Heroin Users Carry HIV to Masses in Eastern Europe, Asia

From the jungles of southeast Asia to streets in Eastern Europe, HIV is riding on the back of a global heroin epidemic. Among the most populous nations on earth, HIV is threatening to reach into the general population.

"Central Asia is a bomb waiting to explode," said Kasia Malinowska-Sempruch, who directs a drug-related AIDS program for the Open Society Institute. Financed by maverick philanthropist George Soros, the Open Society Institute urges that the world adopt successful harm reduction tactics, such as the needle exchange programs credited with halving HIV infections among San Francisco drug users after the rate peaked at 15 percent. Outbreaks among injectors can quickly spread because most drug users, themselves heterosexual, can pass the virus to their sex partners.

The highest increases in the rate of HIV infections are in the former Soviet Union. As many as 840,000 Russians are estimated to have HIV -- the great majority of them drug-related cases. A quarter-million Ukrainians, or 1 percent of the population, are HIV-positive, the highest rate in Europe. Three out of four infections are among drug users or their sexual partners, and ominously, the number of pregnant women with HIV is rising -- suggesting a shift toward a heterosexual epidemic similar to Africa's.

Current estimates are that 1 percent of the population in the Commonwealth of Independent States uses injection drugs. "More than 90 percent of new HIV cases in Moscow are related to injection drug use," said Ilona van de Braak of the AIDS Foundation East-West.

Drug-related epidemics are turning up along the heroin trade routes from Afghanistan to Burma. Already, at least 4 million are believed infected in India. In China, pockets of drug-driven outbreaks have turned up in seven provinces, with infection rates among heroin users approaching 70 percent. HIV rates at a Jakarta drug treatment center rose from 15 percent to 40 percent within 18 months. Vietnamese researchers in Hanoi found more than half of 30 drug users shared needles, and seven out of eight reported their peers did so "very often."

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