1

2 Global HIV prevalence in adults, 1985 UNAIDS/WHO, 2006

3 Global HIV prevalence in adults, 1995 UNAIDS/WHO, 2006

4 Global HIV prevalence in adults, 2005 UNAIDS/WHO, 2006

5 Global estimates for adults and children, 2006 People living with HIV39.5 million New HIV infections in million Deaths due to AIDS in million Source: 2006 Report on Global AIDS Epidemic - UNAIDS

6 Adults and children estimated to be living with HIV, 2005 Total: 38.6 (33.4 – 46.0) million Western & Central Europe [ – ] North Africa & Middle East [ – ] Sub-Saharan Africa 24.5 million [21.6 – 27.4 million] Eastern Europe & Central Asia 1.5 million [1.0 – 2.3 million] South & South-East Asia 7.6 million [5.1 – 11.7 million] Oceania [ – ] North America 1.3 million [ – 2.1 million] Caribbean [ – ] Latin America 1.6 million [1.2 – 2.4 million] East Asia [ – 1.1 million]

7 Source: 2006 Report on Global AIDS Epidemic - UNAIDS

8 Estimated number of adults and children newly infected with HIV, 2005 Total: 4.1 (3.4 – 6.2) million Western & Central Europe [ – ] North Africa & Middle East [ – ] Sub-Saharan Africa 2.7 million [2.3 – 3.1 million] Eastern Europe & Central Asia [ – ] South & South-East Asia [ – 2.3 million] Oceania7200 [3500 – ] North America [ – ] Caribbean [ – ] Latin America [ – ] East Asia [ – ]

9 Source: 2006 Report on Global AIDS Epidemic - UNAIDS

10 Estimated adult and child deaths from AIDS, 2005 Total: 2.8 (2.4 – 3.3) million Western & Central Europe [<15 000] North Africa & Middle East [ – ] Sub-Saharan Africa 2.0 million [1.7 – 2.3 million] Eastern Europe & Central Asia [ – ] South & South-East Asia [ – ] Oceania3400 [1900 – 5500] North America [ – ] Caribbean [ – ] Latin America [ – ] East Asia [ – ]

11 Source: 2006 Report on Global AIDS Epidemic - UNAIDS

12 Over new HIV infections a day in 2005 More than 95% are in low and middle income countries About 1500 are in children under 15 years of age About are in adults aged 15 years and older of whom: — almost 50% are among women — over 40% are among young people (15-24) Source: 2006 Report on Global AIDS Epidemic - UNAIDS

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14 Prevalence of HIV Infection per 100,000 by Region – Ukraine, 2006 (based on the official case reporting) Source: Ukrainian AIDS Center, Jan 2007

15

16 Newly registered HIV infections by sex and place of residence – Ukraine, 2005

17 Source: Ukrainian AIDS Center, 2006 Number of HIV-positive cases among injecting drug users – Ukraine, June 2006

18 Intravenous Drug Use From mother to child Sexual Transmission Undetermined Source: Ukrainian AIDS Centre, 2005 Modes of Transmission of HIV-Infection – Ukraine,

19 Source: Ukrainian AIDS Center, 2006 Proportion of HIV-infected women and children born to women with HIV (%) – Ukraine,

20 Percentage of schools with teachers who have been trained in life-skills-based HIV/AIDS education and who taught it during the last academic year was 55% in Percentage of large enterprises/companies that have HIV/AIDS workplace policies and programs was 0% in Percentage of HIV-infected pregnant women receiving a complete course of ARV prophylaxis to reduce the risk of MTCT was 86% in Source: UKRAINE - National Report on the Follow-up to the UNGASS Declaration of Commitment on HIV/AIDS (2005) Assessing Ukraine’s National Response to HIV/AIDS: Ukraine’s 2006 UNGASS Report (Prevention)

21 Percentage of young people aged who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about HIV transmission was 23% in 2004 (Target: 90% by 2005; 95% by 2010). Percentage of young people aged years reporting the use of a condom during sexual intercourse with a non-regular sexual partner was 69% in Percentage of IDUs who have adopted behaviors that reduce transmission of HIV was 20% in Assessing Ukraine’s National Response to HIV/AIDS: Ukraine’s 2006 UNGASS Report (Knowledge Level / Behavior) Source: UKRAINE - National Report on the Follow-up to the UNGASS Declaration of Commitment on HIV/AIDS (2005)

