Eurasia facing rising HIV cases
Kazakhstan, Russia, Ukraine, and Uzbekistan account for 92 percent of newly registered HIV cases in the region.

Lena, 55, from Pavlodar in northeastern Kazakhstan, was addicted to drugs for over 20 years. “I remember how it was using drugs: I fell asleep–it’s winter. Woke up–summer,” she said.
Unsafe injections among drug-users are a leading cause of transmission of the human immunodeficiency virus (HIV) in Eurasia, accounting for over one-quarter of new HIV infections, UNAIDS, the United Nations AIDS program, reports. The data was released in conjunction with the 25th International AIDS Conference, which concluded July 26 in Munich, Germany.
With 140,000 new cases in 2023, Eurasia has seen a dramatic 20 percent increase in new infections over the past 13 years. Kazakhstan, Russia, Ukraine, and Uzbekistan are among the hardest hit, accounting for 92 percent of newly diagnosed cases. “While most other regions around the globe have managed to stabilize the rates of HIV infections, in Eurasia, it is rapidly increasing,” said Andriy Klepikov, regional co-chair of the AIDS 2024 conference. For the first time in history, there are more new infections outside sub-Saharan Africa than within the region.
Lena from Pavlodar beat her addiction with opioid agonist therapy, which relies on substances such as methadone to reduce cravings for heroin, oxycodone or other narcotics. She has been clean for seven years and is now a peer counselor in a mentoring program run by women living with or affected by HIV. The key problem, she said, is that many drug users have no access to “HIV prevention services” or treatment.
Experts contend that restrictive laws, aggressive policing, and stigma are helping to drive the uptick in cases in Eurasia. Only half of the 2.1 million people living with HIV in the region are on antiretroviral therapy. Only 42 percent of people living with HIV have suppressed viral loads, the lowest level in the world. Suppression prevents the spread of the disease. “If people are pushed underground, the HIV response will not succeed,” a statement released by UNAIDS quoted Eamonn Murphy, the organization’s regional director for Eastern Europe and Central Asia and Asia Pacific, as saying. Between 2010 and 2023, the number of AIDS-related deaths rose by 34 percent.
UNAIDS noted the “criminalization of small amounts of drug possession for personal use” in nearly half of the countries, the criminalization of sex work in all 16 countries of the region, and the penalization of HIV transmission in almost all countries. In Kyrgyzstan, 49 percent of respondents who inject drugs, and in Tajikistan, 32 percent of people living with HIV reported avoiding medical care because of stigma and discrimination.
In Russia, LGBTQI+ people faced “concerted attacks,” the report said. At the same time, 94 percent of all new HIV cases in 2022 were among so-called “key populations”: people who use drugs, gay men and other men who have sex with men, sex workers, and people in prison.
According to regional co-chair Klepikov, “drug use, stigma, and harmful policies” have been “exacerbated by violent conflict.” Still, despite the destruction of hospitals in Ukraine, more than 118,000 people were receiving antiretroviral therapy there at the end of 2023. Only “slightly fewer” than before the war, experts said.
“The barriers of stigma and discrimination need to be broken down,” said Winnie Byanyima, executive director of UNAIDS. At the same time, the expansion of support initiatives, like the mentoring program where Lena from Pavlodar works, can be part of the solution. Only 12 percent of resources go to prevention programs for “key populations.” Yet their transformative impact cannot be overstated, even for those who are not on the receiving end. “I am reborn from this work,” she said.
Ekaterina Venkina is a journalist specializing in foreign policy and international relations. She is a graduate of Columbia University’s School of Journalism.
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