CBC News Viewpoint
By Sara Newham
November 2, 2004
SourceWhen Natasha caught her mother disinfecting the dishes at their family home one day, she was instantly hurt. Natasha, 33, is HIV-positive.
"My mother started crying. She said she knew nothing about HIV," Natasha recalled.
A former alcoholic and injecting drug user, Natasha contracted HIV eight years ago through a contaminated needle.
She became an alcoholic at 18 when she started working as a waitress in a bar in the small city of Poltava in eastern Ukraine. A few years later she began injecting opium while living with her younger brother, also an injecting drug user. "Alcohol was not enough," she said. "I decided to change something. I found another way of being included in life. I was a drug addict for five years." She contracted the virus two or three years after beginning her drug use. At the time, she thought HIV and AIDS was a problem in Africa, not in Ukraine.
Today HIV and AIDS is the top health issue confronting Ukraine.
With an estimated 360,000 people living with HIV or AIDS – about 1.4 per cent of the population between the ages of 15 and 49 – Ukraine has the highest rate of HIV/AIDS prevalence in Europe. By comparison in 2003 Health Canada estimated that 56,000 Canadians are living with the disease, about 0.2 per cent of the total population of Canada.
Young people, between 15 and 29, account for about 80 per cent of HIV cases in Ukraine and the majority of HIV-positive patients in the country are injecting drug users and their sexual partners. An additional concern is that the number of women - and the children born to them - infected with the disease has been growing since 1999. Southern Ukraine is the worst affected area and accounted for 75 per cent of all people living with HIV/AIDS in Ukraine at the end of 2003.
Unprecedented economic, social, and political change is one of the fundamental reasons Ukraine finds itself in this situation. The effects of these changes have exacerbated Ukraine's vulnerability to the spread of the disease and reduced society's ability to respond.
Problems such as a growing illegal drug trade, socio-economic decline, family disintegration, an increase in risky sexual behaviour among youth, and the deterioration of the educational system; have all contributed to the spread of the virus. Add to this, a discomfort among women in negotiating condom use with their partners and traditional taboos about sexuality, and you have created the conditions for the general HIV epidemic facing the country today.
One of the biggest challenges in dealing with HIV and AIDS in Ukraine is the lack of correct information and education about the virus: how it is transmitted, steps to avoid infection, vulnerable groups, how to help those who are living with it. The lack of information contributes both to the spread of the virus and to the stigma suffered by those who live with HIV and AIDS.
This stigma has proven to be one of the greatest barriers to an effective national response.
Although Natasha has a strong support network of friends and family, many HIV-positive people in Ukraine do not. Instead, they face isolation and/or ostracism from family and friends, discrimination from health care workers, dismissal from a job or conditions that force them to quit, and discrimination from neighbours.
Earlier this year, the All-Ukrainian Network of People Living with HIV/AIDS, a non-governmental organization, moved offices when they were not permitted to use the common elevator in the building because other residents feared that they or their children would be infected if an HIV-positive person breathed on them while in the elevator together.
Because of this and other types of discrimination - as well as a fear that their information is not kept confidential - many of those infected with the disease do not register their HIV status so the number of actual registered cases is only 70,000.
The lack of correct information and/or access to services also prevents some at-risk or HIV-infected people from getting tested.
Thus, the prognosis for the spread of the disease is bleak. Even in the best case scenario, more than 43,000 Ukrainians will die and more than 46,000 children will have been orphaned because of AIDS by 2010. Under the worst-case scenario, about 1.5 million people will become infected and nearly 100,000 people will die because of AIDS in the next five years.
National and international orginizations and the Ukrainian government are involved with numerous HIV/AIDS-related initiatives as part of the country's national response to the disease. Progress has been achieved, but there is still more work to be done.
Natasha says that HIV-positive people can help themselves more than they think.
"For people who have an incurable disease, they have two possible ways of living. The first way is to stigmatize oneself. The second way is to live a wonderful life, enjoying every moment."
This second way is how Natasha has chosen to live.
She moved to Kiev a year ago to further her career as the Regional Coordinator at the All-Ukrainian Network of People Living with HIV/AIDS. She lives with an HIV-negative man whom she hopes to marry and she has no regrets. She leads a different life now than she did eight years ago when she was angry about what happened to her and believed she had only one or two years left to live. Now she looks at life with a little bit of optimism.
"The last 33 years have made me the person I am. If in my life there was no alcohol, no drugs, and no infection, I would not be the person I am today," she said. "Now I'm trying to do things to leave a good memory of my life and my work and not to be forgotten."
Copyright © CBC 2005
Sara Newham is a freelance journalist currently working with the United Nations Development Programme in Kiev, Ukraine. She has previously reported for the Victoria Times Colonist and the Nelson Daily News. She has a master's degree in journalism and a BA in international relations from the University of British Columbia.