HIV/AIDS prevalence in the Southern Caucasus.

According to statistics, Armenia, Azerbaijan and Georgia, are the countries with low prevalence of HIV (<0.3%). Yet the dramatic almost nine fold increases in registered HIV cases in the region between 2000 and 2008 (from 574 to 5323) remain a cause for serious concern. This report summarizes and compares the latest data on the epidemiology of HIV/AIDS in Southern Caucasus: Armenia, Azerbaijan and Georgia. It also provides a comparison with HIV/AIDS situation in Eastern Europe. The work is mainly based on the review of UNAIDS 2010 country progress reports and end-year reports of HIV/AIDS Surveillance in Europe. Tables and graphs have been created to summarize the obtained information and to improve the analysis. Trends in HIV/AIDS spread in Southern Caucasus are similar to trends in Eastern Europe: the number of HIV and AIDS cases continues to increase. The vast majority of people living with HIV/AIDS were aged 25-49-years at the time of diagnosis. The official information confirms that the epidemic in Southern Caucasus remains located among males (with 83.8% in Azerbaijan, 75% in Georgia, and 73% in Armenia) and most-at-risk populations. In Georgia and Azerbaijan, as in Eastern Europe, the predominant mode of transmission is through injecting drug use (58.8% and 64.2%, respectively), while in Armenia over the last several years the transmission has shifted from injecting drug use to heterosexual spread (50.2%). The second reported mode of transmission in Georgia and Azerbaijan is unprotected heterosexual activity (34.9% and 23.4%, respectively). Medical transmission, mother to child transmission, and transmission among men who have sex with men are rare, typically comprising less than 3% of total registered transmission in each country of the region. As UNAIDS contends the prevalence values are underestimated, and the registered numbers of HIV/AIDS cases in the region do not reflect the actual spread of the infection. There is also a substantial discrepancy between the cumulative number of HIV/AIDS cases reported in the national case reporting systems and the HIV prevalence reported in surveys (high prevalence observed in IDUs in Armenia and Azerbaijan, and in MSM in Georgia). In the context of such underreporting, population-based and community-based HIV surveys have far better public health utility in estimating burden of HIV/AIDS than the case reporting system.