Europe

Like the USA, most Western and Central European countries have greatly reduced the rate of HIV transmission in medical settings (through blood screening and universal precautions) and from mother to child (through routine screening, use of preventive drugs and avoidance of breastfeeding). Countries that have implemented comprehensive harm reduction programmes, such as the UK, Germany and the Netherlands, have also maintained a very low rate of infection among injecting drug users. In some cases, the mass media have been used to reach the general population - for example in the UK's "Iceberg" and "Tombstone" campaigns, which were launched in 1987.

Yet despite these successes, the rate of new HIV diagnoses in Europe has risen over recent years. In the UK, the number more than doubled between 1999 and 2003. Although most of those diagnosed acquired their infections in Africa, the rate of transmission within the UK also appears to be rising.¹¹ To arrest this trend, campaigners are calling for better sex education in schools, greater resources for sexual health clinics, and more HIV prevention in the UK targeted at the most vulnerable groups, including immigrant communities.

In Eastern Europe, Ukraine is experiencing an extensive and rapidly expanding HIV epidemic. Most infections are among injecting drug users, but the virus is rapidly spreading from these people to their sexual partners and onwards to the rest of the population. Around 1.4% of Ukrainian adults were living with HIV at the end of 2005 – the highest rate in Europe.¹² Ukraine has one of the most developed harm reduction programmes in the region with over 350 needle exchanges and it has offered opioid substitution therapy since 2004.¹³

Though there are still barriers to accessing HIV prevention in Ukraine, it is a vastly better picture compared to Russia, another country where injecting drug use is driving the HIV epidemic. Little over 60 needle exchanges serve an IDU population of up to 2 million and substitution therapy is illegal.¹⁴