HIV Prevention in Latvia Nearly Non-Existent Due to Multiple Reorganizations

Organizational changes and staff shortages are hampering the fight against HIV/AIDS in Latvia, a local expert there says. And both problems have been partly responsible for the lack of outreach to high-risk groups documented in a recent UNICEF report, said Iveta Skripste, a public health methodologist with the Latvian Center of Infectious Diseases. The report highlights the need for HIV prevention services among vulnerable youth in Eastern Europe and Central Asia, especially those involved with the sex trade and drug use.

Since 2008, intravenous drug use has fallen as the top mode of HIV infection in Latvia, Skripste said. Last year, 49 percent of new cases were linked to heterosexual sex, and 27 percent were acquired through drug use. "But those infected through heterosexual contacts are closely related to the community of drug users," said Skripste.

Lack of resources at both the national and local levels has hindered the effective division of labor in tackling HIV, Skripste said. The state provides prevention supplies such as HIV testing strips and disposable syringes, but local authorities have the responsibility of paying for rent, salaries, and other operational expenses for HIV prevention outreach efforts.

"In the given economic situation, the local governments have very few such employees, therefore the scope of work is much smaller than in previous years," Skripste said. Prevention efforts also have suffered from the reorganizations of several health institutions, including the liquidation of the Public Health Agency, she said.