Our objective is to describe recent patterns and trends in HIV and injecting drug use and to explore possible determinants of the epidemics in eastern Europe. The available data confirm a rapid spread of HIV among injecting drug users (IDUs) in the newly independent states (NIS) and suggest that all successor states of the former Soviet Union are now threatened by such epidemics, while central and southeast Europe have so far been spared from large-scale outbreaks and seem at lower risk. The future course of the epidemic in the NIS will largely depend on trends in drug injecting and on the success of harm reduction programs. Furthermore, there is potential for the further spread of HIV, via heterosexual intercourse, into the general population.
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References
1.
AgarM.H.1977Into that whole ritual thing: Ritual drug use among urban American heroin addicts. In Drugs, Rituals and Altered States of Consciousness, ed. DuToit, 137–48, Rotterdam: Balkema.
2.
AlcabesP.BeniowskiM.BożekE.ZielińskiA.GrundJ.-P.C.WilliamsA.1999AIDS in Poland: Epidemic paradigm for the new frontier. Unpublished manuscript.
3.
AndreevaT.KrasovskyK.1999Public attitude influence as part of harm reduction projects in post-soviet countries. Tenth International Conference on the Reduction of Drug-related Harm, March, Geneva.
4.
AngaranoG.PastoreG.MonnoL.1985Rapid spread of HTLV III infection among drug addicts in Italy. Lancetii:1302.
5.
BallA.RanaS.DehneK.L.1998HIV prevention among injecting drug users: Responses in developing and transitional countries. Public Health Reports113 (Suppl 1): 170–81.
6.
BarnettT.WhitesideA.KhodakevichL.KruglovY.SteshenkoV.1997The social and economic impact of HIV/AIDS in Ukraine. Kiev: British Council.
7.
BastosF.StimsonG.V.TellesP.BarcellosC.1998Cities responding to HIV-1 epidemics among injecting drug users. In Drug Injecting and HIV Infection: Global Dimensions and Local Responses, ed. StimsonG.V.Des JarlaisD.BallA., 149–67, London: University College London Press.
8.
BeniowskiM.BożekE.MosiadzM.1997From AIDS to harm reduction initiatives in Poland (Katowice district). International Conference on the Reduction of Drug-Related Harm, March, Paris.
9.
Bezruchenko-NovachukM.RomantsovV.1998Sentinel surveillance conducted within the frame of the project of HIV prevention among IDUs in the town of Svertlogosrk, Gomel region, Belarus (abstract 43467). Twelfth World Conference on AIDS, July, Geneva.
10.
BirtanovY.AkhetovA.1999Drug consumption and perspectives of harm reduction in Kazakstan. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
11.
BobakM.PikhartH.HertzmanC.RoseR.MarmotM.1998Socio-economic factors, perceived control and self-reported health in Russia: A cross-sectional survey. Social Science and Medicine47: 269–79.
12.
BobkovA.KazennovaE.SelimovaL.BobkovaM.KhaninaT.LadnaiaN.KravchenkoA.PokrovskyiV.Cheingsong-PopovR.WeberJ.1998A sudden epidemic of HIV type 1 among drug injecting users in the former Soviet Union. AIDS Research and Human Retroviruses14: 669–76.
13.
BolekhamV.ZmushkoE.L.1998Home-made drugs as an active factor of HIV-transmission in Russia (abstract A23186). Twelfth World Conference on AIDS, July, Geneva.
14.
BrettleR.P.1986Epidemic of AIDS related virus infection among intravenous drug abusers. British Medical Journal292:1671–77.
15.
BrunetJ.B.1996Report on visit to Russia. Saint-Maurice, France: European Centre for the Epidemiological Monitoring of AIDS, December 2–10.
16.
BurnsS.M.BrettleR.P.GoreS.M.1998The epidemiology of HIV infection in Edinburgh related to the injecting of drugs: A historical perspective and new insight regarding the past incidence of HIV-infection derived from retrospective HIV antibody testing of stored samples of serum. Journal of Infections32:53–62.
17.
