 2005. The epidemic is still in its early stages in this region, which means that prevention strategies may be able to halt and reverse this epidemic. However, transmission of HIV is increasing through sexual contact and drug use among the young (<30 years). Indeed, over 80% of current infections occur in this region in people less than 30 years of age.
Czech Republic announced for World AIDS Day 2008 that 128 people are reported to have HIV this year, for a total of reported 1,170 cases. The disease has claimed 140 lives in the Czech Republic.[6]
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