Ukraine suffers from Europe’s worst HIV epidemic, with the infection rate growing at an alarming 33 percent yearly. Initially striking high-risk groups such as prostitutes and illegal drug users, the epidemic is now making inroads into the general population. Yet HIV prevention education efforts, hindered by limited resources, have lagged in reaching youth, rural residents and others. Services are often inadequate for people who seek HIV counseling and testing. And for those diagnosed with the virus, follow-up care and support are rarely available.

This Initiative will:

• • Strengthen and broaden HIV prevention education
• • Provide accessible and effective voluntary HIV counseling and testing
• • Extend care and support services for infected people

This multipronged approach, bringing together community members and proven local organizations, will change attitudes and behaviors among thousands of

people – curbing the spread of disease that threatens this struggling fledgling country.

Ukraine’s southern port city of Odessa – where illicit drug use, poverty and prostitution mesh to fuel the virus’ spread – has been hit particularly hard by HIV.
Odessa is a key gateway for Asian drug shipments to Europe, and drug use is the leading avenue by which HIV has spread in Ukraine. However, the percentage of sexually transmitted infections is rising dramatically.

Poverty drives rural villagers to Odessa seeking work, but rising unemployment in the city leads many to drug trafficking and prostitution. Tourism creates a growing demand for the illegal sex trade. Each summer, an estimated 6,000 rural girls and women converge on Odessa to work as prostitutes. Many who return home after the tourist season carry the HIV virus with them.

By strengthening local efforts where the needs are most critical – for instance, in rural areas and in under-equipped healthcare centers – this Initiative will stem the spread of HIV and provide critically needed support for people who are already infected.

With HIV virtually unknown in the country before the mid-1990s, Ukraine focused its initial response on educating high-risk groups such as prostitutes and intravenous drug users. Prevention efforts sidestepped the general public, especially in rural areas. Yet “the wider population is increasingly at risk,” a 2006 World Bank report says. “Potential catastrophic increases in HIV/AIDS ... are likely in the medium term if measures to curb the epidemic fail.”

Current prevention programs focus heavily on condom use to slow the spread of HIV – neglecting two key elements of the proven “ABC” strategy, which stresses abstinence and being sexually faithful to a single partner in addition to condom use.

Southern Ukraine’s healthcare infrastructure is weak, with staff at government facilities undertrained in HIV prevention and care. In Odessa,

government doctors typically refer people with HIV to nongovernmental organizations for care and support. Such services are virtually nonexistent outside the city.

This Strategic Initiative will enlist local leaders, proven organizations, healthcare providers and community members, and enable them to work together to turn back Ukraine’s AIDS epidemic.

Nadiya Loy, an 11th-grade student in Zhytomyr, Ukraine, says, “I used to believe that sleeping with people who I wanted to get something from was the only way to win the sympathy of my peers. These kinds of relationships and values were being built in our class.” She attended an HIV/AIDS lecture by a Ukrainian organization that received funding through Geneva Global. “It’s just incredible that your lecture affected me and my classmates so much,” she says. “A fundamental change took place in our relationships – almost everybody, including me, agreed to abstain from free sex. I have the desire to tell every student how wonderful it is to keep themselves for their husband or wife. Thank you. You’ve changed my life.”