BurrowsD.RhodesT.TrautmannF.BijlM.StimsonG.V.SarankovY.BallA.FitchC.1998HIV associated with drug injecting in Eastern Europe. Drug and Alcohol Review17:452–63.
18.
ChaissonR.E.MossA.R.OnishiR.OsmondD.CarlsonJ.R.1987Human immunodeficiency virus infection in heterosexual intravenous drug users in San Francisco. American Journal of Public Health77: 169–72.
19.
ChaplinskasS.RackieneJ.1998Harm reduction programs in incarceration departments. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
20.
CorniaG.A.1997Labour market shocks, psychosocial stress and the transition's mortality crisis. Research in Progress 4 Working Paper, United Nations University World Institute for Development economics Research. Helsinki: UNU/WIDER.
21.
CroftsN.ReidG.DeanyP.1997Injecting drug use and HIV infection in Asia. AIDS12 (suppl)B1: S69–78.
22.
CurtisR.SviridoffM.1994The social organization of street level drug markets and its impact on the displacement effect. In Crime Displacement: The Other Side of Prevention, ed. MacNamaraR, East Rockaway, NY: Cummings and Hathaway.
23.
CurtisR.1996The war on drugs in Brooklyn, New York: Street-level drug markets and the tactical narcotics. Ph.D. diss., Teachers College, Columbia University.
24.
DehneK.L. ed. 1998The determinants of the AIDS epidemic in eastern Europe. Report from Monitoring the AIDS Pandemic (MAP), Geneva: UNAIDS.
25.
DehneK.L.KhodakevichL.HamersF.F.SchwartländerB.1999The HIV/AIDS epidemic in eastern Europe: Recent patterns and trends and their implications for policy-makingAIDS13: 741–49.
26.
DehneK.L.KrupaM.BeniowskiM.FitzSimonsD.1996Report of the external review of the national programme for the prevention of HIV-infections and for the care of people living with HIV and AIDS, 23–30 November, Ministry of Health and Social Welfare. Warsaw:UNDP. Geneva: UNAIDS.
27.
DehneK.L.1999Presentation on HIV in central Europe. Proceedings of 5. Mezinarodni seminar, AIDS, 1996: 9–12,22 November, Podebrady, Czech Republic.
28.
de JongW.1998aInjecting drug use and HIV in the Republic of Georgia: Report on a rapid assessment mission to Tbilisi and Batumi. Utrecht: Trimbos Instituut.
29.
de JongW.1998bAIDS prevention in Odessa. Report on the harm reduction and AIDS prevention programme for injecting drug users, Odessa, 19–21 October. Geneva: UNAIDS.
30.
de JongW.B.LazorenkoAdamianR.BuselA.KhodakevichL.KiunovV.KumarS.WeilerG.1999Rapid assessment and response on IDU and HIV in Central Asia. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
31.
Des JarlaisD.C.FriedmanS.R.SotherhanJ.L.WenstonJ.MarmorM.YankovitzS.1994Continuity and change within an HIV epidemic: Injecting drug users in New York City, 1984 through 1992. Journal of the American Medical Association271:121–27.
32.
Des JarlaisD.C.PerlisT.FriedmanS.R.1998Declining seroprevalence in a very large HIV epidemic: Injecting drug users in New York City, 1991–1996. American Journal of Public Health88:1801–06.
33.
DonovanM.D. ed. 1996The New Professional Chef. New York: Van Nostrand Reinhold.
34.
DornN.MurjiK.SouthN.1992Traffickers: Drug Markets and Law Enforcement. New York: Routledge.
35.
European Centre for the Epidemiological Monitoring of AIDS1995AIDS cases reported by 31 December 1995. HIV/AIDS Surveillance in Europe: Quarterly Report48:8–11.
36.
European Centre for the Epidemiological Monitoring of AIDS1999Report of the second meeting of the working group for the technical recommendations on the European HIV case reporting system, 24–25 June, Saint-Maurice.
37.
FormenkoP.1999Effective prevention of HIV infection among injecting drug users. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
38.
GromykoA.1996Sexually transmitted diseases in Eastern Europe: A call for help. Entre Nous33:7–8.
39.
