HIV AND AIDS: Blame and Banishment - the underground HIV epidemic affecting children in Eastern Europe and Central Asia

[VIENNA, 19 July 2010] -  An underground HIV epidemic in Eastern Europe and Central Asia is intensifying at an alarming pace, fuelled by drug use, high-risk sexual behaviour and high levels of social stigma that discourage people from seeking prevention information and treatment, according to a report released by UNICEF.

The report, Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia, highlights the issues faced by children living with HIV, adolescents engaged in risky behaviors, pregnant women using drugs, and the more than one million children and young people who live or work on the streets of the region.   

Marginalised young people are exposed on a daily basis to multiple risks, including drug use, commercial sex and other exploitation and abuse, putting them at higher risk of contracting HIV.   The trends are especially troubling, as the region is home to 3.7 million injecting drug users – almost a quarter of the world total. For many, initiation into drug use begins in adolescence.

Existing health and social welfare services are not tailored to adolescents at greatest risk, who are often exposed to moral judgement, recrimination and even criminal prosecution when they seek treatment and information on HIV. 

“Children and adolescents living on the margins of society need access to health and social welfare services, not a harsh dose of disapproval,” said Anthony Lake, UNICEF’s Executive Director. 

To reach and help young people living with HIV or at risk of HIV infection, medical and civil authorities need to establish non-judgemental, friendly services that address the special needs of marginalised adolescents.

In the Russian Federation, for example, over 100 youth-friendly service facilities have been established, providing reproductive and sexual health services, information, counselling and psychological support. The Atis health center in Moldova is another initiative that is showing promise and saving lives.

“We cannot break the trajectory of the AIDS epidemic in eastern Europe and Central Asia without empowering and protecting children and adolescents,” said Michel Sidibé,  Executive Director of UNAIDS. “We must not rob them of their childhood.”

“It is our responsibility to ensure that they have access to HIV prevention and treatment services.”

An HIV prevention and treatment center in Tajikistan is breaking down barriers of mistrust to reach adolescent girls selling sex.  As one young client said, “In the beginning, I did not believe that the medical check-up, the treatment and condoms would really be free of charge and anonymous.  I thought it was another trap by the police. I agreed to go there with an outreach worker for the first time, but now I go there alone and encourage my friends to use the service as well.”

A recent six-country UNDP study conducted in the region showed that many adults living with HIV fear the social stigma attached to seeking treatment more than they fear the disease, thus driving the epidemic further underground.

The stigma associated with HIV is not restricted to adults and adolescents. Young children living with HIV are routinely denied access to school and kindergartens, and when their status is known, they face rejection and abuse. Alla, the foster mother of an HIV-positive child, tells how her son was ostracised when someone leaked his HIV status to other families. “His classmates say that he is ‘disgusting’ and refuse to play with him,” she said.

“This report is a call to protect the rights and dignity of all people living with or at risk of exposure to HIV, but especially vulnerable children and young people.  We need to build an environment of trust and care, not one of judgment and exclusion,” said Lake. “Only by reversing discrimination against people living with HIV, can Eastern Europe and Central Asia begin to reverse the spread of the epidemic.”

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