THE HIV EPIDEMIC IN EASTERN EUROPE AND CENTRAL ASIA
I. Introduction:
While there is increasing evidence that HIV incidence is in decline among general populations worldwide Eastern Europe and Central Asia are notable exceptions For example HIV infections have increased 13% in the region since 2006 [2] .
A several factors contribute to these rising rates. [3]. First, the political transition in the early 1990s led to substantial economic dislocations as well as an expansion of informal and criminal economies. Second, a highly structured public health system rooted in the Soviet tradition has been unable to effectively transition to meet post-Soviet challenges. Finally, there have been dramatic increases in injection drug use (IDU), associated with an incease in opiate smuggling from the Central Asian state of Afghanistan.
Initially the HIV epidemic in the region was driven by people who inject drugs (PWIDs). However, while risk factor profiles vary substantially between countries of the region [7], surveillance data suggest heterosexual transmission has now become the leading mode of HIV transmission in this region.
Nonetheless, substance use remains an important driver of new infectoins. . Implementation of known interventions to reduce transmission in IDUs has been impeded by challenges in scaling up opioid substitution therapy (OST) as well as other harm reduction efforts such as needle exchange. The use of OST is illegal in Russia and access to these
Nearly three decades ago, there was an increase in deaths of HIV in sub-Saharan Africa. Developing countries have experienced the greatest HIV/AIDS morbidity and mortality, with the highest prevalence rates recorded in young adults in sub-Saharan Africa. In South Africa over three million people are killed by this disease (Macfarlene3). After this epidemic spreaded in Africa and killed people it branched out to other countries in the world.
Opioids are taking over the United States with its addictive composition, once patients are take opioids there is no escaping. The drug directed from opium which is obtained from a plant (Katz). Opioids are most commonly found in prescription pill from making underground sales more common. Since opioids are derived from a plant this makes the reality of home grown drugs more of an issue. American citizens overdosing on opioids is what is sparking the crisis because opioid “overdoses killed more people last year than guns or car accidents” (Katz). Opioids are extremely addictive and that is why so many citizens overdose on these types of drugs. After patients become hooked on opioids their body constantly is needing more and more opium to escape they pain they think they are enduring. The overdosing of Americans is not a small percentage of the population either, it is estimated that “over two million people in America have problem with opioids” proving this growing issue is an ongoing crisis (Katz). The United States government needs to take action immediately to the opioid crisis because doctors are overprescribing patients because they seemingly overreact to pain, and opioids are one of the most addictive drug types in the world.
There have been several news coverages on TV and social network about drug overdose of different cases recently and they have risen people’s concern about the problems of drug abuse national-wide. The drug abuse and opioid epidemic is not a new problem to the American society, actually it has been a serious problem for many years. So what is the situation of drug epidemic now, and how can we find effective ways to deal with this problem? A few writers who ponder this question are Nora D. Volkow, Dan Nolan and Chris Amico.
As the number of intravenous drug users continues to rise, so does the risk of dangerous and potentially fatal complications that are associated with illicit drug use. In this population, death rates are higher due to overdose, AIDs-related mortality, and other blood-borne viruses (Mathers et al., 2013). Mortality rates remain high even though precautions have been taken to reduce them. According to Lavender & McCarron (2013), “Mortality in injecting drug users is up to 22 times higher than for the age-adjusted population, despite increased provision of needle and syringe programs, reduced needle and syringe sharing, and higher uptake of hepatitis B vaccination” (p. 511).
Depending on the source, some would term the heroin and opioid problem in the United States a crisis, while others would use the word epidemic. Regardless of which expression is more accurate, the situation regarding heroin and opioid use, abuse and dependence has ignited national, if not global concern. History shows us that pervasive dilemmas have a tendency to cultivate a variety of intervention and the heroin and opioid crisis is no different.
Sharing of needles used by injection drug users contributes heavily to the spread of blood-borne diseases, accounting for almost one third of new HIV infections outside sub-Saharan Africa (Ball, 2007). Various studies support that blood-borne disease transmission and contraction are strongly linked to injection drug use. A study conducted by Semaan et al. that analyzed data of 10,301 persons who inject drugs in revealed that 32% had shared syringes during the 12 months prior (Semaan et al., 2011). A second study involving 309 injection drug users found HIV, hepatitis B and hepatitis C prevalence of 42.4%, 80.9%, and 74.1%, respectively. The study also revealed that 63.8% of the participants engaged in indirect sharing practices within six months prior.