GrundJ.-P.C.BurrowsD.1999Preparation and use of injectable opium in Eastern Europe, Central Asia and Newly Independent States. Workshop. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
40.
GrundJ.-P.C.VerbraeckH.OffnerP.1999Drug use in Roma communities in central and eastern Europe: Implications for community health and public policy. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
41.
GrundJ.-P.C.1998Není všeobjímajících rešení: Potreba inovace a poucené debaty o drogové politice, In Kolektiv Autoru: Drogy na predpis - lékarská preskripce narkotik. Vedecké podklady a první zkušenosti, 356–89, Olomouc, Czech Republic: Votobia Publishers and Open Society Fund Praha.
42.
GrundJ.-P.C.CoffinP.O.1997Inovativna politika kot odgovor na porajajoce se probleme v zvezi z drogami in AIDS-om v Srednji in Vzhodni Evropi: Paradigma zmanjsevanja skode. Revija MREZA DROGV(2–4): 8–19.
43.
GrundJ.-P.C.1997Developing harm reduction policies in response to drugs and AIDS problems in central and eastern Europe. Eighth International Conference on the Reduction of Drug-Related Harm, March, Paris.
44.
GrundJ.-P.C.FriedmanS.R.SternL.S.JoseB.NeaigusA.CurtisR.Des JarlaisD.C.1996Drug sharing among injecting drug users: Patterns, social context, and implications for transmission of blood-borne pathogens. Social Science and Medicine42(5): 691–703.
45.
GrundJ.-P.C.HeckathornD.D.BroadheadR.S.AnthonyD.L.1995In Eastern Connecticut, IDUs purchase syringes from pharmacies but don't carry syringes. [letter]Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology10(1):104–05.
46.
GrundJ.-P.C.NolimalD.1995A heroin epidemic in Macedonia: Report to the Open Society Institute, New York and the Open Society Institute, Macedonia. New York: The Lindesmith Center.
47.
GrundJ.-P.C.BlankenP.1998From ‘Chasing the Dragon’ to ‘Chinezen’: The Diffusion of Heroin Smoking in the Netherlands. Rotterdam: European Addiction Research Institute (IVO).
48.
GrundJ.-P.C.KaplanC.D.AdriaansN.F.P.BlankenP.1991Drug sharing and HIV transmission risks: The practice of “frontloading” in the Dutch injecting drug user population. Journal of Psychoactive Drugs23:1–10.
49.
GurubacharyaR.L.GurubacharyaV.L.BakundoleJ.S.1998Prevalence of HIV amongst intravenous drug users in Kathmandu (abstract 232246). Twelfth World Conference on AIDS, July, Geneva.
50.
HamersF.BatterV.DownsA.AlixJ.CazeinF.BrunetJ.B.1997The HIV epidemic associated with injecting drug use in Europe: Geographic and time trends. AIDS11:1365–74.
51.
HamersF.1997Monograph on HIV infection in Ukraine. Saint-Maurice, France: European Centre for the Epidemiological Monitoring of AIDS.
52.
HamidA.1992The developmental cycle of a drug epidemic: The cocaine smoking epidemic of 1981–1991. Journal of Psychoactive Drugs24 (4): 337.
53.
HarstockP.KoslovA.P.1998Epidemiology of drug abuse-related HIV in Russia (abstract 23225). Twelfth World Conference on AIDS, July, Geneva.
54.
HeimerR.1999Do homebrewed liquid opiates transmit HIV-1? Sixth International Conference on AIDS, STDs and Cancer, May, St. Petersburg.
55.
HontiJ.ZelenaiK.1999Steps on the methadone path in Hungary. International Conference on the Reduction of Drug-Related Harm, March, Geneva.
56.
HtoonM.T.LainH.H.SanK.O.ZanE.ThweM.1994HIV/AIDS in Myanmar. AIDS8 (suppl 2): S105–09.
57.
IsmailR.1998HIV/AIDS in Malaysia. AIDS12 (suppl B): S1–10.
58.
JoseB.FriedmanS.R.NeaigusA.CurtisR.GrundJ.-P.C.GoldsteinM.F.Des JarlaisD.C.1993Syringe-mediated drug sharing (backloading): A new risk factor for HIV among injecting drug users. AIDS7: 1653–60.
