SEXUALLY TRANSMITTED INFECTIONS (STIs) INCLUDING HIV/AIDS
Reproductive health programmes should increase their efforts to prevent, detect and treat sexually transmitted diseases and other reproductive tract infections, especially at the primary health-care level.1
Governments, from the highest political levels, should take urgent action to provide education and services to prevent transmission of all forms of sexually transmitted diseases and HIV and develop and implement national HIV/AIDS policies and action plans, and take steps to mitigate the impact of the AIDS epidemic by mobilizing all sectors and segments of society to address the social and economic factors contributing to HIV risk and vulnerability.2
The occurrence of sexually transmitted infections has increased alarmingly in this part of the world. Factors contributing to the spread of epidemic include: mass unemployment and economic insecurity, opening of boarders, liberalisation of social and cultural norms, the disintegration of the health care system and the low level of knowledge on STIs and protection against them mainly due to the lack of sexual education. Protection against STIs is not integrated into primary health care. Reported rates of sexually transmitted infections are very high. For example, there are stark differences in the incidence of syphilis, with an average incidence of 2 cases per 100,000 in the European Union, 11 in Central and Eastern Europe generally and 221 in the former Soviet Union.3 It is obvious that preventive measures taken by the government are highly unsatisfactory.
HIV/AIDS incidence is rising faster in this region than anywhere else in the world. In 2002, there were an estimated 250 000 new infections in this region, bringing to 1.2 million the number of people living with HIV.4 No more than 1000 people receive anti-retroviral treatment. Until 1994 almost no country was reporting HIV infections. The first widespread outbreak of HIV took place in Ukraine and Belarus in 1995. Soon other countries joined: Moldova in 1996, Russia in 1998, followed by Latvia and Kazakhstan.5 In Estonia reported infections jumped from 12 in 1999 to 1474 in 2001. In Latvia the number of infections rose from 25 in 1997 to 807 in 2001. In Kazakhstan 1926 infections were reported by June 2002.6 The HIV spread is also evident in Azerbaijan, Georgia, Kyrgyzstan, Tajikistan and Uzbekistan. In Commonwealth of Independent States the vast majority of reported HIV infections are among young people – mainly drug-users. Although improving in some countries, levels of condom use remain low. In Ukraine only 28% of young women had used a condom when they first had sex. The numbers of infections are believed to be underreported. Fear, denial and lack of information are barriers to knowing the extent of the HIV and AIDS problem in the CEE. Although the numbers of HIV-positive women are not high, the lack of services and programs for women and particularly for vulnerable young girls results in increasing numbers of HIV/AIDS infected women.7
The low
awareness on sexually transmitted infections in a society can be demonstrated by an
example from Ukraine. In a study conducted in Ukraine, about one third of women, who
experienced recent symptoms that most probably resulted from STIs did not seek any
treatment for them.8
In the Russian
Federation between 200 000 aand 400 000 cases of syphilis are reported annually.9
In Latvia, reported cases of syphilis have increased 28-fold in a five-year period.10
In Tajikistan
only 10 % of adolescents girls had ever heard of HIV/AIDS.11
In the Russian
Federation the number of HIV cases reported in mid-2002 was over 200 000. The actual
number of people now living with HIV in the Russian Federation is estimated to be many
times higher than these reported figures. However, relative to population size, Estonia
has now the highest rate of new HIV infections in this region.12
Ukraine
remains the most affected country in the region with an estimated adult HIV prevalence
rate of 1% and an estimated 250 000 people living with HIV. While 3 of infections are due
to injecting drug use, the proportion of infections (mostly women) due to sexual
transmission is growing.13
EXAMPLE OF GOOD PRACTICE
Prevalence of HIV/AIDS remains low in countries such as the Czech Republic, Hungary and Slovenia, where well-designed national HIV/AIDS programmes are in operation.14
REFERENCES:
1 “Cairo Programme of Action”, supra note 1, par. 7.30 and 7.32.
2 “Cairo Plus Five”, supra note 13, par. 67.
3 UNICEF (1999), “Women in Transition”, supra note 7, p. 71.
4 UNAIDS / WHO (2002) “AIDS Epidemic Update. December 2002”, p. 12.
5 UNAIDS “Report of the Global HIV/AIDS Epidemic 2002” (“The Barcelona Report”), p. 32.
6 “AIDS Epidemic Update. December 2002”, supra note 64, p. 13-14.
7 UNAIDS “Report of the Global HIV/AIDS Epidemic 2002” (“The Barcelona Report”), p. 32 – 35.
8 CDC, “Ukraine Reproductive Health Survey”, supra note 27, p. 209.
9 “AIDS Epidemic Update. December 2002”, supra note 64, p. 15.
10 UN Non-Governmental Liaison Service (NGLS) “Baltic UN – NGO Consultation on Women” September 1996 (UNCTAD/NGLS/73), p. 27.
11 “The Barcelona Report”, supra note 67, p. 34.
12 “AIDS Epidemic Update. December 2002”, supra note 64, p. 14.
13 “The Barcelona Report”, supra note 67, p. 33.
14 “AIDS Epidemic Update. December 2002”, supra note 64, p. 15..