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VIENNA (Reuters) - An underground HIV epidemic in Eastern Europe and Central Asia is building at an alarming pace, fuelled by drug use, risky sex and severe social stigma that stops people asking for help, the United Nations said on Monday.
In a report published at an international conference on AIDS, the U.N. children's fund UNICEF said health and social services in the region do little for young people at high risk of HIV, who are instead subject to judgement, recrimination and even prosecution if they seek treatment or information on HIV.
The incurable human immunodeficiency virus (HIV) that causes AIDS is now spreading faster in Eastern Europe and Central Asia than anywhere else in the world.
According to UNAIDS, the prevalence of HIV in the region has risen by 66 percent since 2001, bringing the number of people living there with HIV to 1.5 million in 2008. The rate of spread means that during the six-day Vienna AIDS conference, another 3,000 people in the region will become infected with HIV.
UNICEF said it had had reports of increases in HIV prevalence of up to 700 percent in five regions of Russia. In Ukraine HIV rates of 1.6 percent of the general population are the highest in Europe and experts say Central Asian countries are the new hot-spots of rapidly increasing HIV transmission.
Anthony Lake, UNICEF's executive director, said efforts to contain this rapid spread were being thwarted by harsh political and social attitudes, particularly to the 3.7 million injecting drug users in the region who are at very high risk of HIV.
"Children and adolescents living on the margins of society need access to health and social welfare services, not a harsh dose of disapproval," he said in commentary with the report. "We need to build an environment of trust and care, not one of judgement and exclusion."
About 33.4 million people worldwide are infected with HIV. Since AIDS emerged in the 1980s, almost 60 million people have been infected with it and 25 million have died. Drug users can spread HIV by sharing needles with an infected person.
UNICEF said authorities in Eastern Europe and Central Asia needed to set up non-judgmental services to address the needs of marginalised people such as drug addicts and prostitutes.
Its report pointed to a few examples of success: In Russia, for example, more than 100 youth-friendly HIV service facilities have been established, it said, to provide sexual health services, information, counselling and psychological support.
And in Tajikistan a centre set up to promote HIV prevention and treatment is breaking down barriers and reaching young women who sell sex. It quoted one client as saying:
"In the beginning, I did not believe that the medical check-up, the treatment and condoms would really be free of charge and anonymous. I thought it was another trap by the police. I agreed to go there with an outreach worker for the first time, but now I go there alone and encourage my friends to use the service as well."
UNICEF said another recent U.N. study of six countries in the region showed that many adults living with HIV fear the social stigma of seeking treatment more than they fear the disease -- a factor it said was "driving the epidemic further underground."