59.
KabiovB.1999‘Black Poppy’ operation finished. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
60.
KalaM.1996Substancje powodujace uzaleznienie w praktyce. Instytutu Ekspertyz Sadowych w Krakowie Przeglad Lekarski54(6):430–37.
61.
KhodakevichL.1997Development of HIV epidemics in Belarus, Moldova and Ukraine and response to the epidemics. Eighth International Conference on the Reduction of Drug Related Harm, March, Paris.
62.
KhodakevichL.DehneK.L.1998HIV epidemics in drug using populations and increasing drug use in central and eastern Europe. Inaugural meeting: Global Research Network on HIV Prevention in Drug Using Populations, 25–26 June, Geneva. National Institute on Drug Abuse.
63.
KhodakevichL.KobyshchaY.1999Changes of the national legislation in relation to the HIV prevention in IDUs in some countries of the European region. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
64.
KilibardaM.1993HIV-infection among drug abusers in the Belgrade area. Bulletin of Narcotics45(1): 135–46.
65.
KlavsI.KristancicL.PoljakM.LucuB. CelanKrekJ.KrekM.KastelicZ.KroseljR.1998Unlinked anonymous HIV prevalence monitoring in IDU, MSM, STD patients, and pregnancies in Slovenia (abstract 1389). Twelfth World Conference on AIDS, July, Geneva.
66.
KlavsI.KristancicL.LucuB. CelanPoljakM.KrekJ.1996Results of unlinked anonymous HIV prevalence monitoring of pregnant women, STD patients and injecting drug users in Slovenia (abstract Tu.C.200). Eleventh International Conference on AIDS, Vancouver.
67.
KoesterS.1992Copping, running and paraphernalia laws: Contextual variables and needle risk behaviour among injection drug users in Denver. Human Organization53: 287–95.
68.
KonI.1995The Sexual Revolution in Russia. From the Age of the Czars to Today. Free Press: New York.
69.
KorfD.J.van AalderenH.HoogenhoutH.SandwijkP.1990Gooise Geneugten. Legaal en Ilegaal Druggebruik in de Regio, Amsterdam. Amsterdam: SPCP.
70.
KumarS.1998Regional Overview on HIV Epidemiology and Prevention Research in Drug Use Populations in Central Asian Republics. Geneva: UNAIDS.
71.
LadnaiaN.N.PokrovskyiV.BobkovA.SavchenkoI.KazennovaE.KravtchenkoA.V.1998Correlation between risk factors for HIV infection in Russia and HIV-1 subtypes isolated in Russia, 1994–1997 (Abstract 436/13206). Twelfth World AIDS Conference, July, Geneva.
72.
LaiskonisAMatulasA.1999Drug addiction in Lithuania. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
73.
LeinikkiP.1997AIDS epidemic in Kaliningrad. Lancet349:1914–15.
74.
LeonD.A.ChenetL.ShkolinikovV.M.ZakharovV.M.ShapiroS.RakhmanovaJ.VassinS.McKeeM.1998Huge variations in Russian mortality rates 1984–1994: Artifact, alcohol or what?Lancet350:383–88.
75.
Leszczyszyn-PynkaM.WnukA.Boron-KaczmarskaA.BanderD.UrbanowitzW.Wawrzynowicz-SyczewskaM.1996Prevalence of HBV and HCV markers in HIV positive patients and in a high risk group of HIV infection (abstract Tu.C.2516). Eleventh International Conference on AIDS, July, Vancouver.
76.
LiitsolaK.TasinovaI.LaukkanenT.KorovinaG.SmoslkayaT.MomotO.MahkilleysonN.ChaplinskasS.Brummer-KorvewnkonitoH.VanhataloJ.LeinikkiP.SalminenM, 1998HIV-1 genetic subtype A/B recombinant strain causing an explosive epidemic in injecting drug users in Kaliningrad. AIDS12:1907–19.
77.
