Start Date:  Oct 2003   End Date:  Oct 2004   Status: Completed

Central Asia has been confronting four overlapping epidemics - drug use, sexually transmitted infections (STIs), HIV/AIDS and tuberculosis (TB). The drug use, HIV/AIDS and STIs epidemics are mainly among young adults, while the TB epidemic affects adults in their more economically productive years. Although the number of reported cases of HIV in Central Asia is still very low, the growth rate of the epidemic - from about 500 cases in 2000 to over 12,000 in 2004 - is a cause for serious concern. Central Asia lies along the drug routes from Afghanistan to Russia and Western Europe, and it is estimated that it has half a million drug users, of which more than half inject drugs. The majority of users are men under 35, although drug use is increasing rapidly among women. However, HIV infection incidence and prevalence are estimated to be several times higher than reported figures. The lack of accuracy in reporting stems from the lack of proper diagnostic systems and the absence of an efficient surveillance system.

Current and future epidemic outbreaks of HIV throughout the region may continue to be driven by a) the explosive growth in injecting drug and commercial sex work use; b) concurrent epidemics of sexually transmitted infections (STIs); c) economic and political migration; d) limited capacity of governments and civil society to implement effective preventive responses; and e) low levels of awareness of HIV and STIs and of knowledge about risk practices and protection. These conditions arise from economic decline since independence, as well as high volumes of illicit drug transit through the region and growth of local consumer markets for these drugs.