HIV was not a significant problem in Ukraine prior to 1994. Since then, the epidemic has exploded among intravenous drug users and the number of people with HIV has also increased in other groups. If the epidemic takes hold, what are the likely economic, social and political consequences for Ukraine?

To respond to this situation, health policy-makers and planners need to know how far and fast HIV will spread and which groups are most likely to be affected. Researchers from the UK University of East Anglia and colleagues explore the ways in which the epidemic might develop without intervention. What features of Ukrainian society would encourage the spread of HIV?

Between 60,000 and 180,000 Ukrainians may already be infected with HIV. The study suggests that the epidemic could develop in two ways. If, as in parts of Western Europe, infection is spread primarily among injecting drug users, adult prevalence would reach around 1.4 percent by 2010.

If the epidemic instead follows the pattern seen in south-east Asia and Brazil, with rapid spread of HIV into the heterosexual population, a peak adult prevalence of about 3.9 percent would be reached in 2011. Almost 1.5 million people would be infected with HIV by 2010.

The study also predicted that either scenario would:

• increase the number of orphans by up to 69,000 by the year 2006, up from 8200 in 1996
• double the number of elderly people in need of care due to loss of support from HIV-positive relatives
• swell hospital bed requirements for AIDS cases from around 350 in 2000 to between 1281 and 1982 by 2004.

Changes in Ukrainian society may make certain sections of the population particularly vulnerable to HIV and AIDS. The authors recommend that interventions should target the following groups:

• low-income households - more than 63 percent of the population live below the poverty line, resulting in poor health and nutrition
• the unemployed - unemployment may increase entry into the sex industry or foster crime or self-destructive behaviour such as alcohol or drug use
• older people - Ukrainians have the oldest average age in Europe and the elderly are increasingly vulnerable to the impact of the AIDS epidemic on family support networks
• young adults - the consequences of deaths among this group will be magnified as they form a small proportion of the Ukraine population.

Efforts to curb the HIV epidemic in the Ukraine will be hampered by the continuing reduction in government funding for healthcare. Sexual health education is a priority. Sexual attitudes and behaviours are becoming increasingly liberal and "Westernised" in Ukraine. However, knowledge of sexual health is still quite limited and condom use is low.

Source(s):
'The HIV/AIDS epidemic in Ukraine: its potential social and economic impact,' by T. Barnett, A. Whiteside, L. Khodakevich, Y. Kruglov and V. Steshenko, Social Science and Medicine 51 (2000)

Funded by: The British Council

id21 Research Highlight: 19 September 2001

Further Information:
Tony Barnett
School of Development Studies
University of East Anglia
Norwich
NR4 7TJ
UK

Tel: +44 (0)1603 592807
Fax: +44 (0)1603 451999
Contact the contributor: a.barnett@uea.ac.uk

University of East Anglia

Alan Whiteside
Health Economics and HIV/AIDS Research Division
University of Natal
Durban 4051
South Africa

Tel: +27 (0)31 260 2590
Fax: +27 (0)31 260 2587
Contact the contributor: whitesid@eru.und.ac.za

University of Natal, South Africa

Other related links:
Search the UNAIDS site for epidemiological data and other information.

UNDP also has information on HIV/AIDS.

The World Bank's site on AIDS economics covers news, research and other information.