LindanC.LieuT.GuangL.T.LapV.D.ThucN.ThinhT.LurieP.MandelJ.S.1997Rising HIV infection in Hi Chi Minh City heralds emerging AIDS epidemic in Vietnam. AIDS11 (suppl 1) S5–13.
78.
LukashovV.V.KaramovE.V.EreminV.F.TitovL.P.GoudsmitJ.1998Extreme founder effect in an HIV subtype A epidemic among drug users in Svetlogorsk, Belarus. AIDS Research and Human Retroviruses14:1299–1303.
79.
LuninI.HallT.L.MandelJ.S.1995Adolescent sexuality in St. Petersburg, Russia. AIDS9 (suppl 1):S53–60.
80.
MadrayH.SergeyevB.RumyantsevaT.P.OparinaT.VolkanevskyV.L.BroadheadR.S.HeckathornD.D.1998Yaroslavl (Russia) harm reduction project for drug injectors: Impact results (abstract 33404). Twelfth World Conference on AIDS, July, Geneva.
81.
MarmorM.Des JarlaisD.C.CohenH.1987Risk factors for infection with human immunodeficiency virus among intravenous drug abusers in New York City. AIDS1:39–44.
82.
MeleshkoL.1999HIV prevention among injecting drug users in Svetlogorsk, Belarus. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
83.
MiklJ.SudarZ.SmithP.F.BruckovaM.JedlickaJ.KastankovaV.TryznaR.DeHowitzJ.1997HIV infection and High Risk Behaviors among Patients Attending an STD Referral Clinic in Prague, Czech Republic. Albany: New York: State Department of Health Bureau of HIV/AIDS Epidemiology.
84.
Ministry of Health, Belarus1998AIDS in Figures. Information Bulletin 26. Minsk: Centre for AIDS Prevention, Belarus Ministry of Health.
85.
MoskalewizcJSwiatkiewiczG, 1992Drug Demand Reduction in Poland: Inventory of Data Prepared for the PHARE Programme “Fight against Drugs.”Warsaw: Intersalus.
86.
MoskalewizcJ.SierolawskiJ.1995Joint Pompidou Group/UNDCP Project: Extension of the Multi-city Network to Central and Eastern Europe: Lifestyles of Drug Dependent Persons Living in Poland. Strasbourg: Council of Europe.
87.
NabatovA.A.MasharskyA.E.VerivochinS.V.MaksimenokE.V.TchentsovaN.P.KobyshchaY.KozlovA.P.1999HIV-1 sero- and genotyping of HIV/AIDS outbreaks in Ukraine IVDU populations: Different subtypes in different cities. Twelfth World Conference on AIDS, July, Geneva.
88.
NikolovZ.MomchilV.1999A research project on initiative for health/Sofia, supported by UNDP project on touching reality. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
89.
NolimalD.JermanT.1996Project Extension of the Multi-City Work to Central and Eastern Europe. City Report Ljubljana. Pompidou Group/UNDCP:Strasbourg.
90.
PandaS.SarkarS.BhattacharyaS.K.DetelsR.1998HIV-1 in injecting drug users and heterosexuals. Lancet352:241.
91.
ParkerH.NewcombeR.BakxK.1987The new heroin users: Prevalence and characteristics in Wirral, Merseyside. British Journal of Addiction82:147–57.
92.
PeakA.RanaS.MaharjanS.H.JolleyD.CroftsN.1995Declining risk for HIV among injecting drug users in Kathmandu, Nepal: The impact of a harm reduction programme. AIDS9:1067.
93.
PearsonG.GilmanM.McIverS.1987Young People and Heroin. Aldershot: Gower.
94.
PokrovskyiV.V.SavtchenkoI.Y.LadnaiaN.N.1997HIV-infection surveillance in Russia in 1987–1996 (statistics), Moscow, 105275, 2, 15, 8-ya Ulitsa Sokolinoy Gory: Russia AIDS Centre.
95.
PokrovskyV.V.SavtchenkoI.Y.LadnaiaN.N.GoliusovA.T.1998A recent epidemic of HIV infection in Russian IVDUs (abstract 13191). Twelfth International Conference on AIDS, July, Geneva.
96.
