Sex Now Chief Cause Of Ukraine's AIDS Epidemic

KIEV, Ukraine -- "I am not a drug addict!" insisted Andri, 32, staring desperately at the walls of a clinic for people with HIV in Kiev.
The young father contracted HIV through a casual sexual relationship, like alarming numbers of others in a country where heterosexual transmission has overtaken drug abuse as the main cause of AIDS.

The trend has alarmed researchers, showing that the HIV epidemic in Ukraine has now moved out of the niche of intravenous drug users and into the heterosexual mainstream.

With an HIV prevalence rate of 1.11 percent among Ukraine's adult population as of 2009, the former Soviet republic is one of the states in Europe worst hit by the epidemic.

For years, the virus has been spread mainly in Ukraine by intravenous drug users but the trend has changed with startling speed.

Since 2008, more Ukrainians have been contracting HIV through heterosexual sex than through drug abuse. In 2009, 43 percent of Ukrainians infected with HIV caught the virus through heterosexual sex and 35 percent by drug injection.

Experts have warned that this means the epidemic risks no longer affecting mainly high-risk groups like drug users, prostitutes and homosexuals but the general population as a whole.

"There are already signs of a generalisation" with the HIV infection rate of pregnant women now standing at more than one percent in some regions, said Svitlana Antonyak, an official from the national HIV clinic.

"Two thirds of cases of sexual transmission are linked to intravenous drug use," said Tetyana Deshko of the Ukrainian branch of the NGO International HIV/AIDS alliance.

She described the typical path of transmission in today's Ukraine: "A drug user who probably does not know he is HIV positive has a relationship with a woman who probably does not know that her partner is a drug user."

Andri was infected with HIV during an adulterous relationship with a former lover who he suspects now is a drug addict.

"I saw the traces of injections on her arms but she said it was because she had just been to hospital," said Andri, who learned of his diagnosis at the start of the year.

He insists that he used a condom, but it broke. "I put another one on, and thought that it would do. It was stupid. Stupid!"

Almost half of Ukrainians between 25-49 who say they had more than one sexual partner in a year do not use condoms, said a national report compiled by the Ukrainian ministry of health for UNAIDS.

"A condom is often seen (in Ukraine) as a sign of not trusting your partner," said Tetyana Deshko. Moreover many in Ukraine still see AIDS as a problem affecting only disadvantaged groups."

"There's lack of information campaigns of good quality, capable of changing young people's behaviour," Antonyak said.

"My 20-year old son told me he always uses a condom because he was here, at the hospital, helped me and saw people suffering here. Probably that's what we need to do", she added.

Alarmingly "only one HIV victim in four" in Ukraine is actually aware that they have been infected, said the national report.

As of January, 101,000 Ukrainians were infected with HIV according to official figures but the real number is estimated at 360,000. The number of deaths from AIDS was 19,000 between 1987 and April.

However in a ray of hope, the use of antiretroviral therapy resulted in the first cut in the mortality rate from AIDS, of 2.6 percent, last year. Antiretrovirals were introduced to Ukraine only six years ago.

But funds are limited and at least 7,500 patients who need the drugs are not receiving them.

"We really need help from donors," said Svitlana Cherenko, head of the state committee for the fight against AIDS.

Ukraine already received 230 million dollars from the Global Fund to Fight AIDS, Tuberculosis and Malaria for the years 2004-2012 and will this month put in a new request with the organisation for estimated 300 million dollars for 2012-2017.