Tuesday, July 3, 2007

HIV/AIDS in Ukraine: Lessons learned from the "Альянс"

My Ukrainian professor spent all of last week preparing us for a meeting with a mysterious “Ukrainian delegation." This group had asked to visit our class at Pitt on Friday morning, and my professor had obliged. When we asked her about the composition of this “delegation” (Are they students from Ukraine? Professors?), she said she did not know. When we asked her why they wanted to waste their valuable time in the US witnessing the painful, frustrating process of three Americans learning Ukrainian, she also did not know. It was a riddle, and my classmates and I had no idea what to expect.

Still, we diligently prepared a presentation on our class activities, full of references to Cossacks and horilka; practiced a skit about birthday parties; and memorized the answers to several questions that we were sure the members of the delegation would ask us (“Why on earth are you studying Ukrainian?” being the most anticipated). All of this was done in Ukrainian, of course.

Friday morning came, and the “delegation” was a no show. My professor was not troubled, however, because she had received an apologetic call earlier, and they had invited us to pay them a visit at one of the local hospitals after lunch in lieu of their visiting us at Pitt that morning.

So, mystery solved. Turns out, the delegation was composed of physicians and public heath experts involved in HIV/AIDS work in Ukraine.



They had come to America for a short time on a kind of medical exchange program.

Of course I was thrilled at such a turn of events, although I can't say the same for my two classmates, neither of which is interested in health policy. (One of them is a graduate student studying Ukrainian folklore, and the other is a linguistics and religion major at Pitt.) Now, instead of seeing the meeting as a conundrum, I saw it as an opportunity to meet experts in Ukrainian public health who might be willing to help me on my project.

When we arrived at the hospital on Friday afternoon, we went to a small room and watched the 10 or so members of the Ukrainian delegation give a power point presentation (in Russian, with an English translator at hand) on the efforts of their organization, called the International HIV/AIDS Alliance. It was a truly fascinating lecture. I had no idea about the enormous problem Ukraine is having with AIDS. Here’s a quick summary that I gleaned from the presentation and from the Alliance’s website:

Ukraine is experiencing one of the fastest growing HIV epidemics in the world. It is estimated that 1.4% of people aged between 15 and 49 are living with HIV. This is the highest percentage in Europe, and according to UNAIDS/WHO, the actual number of people infected is considerably higher than official statistics suggest. And the epidemic is still growing. In 2006, 16,078 new cases of HIV-infection were officially registered, up from 13,770 in 2005.

Some basic facts about Ukraine and HIV:

Total population
46,481,000
Life expectancy
(W) 73 (M) 62
People living with HIV
410,000
HIV prevalence
1.4%
Deaths due to AIDS
22,000

Southern and eastern regions of Ukraine are the most affected, including the oblasts of Dnipropetrovs’k, Donets’k, Odesa, Mykolaiv and the Crimean Republic. While a third of the population lives in these regions, they represent two-thirds of all officially registered HIV cases. Western regions of Ukraine remain the least affected. I don't know why this is... All I know is that the south and east are more "Russified" than the west in terms of language and culture. Perhaps the southern and eastern areas are also poorer than the west? If anyone knows, let me know.

The International HIV/AIDS Alliance office in Ukraine was established in December 2000 with funding from the United States Agency for International Development (USAID). Its total available funding until 2008 exceeds $70 million.

The Alliance in Ukraine prioritizes community support to reduce HIV infection in the population groups most vulnerable to HIV (injecting drug users, female sex workers, men who have sex with men, prisoners and street children aged 10-18 years); develop community support for HIV-positive people and those close to them; reduce the stigmatisation of, and improve services for, people living with HIV and those groups most vulnerable to HIV; and identify, share and replicate best practice in most effective public response to the epidemic.

The Alliance's contributions appear to be very important. According to the delegation, although the Ukrainian government has continued to increase its funding for HIV/AIDS programs, the amount of money it provides is still quite pitiful given the scope of the problem. For example, right now, most of the money that funds antiretroviral treatments comes from international organizations like the Global Fund, not the state budget. Only 39% of the people who need ARV therapy in Ukraine actually receive it, due to the financial constraints of both the individuals and the NGOs who are trying to subsidize their treatments.

I'd like to learn more about the HIV/AIDS crisis in Ukraine. After the presentation, I struggled through a conversation in Ukrainian with a member of the delegation who lives in Kyiv. We swapped contact information, so hopefully we will have a chance to meet again and discuss all of this...

But maybe in English next time? :)

111 comments:

olechko said...

yeah, it's a big deal, glad to hear there is some resonance to this problem overseas. On the lighter note: Elton John came by the other week to Kyiv with an exhibit, free concert and an anti-AIDS message to the Ukrainians...

SKWALLACE said...

From my sister's friend, who grew up in Ukraine (I hope she doesn't mind):

-----------------------

Re: why eastern/southern Ukraine is more heavily affected by HIV than the west

"Anyway, I’ll trying to answer you question on that matter. Well, the things are: Western regions of Ukraine remain the least affected by AIDS, because people in that area kept their traditions and culture.

I think they are more conservative in a good way. Girls are having fewer boyfriends, and more girls are virgin before marriage, compared to the girls in Eastern part of the country, which looks like USA in the 60th time period. The culture different are big between East and West part of Ukraine. The Southern and Eastern parts of Ukraine have more immigrants, military personnel, and tourists. These regions are close to the Black Sea which has major sea ports. These regions are heavily influence by Russian and American culture."

----------------------

I think this is very interesting. I was aware of the cultural and political differences between eastern and western Ukraine, but I had no idea that health outcomes were correlated to it! This topic would make for a great medical anthropology dissertation...

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