PolaneckyV.SijdaJ.StudnickovaB.1996Prevalence study of serious substance abuse in the Czech Republic. Central European Journal of Public Health4(3): 176–84.
97.
RebagliatoM.AvinoM.J.Hernandez-AguadoI.1995Trends in incidence and prevalence of HIV-1 infection in intravenous drug users in Valencia, Spain. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology8:297–301.
98.
RentonA.M.BorisenkoK.1998Epidemic of syphilis in the newly independent states of the former Soviet Union. Current Opinion in Infectious Diseases11:53–56.
99.
RhodesT.BallA.StimsonG.KobyshchaY.FitchC.PokrovskyiV.Bezruchenko-NovachukM.BurrowsD.RentonA.AndrushchakL.1999aHIV-infection associated with drug injecting in the newly independent states, eastern Europe: The social and economic context of epidemics. Addiction94 (in press).
100.
RhodesT.StimsonG.V.CroftsN.BallA.DehneK.L.KhodakevichL.1999bDrug injecting, rapid HIV spread, and the ‘risk environment’: Implications for assessments and response. AIDS13 (in press).
101.
RobinsonN.J.1997Draft monograph on HIV infection in Poland. INSERM and European Centre for the Epidemiological Monitoring of AIDS, Saint-Maurice, France.
102.
RoseR.1997New Baltic Barometer III: A Survey Study. Studies in Public Policy, No. 272. Centre for the Study of Public Policy. Glasgow: University of Stratheiyde.
103.
SarkarS.MookerjeeP.RoyA.E.1991Descriptive epidemiology of intravenous heroin users: A new risk group for transmission of HIV in India. Journal of Infection23(2):201–07.
104.
SavtchenkoI.LadnaiaN.N.BochkovaM.S.PokrovskyiV.V.BurastovaE.V.1996HIV antibody testing policy and HIV infection spreading in IDU in Russian Federation (abstract 23225). Twelfth World Conference on AIDS, Geneva, July.
105.
SierosławskiJ.ZielińskiU.SzataW.1997Extension of the Multi-city Network to Central and Eastern Europe, Cooperation Group to Combat Drug Use and Illicit Trafficking in Drugs. Warsaw city report. Joint Pompidou Group/UNDCP Project. Strasbourg: Council of Europe.
106.
StarkK.WirthD.SierosławskiJ.Godwod-SikorskaC.MuellerR.1994High HIV prevalence in injecting drug users in Warsaw, Poland. Journal of Acquired Immune Deficiency Syndromes and Retrovirology7(8): 877–78.
107.
StarkK.MüllerR.BienzleU.Guggenmoos-HolzmannI.1992Frontloading: A risk factor for HIV and hepatitis C virus infection among injection drug users in Berlin. AIDS10: 311–317.
108.
StauffacherM.1997Treatment Demands in Nineteen European Cities: Cooperation Group to Combat Drug Abuse and Illicit Trafficking in Drugs (Pompidou Group). Synthesis Report. Strasbourg: Council of Europe.
109.
StimsonG.V.1998Reconstruction of the subregional diffusion of HIV-infection among injecting drug users in southeast Asia: Implications for early intervention. AIDS8:1630–32.
110.
StimsonG.V.ChoopanyaK.1998Global perspectives on drug injecting. In Drug Injecting and HIV Infection: Global Dimensions and Local Responses, ed. StimsonG.V.Des JarlaisD.C.BallA., London: University College.
111.
StrathdeeS.A.van AlmeijdenE.J.C.MesquitaF.WodakA.RanaS.VlahovD.1998Can HIV epidemics among drug users be prevented?AIDS12 (suppl): S71–79.
112.
SulajZ.1996Drug misuse trends over the period 1995–1997. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
113.
UjhelyiE.TarjanV.SzomarK.ZacherG.1999Prevalence of HIV, HbsAg, Anti-HBS and HCV among Hungarian drug users. Tenth International Conference on the Reduction of Drug Related Harm, March, Geneva.
114.
UNAIDS1999UN Facilitated Response to HIV/AIDS, STD and Drug Abuse in Central Asian Countries 1996–1998. Almaty: UNAIDS.
115.