22 Association of HIV/AIDS with behaviours that may be considered socially unacceptable by many people Stigma and discrimination constitute one of the greatest barriers to dealing effectively with the epidemic –They discourage governments from acknowledging or taking timely action against AIDS –They deter individuals from finding out about their HIV status and seek support and care –They inhibit those who know they are infected from sharing their diagnosis and taking action to protect others and from seeking treatment and care for themselves Strong movement of people living with HIV that affords mutual support and a voice at local and national levels is particularly effective in tackling stigma. The presence of treatment makes this task easier too Stigma and discrimination

23 Scenario/ OutcomeOptimisticPessimistic Number infected with HIV, thous Adult prevalence rate, %1,93,5 New annual HIV infections, thous.2994 Cumulative number of those needing ARV treatment, thous New annual AIDS cases, thous.3767 Annual AIDS deaths, thous.3565 Cumulative AIDS deaths, thous Life expectancy, yrs Total Male Female 68,5 63,4 72,9 66,7 61,6 71,0 Total population, mil.43,943,7 Summary of scenario outcomes for progression of HIV/AIDS Epidemic in Ukraine, 2014 Source: World Bank and International HIV/AIDS Alliance, Socioeconomic Impact of HIV/AIDS Epidemic in Ukraine, 2006

24 Impact on labour force: Estimated to be an 11.6% reduction by 2014 due to the demographic decline Additional reduction in labor force participation is caused by the HIV/AIDS –An 1–2 % reduction in 2014 on the national level; –Much higher reduction in the worst affected regions, i.e. 2.7–3.6 % in Donetsk oblast and 2.2–4.2% in Odesa oblast Impact on budget: Additional annual HIV/AIDS treatment expenditure including ARV will reach 630 mln UAH Annual budget revenue losses through unpaid taxes and levies (pension fund and social security fund covering temporary disability and unemployment) may reach 418 mln UAH Modelling Macroeconomic Impact of HIV/AIDS Epidemic in Ukraine (1) Source: World Bank and International HIV/AIDS Alliance, Socioeconomic Impact of HIV/AIDS Epidemic in Ukraine, 2006

25 Main mid-term effects: (by 2014 with AIDS, compared to the no-AIDS baseline scenario): 1-6% reduction in the level of output (GDP in constant prices); 2-8% reduction in total welfare; 1-9% reduction in investment; and 3-9% reduction in total exports labour-intensive sectors whose labour inputs suffer from the epidemic are among the worst affected –Production of non-energy materials –Metallurgy and metal processing Source: World Bank and International HIV/AIDS Alliance, Socioeconomic Impact of HIV/AIDS Epidemic in Ukraine, 2006 Modelling Macroeconomic Impact of HIV/AIDS Epidemic in Ukraine (2)

26 Key Audience - Young people (1) Why Youth in school are easy to reach, and accessible in large number Youth are a powerful prevention resource in their own right Changing behaviour and attitudes is easier if started before patterns are formed In addition, in generalised epidemics, 40% all new HIV infections occur in ages 15-24, girls and young women are disproportionately affected, making them another top priority for HIV prevention What HIV and gender issues included in school curriculum Address gender power imbalances with life skills building for boys and girls Comprehensive and appropriate sex education Access to youth friendly health services and HIV counselling and testing Removal of legal barriers to access prevention and care Involve parents and adults in community in school-based HIV prevention activities Mass media campaign to raise awareness, promote public debate, reduce stigma

27 Differences between epidemic stages Low ― include HIV and gender issues into school and teacher training curricula Concentrated ― focus on most at risk young people Generalised (medium and high) ― comprehensive life skills programme for all young people, focus on addressing gender power inequity, reducing number of partners and delay of sexual debut Mass media campaign to raise HIV awareness including vulnerability of girls, reduce stigma and school based programmes in all epidemic stages How School based programmes Access to out of school youth through youth clubs, workplace programmes etcetera Mass media and social mobilization Key Audience - Young people (2)

28 Ukraine has most intense AIDS epidemic in Europe Epidemic affects mainly youth and continues to progress among and beyond at-risk populations Coverage and intensity of most existing programmes are not having impact on epidemic AIDS will have significant and growing socio-economic impact in Ukraine Conclusion: Key Messages

29 To defeat HIV and AIDS, we need to reduce the number of people who become infected Prevention is still the only “cure” we have for HIV/AIDS and needs to be intensified Community and youth (especially at risk) based prevention efforts need to be urgently intensified All and everyone need to get involved ! Conclusion: Key Messages (cont.)

30 Thank you! Дякую!