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Number of HIV Cases in Former USSR Now Outstrip Those in US

Originally published by Reuters Health, July 11, 2002

BARCELONA, Spain (Reuters Health) — The HIV epidemic in the former Soviet Union is growing faster than anywhere in the world and threatens to spread from injecting drug users into the wider population unless action is taken, researchers said on Thursday.

"From a small number of cases in 1995, HIV infections have grown so quickly that an estimated one million people in the former Soviet Union are infected with HIV—more than in the US," Dr. Anna Shakarishvili from the US Centers for Disease Control and Prevention told reporters at the International AIDS Conference.

At present, 90% of HIV-infected people in former Soviet states are injecting drug users, but Dr. Shakarishvili and colleagues from the Russian Association for Sexually Transmitted Infection Prevention now report worrying signs of an epidemic among sex workers and the homeless that threatens to spread further through heterosexual sex.

The researchers studied 400 non-drug using men and women at centers for the homeless in Moscow and found that 1% were HIV-positive, compared to just 0.18% in the general population. Thirty percent were infected with sexually transmitted diseases like chlamydia and gonorrhea, which increase the risk of becoming infected with HIV.

Over 64% of men and 40% of women in the study said they did not use a condom the last 10 times they had sex, Dr. Shakarishvili added.

In another study, the researchers looked at HIV rates and risk-taking among 190 women who exchanged sex for money or other commodities, only 21% of whom considered themselves as sex workers. Of these women, 2.8% were HIV-positive and around 70% had one or more sexually transmitted disease.

The women had an average of 168 partners in the past year, 1% took opiate drugs, and 5% used cannabis. Ninety percent said they used condoms, 63.2% practiced oral sex and 15.8% had anal sex.

"This research shows marginalized women are at significant risk through heterosexual sex," Dr. Shakarishvili said. "Without intervention, the epidemic could spread more widely to the general heterosexual population through commercial sex work."