Eastern Europe and Central Asia is one of only two regions where overall HIV prevalence has not declined in recent years. The 19,000 new HIV infections among people aged 15–24 in 2017 was only about 9 per cent smaller than the 2010 figure, as opposed to other regions where reductions up to 25 per cent have been observed. Adolescents’ vulnerability is also signalled by a region-wide ART coverage rate of just 37 per cent among all people living with HIV over the age of 14, a rate far below the global one of 59 per cent. The full extent and consequences of the lack of effective, quality HIV prevention and treatment services for adolescents are unknown because many countries do not publish HIV estimates.
Although most HIV epidemics in the region are becoming more general in nature, key populations remain the most affected. The risks and vulnerabilities associated with adolescents overall are even greater among those who belong to one or more key population groups, because they face multiple barriers to essential prevention and treatment services due to punitive laws, discrimination and stigma around behaviours such as illicit drug use and certain kinds of sexual activity.
Late HIV testing is a key challenge throughout the region. Although infections tend to occur as a result of behaviours initiated during adolescence, the HIV diagnosis tends to be established at a later stage. Many countries fail to recognize that raising awareness among young people and offering them better access to early HIV testing are critical.
The impact can be seen, for example, in estimates of HIV prevalence exceeding 5 per cent among two groups of people younger than 25: in Ukraine, young men who have sex with men, and in Kazakhstan, people who inject drugs, including young pregnant women. Halting overall HIV epidemics throughout the region requires targeted prevention and treatment interventions that aim to expand safe and consistent access to essential HIV services among such highly vulnerable populations.