Influence of social changes on the evolution of HIV infection in Romania.

The Romanian HIV epidemic started and evolved as a paediatric one, accounting for more than a quarter of the total European juvenile AIDS cases. In response to this major AIDS outbreak, emphasis was placed on the patient's treatment, by implementation of a free, universal access program of Highly Active AntiRetroviral Therapy. This approach has been highly successful, and has greatly increased the rate of survival in infected children. Nevertheless, these children are now teenagers or young adults, representing a large cohort of "long term survivors"- a unique population that represent a great challenge for the public health system and for their integration in the civil society. As the number of HIV infected adults is increasing, new high-risk behaviour groups, as well as vulnerable populations (young people, people living in poverty, Rroma community) need to be reached in prevention programs. This article explores the impact of the socio-economic changes on the evolution of the HIV epidemic in Romania and speculates about the factors that might drive future increases in the incidence of HIV infections.