Nonmedical Prescription-Opioid abuse in the United States and Michigan has continued to rise, and with it, the devastating results that accompany it. Research has shown that increased opioid abuse leads to an increase in overdose and death, increases in crime and increased incidences of costly blood borne diseases like HIV, AIDS and Hepatitis. It also leads to increased societal costs, such as an increasing number of children in foster care and increased healthcare, workplace and criminal justice costs that can decimate communities and local budgets. Many communities were caught with their heads in the sand, as they were overwhelmed by the influx of prescription opioids into their communities. When policies were finally implemented to curb the amount of prescription opioids in their communities, rates of heroin use (also an opioid) began to skyrocket and people began realizing they had an opioid epidemic on their hands. How to combat this heroin epidemic has been the topic of many debates. This article will attempt to examine the relationship of nonmedical prescription-opioid abuse and its effects on heroin use.
The opium epidemic is leading many Americans down a path that will ruin not only their lives but their loved ones also. “Safe Injections Sites” will only raise addiction rates and opium consumption in the United
In the US, according to CQ Researcher, the number of those that used heroin had more than doubled between the years of 2002 and 2004 and doubled again between 2011 and 2013. It is a growing issue especially due to
Social conflicts and struggles are an inevitable part of any society in any country. These struggles can include an increased rate in crime, unemployment, domestic/general violence, and overall civilian depression. When governments cannot seem to find a means to an end, they often turn and look for something to blame for their struggles, and that thing is more often than not, drugs. For many years, several opiates and drugs were primarily used for medicinal purposes, were seen to have an abundance of health benefits and was widely accepted among communities. Although, with the increasing social conflicts and economic conditions, authorities turned to and targeted many different forms of once accepted drugs, and made them the scapegoat for the problems they were facing.
Incarceration of individuals is rapidly rising and the “war on drugs” has targeted opioid addicted users with no other ways of treatment other than jail time. Opioids are widely used for people with legitimate problems and they're easy accessibility is making it possible for people of all ages and race to get a hold of. The crisis of opioid epidemic is only getting bigger along with the jail population. Anything from Xanax to Codeine can be easily attainable for the purposes of getting high. Another that is illegal however is heroin. Anyone and their addiction to opiates can lead them to being incarcerated possibly in the future. And this is a problem that needs to be addressed because these our the next generations we are talking about.
Tajikistan gained its independence from the Soviet Union in 1991 and in its short life has already seen considerable amounts of turmoil. When it was first declared a sovereign nation it was plunged very quickly in to civil war. The war led to a quick decline in the nation’s economy. This war crippled the nation leaving Tajikistan very weak in the June of 1997 when the war finally drew to a close. This civil war weakened Tajikistan’s legitimate economy and left many people to “rely on the revenues of illicit opiate trade”. Tajikistan is slowly recovering from the effects of becoming a new nation, plagued with war and drug problems early in its life, and this requires the government to find a way to end the drug usage and distribution problem that grips the country along with the corruption of the state in an attempt to improve the economy and living conditions of Tajikistan.
The African countries south of the Sahara have some of the best HIV surveillance systems in the world. They provide solid evidence that the HIV infection rate has stabilized at a relatively low level in Senegal and that the extremely high rates in Uganda have been reduced. However, in most sub-Saharan countries adults and children are acquiring HIV at a higher rate than ever before: the number of new infections in the
Sub-Saharan Africa is the region of the world that is most affected by HIV/AIDS. The United Nations reports that an estimated 25.4 million people are living with HIV and that approximately 3.1 million new infections occurred in 2004. To put these figures in context, more than 60 percent of the people living with the infection reside in Africa. Even these staggering figures do not quite capture the true extent and impact that this disease causes on the continent. In 1998, about 200,000 Africans died as a result of various wars taking place on the continent. In that same year, more than 2 million succumbed to HIV/AIDS (Botchwey, 2000).
HIV is a virus that is spread almost all over the world. Although in some places health care isn’t as developed and therefore it spreads more in those regions. Sub-Saharan Africa holds more than 70%, 25 million, of all HIV positive people in the world. Second highest is Eastern Europe together with Central Asia with 1.3 million. It is spread over most of the world, including Asia and the Pacific, the Caribbean, Central and South America, North Africa and the Middle East and Western and Central Europe (“The Regional Picture”).