Drug abuse fuelling HIV/AIDS

One of the main factors driving the spread of HIV/AIDS in Kyrgyzstan is the boom in intravenous drug consumption, now reaching alarming levels in the southern region of Osh and in the capital, Bishkek, in the north of the country, United Nations specialists told IRIN. "In the past eleven months of 2001, we have registered 115 new cases of HIV in Kyrgyzstan. This represents an eightfold increase compared to 2000 at the national level and a 35-fold increase for the region of Osh," Larisa Bashmakova, UNDP's HIV/AIDS coordinator for Kyrgyzstan, told IRIN. Latest figures indicate 168 people registered as living with HIV/AIDS, most being men under the age of 30. It is estimated that 90 to 95 percent of those recently infected are intravenous drug users (IDUs). The epidemic is largely concentrated in the southern region of Osh. "Osh is at the crossroads of drug-routes from Afghanistan to Russia. A dose of heroin costs 25 soms (US 50 cents), which makes it cheaper than a bottle of vodka or even beer," Bashmakova said. In a region where the average monthly salary remains below US $50, drug production and dealing are a tempting source of income in this povery-stricken former Soviet republic. Many young Kyrgyz citizens are turning to drugs as an escape from economic hardship and lack of opportunities. "Today we have an estimated 50,000 drug users in Kyrgyzstan, mostly IDUs, of which 20,000 are in Bishkek. This situation has created a market for drug-dealers not only in the south but now in the north of the country, especially in larger cities," Bashmakova said. Experts estimate that about three out of every four IDUs are HIV-positive. If no steps are taken, the number of HIV-infected people in Kyrgyzstan could reach 5,000 by the end of 2002. But Kyrgyzstan appears to be taking the threat of drugs and AIDS seriously, and stands out in the region as being particularly innovative in its response to the epidemic. Under a new UNDP and UNAIDS programme starting next year, the drug methadone will be distributed free to female IDUs and HIV-positive IDUs. Taken orally under medical supervision, methadone reduces the risk of infection from needle sharing. "The reason for this success is that the [Kyrgyz] political establishment has been lobbied by AIDS specialists, and is involved in a national programme against AIDS, whereas in neighbouring countries, which have received in comparison the same financial support from donors, there is no political will to prioritise the fight against AIDS," explained Bashmakova. Kyrgyzstan is also actively promoting needle-exchange programmes, which significantly reduce the spread of infectious diseases among IDUs. Currently, 1,400 IDUs have access to free syringes in Bishkek, Takmak, 60 km east of the capital, and Osh. On average, the programmes register a 90 percent rate of needle returns. Leaders of both the Muslim and the Christian Orthodox communities have been approached and have become supportive of condom use and needle-exchange programmes. Yet despite high levels of awareness, the message is not getting through clearly enough to young people. "Media are not genuinely interested to cover the issue of AIDS, usually giving a slightly scandalous coverage. What we need crucially is a youth programme, because nothing is targeted specifically at them. Only a long-term, sustainable programme will make a difference," Bashmakova emphasised. AIDS experts agree that more resources need to be directed at populations most at risk - IDUs, commercial sex workers and young people. Free high-quality condoms are not available to most of these high-risk groups. The few AIDS campaigns in rural areas - where up to 80 percent of the Kyrgyz population live - have made little impact.