What drives the AIDS epidemic in Central and Eastern Europe - The impact of social and biological aspects

Presenter: Diana Sonntag, TU Chemnitz

Abstract

Rationale:
The HIV/AIDS epidemic spreads rapidly in Central-East Europe. To prevent further transmissions within and beyond Central-East Europe, policymakers need to understand underlying factors that facilitate these epidemics. Much attention has been paid on epidemiological aspects though neglecting other important factors like social stigmatization and concomitant diseases like tuberculosis.

Objectives:
This paper aims to analyze how biological and social factors influence the spread of HIV/AIDS in Central-East Europe.

Methodology:
We construct an unbalanced panel data set for 28 central-east European countries between 1995 and 2006 using data from the UNAIDS, EUROHIV, WHO, and WDI databases. This rich data set allows us to analyse the determinants of HIV/AIDS in a cross-section of 28 central-east European countries and over time. In particular, we test two recent observations: First, HIV seems to spread most in regions with high tuberculosis prevalence rates. Also, the less developed health care sector and poor living conditions, i.e. malnutrition and difficult social conditions in the aftermath of the COMECON collapse, seem to facilitate the HIV transmission. Secondly, social stigmatization of HIV-infected individuals and marginalisation of subpopulations with high-risk behaviour and a lacking social integration of children and adolescents leads to social marginalization making an effective HIV/AIDS education extremely difficult. We analyze if these social factors also contribute to the disease’s rapid spread in Central-East Europe.

Results:
Our results show that the HIV prevalence rises with higher tuberculosis prevalence. Thus, improving heath care in the central-east European countries and taking into account the interdependency of HIV and its co-factors may help to decrease HIV prevalence rates. We also find a positive relationship between social factors like stigmatization and marginalisation of subpopulations with high-risk behaviour and the spread of the HIV/AIDS epidemic.

Conclusions:
HIV/AIDS cannot be looked at isolated from regional concerns in Central-East Europe like a lacking social integration of the youth and a high prevalence of tuberculosis. Anti-HIV programmes are effective only if biological synergies between HIV and other infectious diseases like tuberculosis or sexual transmitted diseases are explicitly addressed. Moreover, social aspects have to be a priority of anti-HIV policies to curtail HIV in the central-east European countries and to prevent massive spillovers to Western Europe.