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The worsening HIV crisis in Eastern Europe and Central Asia
GFO Issue 430

The worsening HIV crisis in Eastern Europe and Central Asia



Article Type:

Article Number: 7

The only region where HIV prevalence is increasing calls for sustained efforts to tackle its epidemic

Abstract: The Eastern Europe and Central Asia region continues to face a growing HIV epidemic. HIV incidence is increasing and there are no reductions in AIDS-related mortality. The epidemic is largely driven by injection drug use and unprotected sex among key populations who face significant legal barriers, including criminalization, discrimination, and stigma. This hinders their access to life-saving medicines and healthcare services. There is a clear need for continued funding for sustainability and advocacy on HIV in EECA. Governments, international organizations, and donors must prioritize funding for HIV prevention and treatment programs, harm reduction programs, advocacy campaigns, and research to address the region’s HIV epidemic.

According to the Global AIDS Update 2022, Eastern Europe and Central Asia (EECA) has the fastest growing HIV epidemic in the world. In 2021, 160,000 [130,000–180,000] people were newly infected with HIV — a 48% increase since 2010. There were 44,000 [36,000–53,000] AIDS-related deaths in the region in 2021, 32% higher than in 2010.

The UNAIDS report tells us that regional HIV prevention and treatment service coverage remains insufficient. As of 2021, 63% of people living with HIV (PLHIV) were aware of their status, 81% of people who knew their HIV-positive status were on treatment (51% of all PLHIV) and 94% of people on treatment were virally suppressed (48% of all those infected). Unsafe injecting practices are a key factor in the region’s epidemic. Opioid agonist therapy (OAT) is available in Armenia, Kazakhstan, Kyrgyzstan and the Republic of Moldova, but it barely reaches those in need in Kazakhstan and is unavailable in Turkmenistan and Uzbekistan.

The figure below indicates the dire state of the region’s epidemic.

Figure 1.Number of new HIV infections and AIDS-related deaths, EECA, 2000–2021

The next two figures shows how the epidemic is being driven by men who have sex with men (MSM) and people who inject drugs (PWID).

Figure 2. Distribution of acquisition of new HIV infections by population and sex (aged 15–49 years), EECA, 2021

Source: Global AIDS Update 2022

Figure 3. HIV prevalence among key populations compared with adults (aged 15–49 years), reporting countries in EECA, 2017–2021