A Tale of Two Countries: The HIV Epidemic in Georgia and Ukraine, two countries of the Former Soviet Union Open Access

Abstract

Background: The collapse of the Soviet Union in the early 90's lead to numerous countries gaining independence and people gaining their freedom, however, it also lead to the collapse of many established public health services. As the Soviet Union fell, port cities along the Black Sea became more accessible to opium distribution and drugs, which led to an increase in injection drug use. Subsequently, the rate of HIV infection began to grow. The epidemic took off in Ukraine, which now has a generalized epidemic, while it has not yet taken off in Georgia. Why these two countries have had such dramatically different epidemics remains largely unknown.

Objective: The purpose of this thesis is to describe the epidemiology of HIV in Ukraine and Georgia and hypothesize the differences of their HIV epidemics. It will also put forth policy recommendations to Georgia to prevent the HIV infection rate from increasing as it did in Ukraine.

Methods: Analysis of national surveillance data available from Georgia and Ukraine. Interviews were conducted with key opinion leaders in Georgia and Ukraine, and various international organizations to compile their points of view and opinions about HIV in these two countries.

Results: Both countries have had an HIV epidemic fueled by injection drug use. However, Ukraine has seen a dramatic rise in HIV prevalence and now has a generalized epidemic with an HIV prevalence of 1.6% in 2007, while Georgia has experienced a much slower raise in cases and the epidemic remains largely concentrated among injection drug users with an HIV prevalence of around 0.1% in 2007 in the general population.

Discussion: Georgia and Ukraine share many similar characteristics in their countries and their HIV epidemics. In order to prevent the HIV/AIDS epidemic in Georgia from mirroring the epidemic in Ukraine policies must be changed. Aggressive policies need to be implemented to address drug use as a public health and not a criminal issue. Antiquated health care systems in both Georgia and Ukraine have hindered their government's ability to properly find, treat, and prevent new cases of HIV and must be modernize in order to prevent HIV from affecting their citizens.

Table of Contents

Table of Contents
I. Introduction...1

II. Methods...5

III. Results...7

a. HIV in Georgia...9

b. HIV in Ukraine...17

IV. Discussion...22

V. Policy Recommendations...25

VI. References...30

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	HIV Georgia Ukraine
Committee Chair / Thesis Advisor	Del Rio, Carlos, Emory University
Partnering Agencies	Non-US governmental agency (e.g., Minister of Health in Haiti)

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