UNAIDS1998aReport on the Global HIV/AIDS Epidemic. December, Geneva: UNAIDS.
116.
UNAIDS1998bRapid Assessment and Response to Injecting Drug Use at Shymkent, South Kazakstan. Almaty: UNAIDS.
117.
UNAIDS1998cPrevalence of Injecting Drug Use and HIV Infection in Tashkent: Report on Conduct of Rapid Assessment and Response. Geneva: UNAIDS.
118.
UNAIDS and Almaty City Centre1998Injecting Drug Use and HIV Spread in Almaty City, Kazakstan: Report on the Rapid Assessment and Response Conducted May 9–18. UNAIDS.
119.
UNAIDS, Expert Group of the Joint United Nations Programme on HIV/AIDS1992Implications of HIV variability for transmission: Scientific and policy issues. AIDS11: Unaids 1- UNAIDS 15.
120.
UNAIDS1996Worksheet: Provisional working estimates of adult living with HIV/AIDS by subcontinent in 1995. 30 April, Geneva: UNAIDS.
121.
UNDCP, United Nations Drug Control Programme1997World Drug Report. New York: Oxford University Press.
122.
UNDCP, United Nations Drug Control Programme1998Annual Report: 1997–1998. Tashkent: UNDCP Regional Office for Central Asia.
123.
United Nations, Office for Drug Control and Crime Prevention1999Global Illicit Drug Trends. New York: United Nations.
124.
United Nations1997Trends in Europe and North America 1996/1997. The Statistical Yearbook. Geneva: Economic Commission for Europe.
125.
United Nations, Crime and Criminal Justice Division1995Crime. No. 26/27, Annex III.
126.
USAID and Centers for Disease Control and Prevention1998HIV/AIDS Strategy in Russia, 1998–2000. Washington: USAID.
127.
van den HoekJ.A.R.CoutinhoR.A.HaasterchtH.J.A.van ZadelhoffA.W.GoudsmittJ.1987Prevalence and risk factors of HIV infections among drug users and drug using prostitutes in Amsterdam. AIDS2:55–60.
128.
WagbergE.RenhammarE.NorenA.Muller-WarnolfB.1997Kaliningrad: Report of Study Visit, June 10–15, 1997. Malmö: City of Malmö Unit of Welfare and Public Health.
129.
WalbergP.McKeeM.ShkolikovV.M.ChenetL.LeonD.1996Economic change, crime and mortality crisis in Russia: Regional analysis. British Medical Journal317: 312–18.
130.
WenigerB.G.LimpakarnjanaratK.UngchusakK.ThanprasertsukS.ChoopanyaK.VanichseniS.UneklabhT.ThongcharonP.WasiC.1991The epidemiology of HIV infection and AIDS in Thailand. AIDS5 (2): 571–85.
WhitesideA.KhodakevichL.KruglovY.SteshenkoV.BarnettA.S.1998The HIV epidemic in Ukraine: Assessing susceptibility and vulnerability (abstract 23366). Twelfth World Conference on AIDS, July, Geneva.
133.
ZhengX.W.TianC.ZhangJ.ChengM.YangX.LiD.LinJ.QuS.SunX.HallT.MandelJ.HurstN.1994Injecting drug use and HIV infection in southwest China. AIDS8:1141–47.
134.
ZhengX.W.ZhangJ.QuS.ChengH.LiD.JiaM.ZhangG.DuanS.1998A cohort study of HIV infection among IDUs and natural history of infection in Ruili, China, 1992–1997 (abstract 23244). Twelfth World Conference on AIDS, Geneva, July.
135.
ZhorabianL.S.SargsyanN.A.NahapetyanK.L.ArmaganyanN.A.ManrikyanM.H.TopchyanS.G.1998Current situation and recent trends of HIV epidemic in the Republic of Armenia (abstract 60239). Twelfth World Conference on AIDS, July, Geneva.
136.
ZellwegerU.WangJ.SchridM.R.SomainiB.1998The male IDU epidemic is closely linked to its secondary epidemic among heterosexual women in Europe (abstract 13200). Twelfth World Conference on AIDS, Geneva, July.
