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This report contains a simple message: without an immediate, accelerated & significantly scaled up response by governments & others, HIV/AIDS risks undermining & even reversing human development gains across the countries of E. Europe & the Commonwealth of Independent States. It also offers concrete solutions. Drawing on best practices & on the proven experience of countries & communities where HIV/AIDS prevention & care have produced results, this report sets out a series of recommendations for policy makers, gov't. institutions, bus. & civil society on exactly how that can be done. A product of the joint efforts of a team of researchers drawn from UN agencies, civil soc. org. & other partners, it is a powerful call to action. Illus.
The Eastern Europe and Central Asia region has the world’s fastestgrowing HIV epidemic. Although still concentrated, the epidemic has diversified, affecting several key populations in many countries. This change has increased the number of people in need, the ways the epidemic can spread, and the complexity of formulating an effective strategy to combat it. At the same time, international funding is insufficient to cover the growing need, and domestic plans to cover the funding gaps, in many cases, fall short. In this environment, the need to use data to make the best possible decisions about using available funds is essential. Tackling the World’s Fastest-Growing HIV Epidemic tells the story of how, in 11 countries across Eastern Europe and Central Asia, small groups of decision-makers and experts came together to carry out innovative, groundbreaking analyses for each country. It details the steps these nations have taken to strengthen their HIV programs based on the findings while highlighting critical issues for the road ahead. In so doing, the book also shows the potential of what can be done with a mathematical model and how it can support real-life improvements in policy and more efficacious budget allocations. It is the record of a unique undertaking to improve public health investments that offers lessons for many communities.
Drug dependence is a complex, chronic, relapsing condition that is often accompanied by severe health, psychological, economic, legal, and social consequences. Injecting drug users are particularly vulnerable to HIV and other bloodborne infections (such as hepatitis C) as a result of sharing contaminated injecting equipment. All drug-dependent individuals, including injecting drug users (IDUs), may be at increased risk of HIV infection because of high-risk sexual behaviors. There are an estimated 13.2 million injecting drug users (IDUs) world-wide-78 percent of whom live in developing or transitional countries. The sharing of contaminated injecting equipment has become a major driving force of the global AIDS epidemic and is the primary mode of HIV transmission in many countries. In some cases, epidemics initially fueled by the sharing of contaminated injecting equipment are spreading through sexual transmission from IDUs to non-injecting populations, and through perinatal transmission to newborns. Reversing the rise of HIV infections among IDUs has thus become an urgent global public health challenge-one that remains largely unmet. In response to this challenge, the Institute of Medicine convened a public workshop in Geneva in December 2005 to gather information from experts on IDU-driven HIV epidemics in the most affected regions of the world with an emphasis on countries throughout Eastern Europe, the Commonwealth of Independent States, and significant parts of Asia. Experts from other regions also provided information on their experiences in preventing HIV infection among IDUs. This report provides a summary of the workshop discussions. Preventing HIV Infection among Injecting Drug Users in High Risk Countries describes the evidence on the intermediate outcomes of drug-related risk and sex-related risk prior to examining the impact on HIV transmission. This report focuses on programs that are designed to prevent the transmission of HIV among injecting drug users. These programs range from efforts to curtail non-medical drug use to those that encourage reduction in high-risk behavior among drug users. Although the report focuses on HIV prevention for IDUs in high-risk countries, the Committee considered evidence from countries around the world. The findings and recommendations of this report are also applicable to countries where injecting drug use is not the primary driver, but in which injection drug use is nevertheless associated with significant HIV transmission.
This report describes the dynamics of the eastern European HIV epidemic. It draws on 20 short presentations prepared by epidemiologists and social scientists from seven countries of the former Soviet Union as well as experts from Denmark, the United Kingdom, and India, for presentation during the meeting on the status and trends of the HIV/AIDS epidemic in eastern Europe. The meeting was held under the auspices of the Monitoring the AIDS Pandemic (MAP) Network on June 23, 1998 in Annecy, France, with funding and preparatory input from UNAIDS. Presentations at the meeting focused on the socioec.