HIV/AIDS in Southeastern Europe : Case Studies from Bulgaria, Croatia, and Romania

In June 2002, the countries of Southeastern Europe (SEE) recommitted themselves to scale up action on the prevention and treatment of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Given the rapid increase in the rate of HIV infection in Eastern Europe in general, and the generally similar risk conditions for low HIV prevalence SEE populations, this commitment is timely in terms of preventing a more widespread epidemic. It should also be recognized by the World Bank as a call to action to support these countries through the application of its comparative advantage in both lending and non-lending activities. The purpose of this paper is to review the current status of the AIDS epidemics in three countries of the Sub-region (Bulgaria, Croatia, and Romania - which constitute the ECC05 Country Department of the World Bank), to evaluate the approaches and strategies currently being used in each country, and to make recommendations both for government strategies and for the Bank's current and potential future involvement in relation to these strategies. The current low levels of HIV infection in SEE present a challenge in gaining recognition of the potential impact of HIV/AIDS on health systems, social structures, and individuals. Moreover, the approach to HIV/AIDS in SEE is complicated by relatively high levels of stigma against vulnerable groups (intravenous drug users [IDU], commercial sex workers [CSW], ethnic minorities such as the Roma, mobile populations, and men who have sex with men [MSM]).