HIV spreading via sex in Uzbekistan

A symbol of the global fight against HIV/AIDS
The fight against HIV/AIDS has produced results worldwide, with some African countries reducing the number of new HIV cases by 50%, but this is not the case in Eastern Europe and Central Asia, the UN has said.

On 29 November, reports on the state of the HIV/AIDS epidemic at global, regional and country level, including Uzbekistan, was presented at Tashkent's Poytaht business centre in connection with World AIDS Day.

The report World AIDS Day: Results, prepared by the UNAIDS programme, noted "unprecedented rapid expansion of measures to counter AIDS has produced results".

In 2011, there were 34 million people with HIV and 2.5 million new cases were registered, while 1.7 million people died from diseases caused by AIDS.

Twenty five countries (over half of them in Africa) with low and medium income saw over a 50% decrease in the number of new HIV cases.

At the same time, the trend of stabilisation of infection observed globally did not reverse the situation in Eastern Europe and Central Asia.

The provision of treatment to HIV patients remains poor in these countries: about 25% of people who has the right to HIV treatment do not receive it.

24,539 patients in Uzbekistan

In this situation, Uzbekistan has achieved certain progress in fighting HIV/AIDS in recent years, according to the director of the National AIDS Centre, Prof Nurmat Atabekov.

"The global AIDS epidemic has not bypassed Uzbekistan," Atabekov said. "The first case was established in 1987 among African students studying in our country."

The number of cases grew every year and stands at 24,539 now.

The epidemic peaked in 2009 when the number of new HIV cases was 4,016.

This figure started falling in 2010 (by 5.5%) and it fell by 11% in 2011.

A total of 3,267 cases were registered in the country in the first 10 months of this year.

Tashkent in the lead

"We now test over 2 million people a year and the rate of occurrence is 0.19 cases per 100,000 people," Atabekov said. "For comparison it was 0.43 in 2008."

He said most HIV patients lived in Tashkent, which accounts for about a third of the total number, Tashkent and Andijan Regions.

"In those regions, including Samarkand Region, the number of new cases is on the rise compared with last year, whereas in the country as a whole this figure remained unchanged compared with 2011," Atabekov stressed.

Risk groups: women and children

The share of female HIV patients is growing as they contract the virus via sex.

In 2005, their share was 21.7% and men's 78.3%, while in 2012 these shares became almost equal - 47.5% are women and 52.5% men.

Ways of contracting the virus is also changing: several years ago most cases were parenteral (through blood during injections), now a majority of cases are due to sex (52.7%).
Prof Nurmat Atabekov

The transfer of the virus from mother to child peaked in 2009 (5.6% of all new cases) and in 2011 (5.3%), but fell to 3.6% in 2012.

"Since 2009 we test all pregnant women for HIV to prevent mother-to-baby contractions," Atabekov said. "A total of 291 HIV cases were established."

However, the main objective is not just to detect HIV mothers but also prevent mother-to-baby contractions for which the "four medical tactics" are implemented.

This is antiretroviral prevention among pregnant women and giving births using caesarean section, antiretroviral prevention among newborns and exclusion of breast feeding.

"As a result, we established only one case of mother-to-baby contraction," Atabekov said. "This means that, by complying with the abovementioned measures, Uzbekistan is capable of ruling out this way of contraction."

The government is now discussing the issue related to purchasing antiretroviral preparations for 2014 as the country has enough preparations for 2013.

Speaking about child HIV patients aged three to six, Atabekov said that compared with 2011 the number of new such patients almost halved this year.

As for patients aged seven to 14, their number has grown a bit, Atabekov said, because of greater numbers of coverage. In other age groups numbers did not change.

Migrants under control

"In the current situation with HIV/AIDS, an important role is played by labour migrants," Atabekov said. "In the past 10 months 243 new HIV cases were registered among them."

They infect their sex partners and thus complicate the situation.

Asked about measures to test labour migrant returning from abroad who could infect their partners, Atabekov said "in our country testing is voluntary and we need to involve civil society to engage migrants to testing."

"We know from the moment of contraction HIV could be detected only three months later and those who go to work abroad from rural areas are known to everyone: medical establishments, neighbourhood and women's committees, religious organisations and police," Atabekov explained.

Moreover, a national commission for AIDS issued orders that these organisations should help medical establishments to test migrants for HIV but voluntarily.

"We have all possibilities"

In order to improve laboratory infrastructure in 2010-2011, the country reconstructed 53 district laboratories in 14 regional centres to the tune of 10 billion sums ($5.4m at the official exchange rate).

These laboratories received 23 types of modern diagnostic equipment worth 7.5 billion sums. Funds came from the state budget.

"We have all possibilities to offer competent services to diagnose and treat HIV patients. The situation is stable in the country now and we should aim to reduce the number of new cases in the country every year," Atabekov concluded.