Prevalence
According to UNAIDS, the Joint United Nations Programme on HIV/AIDS, in 2011, 2.5 million people became newly infected with HIV.[1] The UNAIDS report on the Global AIDS Epidemic states that 34.0 million [31.4 million–35.9 million] people were living with HIV at the end of 2011, although the burden of the epidemic continues to vary considerably between countries and regions.[2]  Data shows that of the 54% of people with access to antiretroviral therapy in low- and middle-income countries, 68% were women. Women also account for 58% of people living with HIV in sub-Saharan Africa. Outside of Sub-Saharan Africa, the virus is still seen mostly in men who have sex with men (MSM), injecting drug users (IDU), and victims of sex trafficking [3].
 
Although globally, the number of men infected with HIV is much higher than that of women, numbers illustrate a sharp incline in the number of women infected by HIV; a phenomenon that has come to be referred to as the “feminization of HIV/AIDS.”[4] .  In the most severely affected countries, three young women are infected for every young man. Whereas the ‘feminization’ of the epidemic is most pronounced in sub-Saharan Africa, women’s vulnerability to HIV is unacceptably high in all epidemiological settings.[5] According to UNAIDS, about 40% of new HIV cases in Eastern Europe and Central Asia in 2007 were women; in Ukraine, women now make up 46% of adults living with HIV.[6]  The majority of women who become infected with HIV do not voluntarily engage in high-risk behavior. Instead, they are vulnerable as a result of the behavior of others, or because they lack the tools, Information and resources needed to protect themselves.[7]
 
There are significant differences in infection rates between Eastern and Western Europe. UNAIDS reported  900,000 infected adults and children in Western and Central Europe, with 30,000 new HIV infections, and 7,000 deaths from the virus in 2011.  Overall, the total number of people living with HIV in Western Europe has been on the rise and the number of deaths has been decreasing due to the availability of antiretroviral drugs.[8] 
 
However, the prevalence of the virus has doubled in Central Asia and Eastern Europe over the same period. In 2011, an estimated 1.4 million people were living with HIV in Eastern Europe and Central Asia, with 140,000 new HIV infections and 92,000 deaths resulting from HIV/AIDS.[9]  In the early-to-mid-1990s, there were 183 registered cases of HIV in Ukraine, and there were more than 68,000 by mid-2004.  There were 125 reported cases of pregnant women with HIV in Russia in 1998, and in 2003, there were 3531.[10]  It is unclear whether this increase is the result of better reporting or if it indicates an actual increase in the number of cases. Almost 90% of new HIV infections in the region occurred in the Russian Federation (66%, representing 1.1% of the population) and Ukraine (21%, representing 1.6% of the population).  In Russia, two-thirds of the infections among women are the result of heterosexual contact, and the numbers continue to increase.[11] 
 
The epidemic in Eastern Europe is seen mainly in IDU who share unsterile equipment, victims of sex trafficking, and MSM, although the proportion of this last group is smaller than it is in Western Europe, where it represents 50% of all cases.[12]  It is likely, however, that the extent of HIV infection among MSM in Eastern Europe is unknown, due to the stigma attached to this particular behavior. 
 
Drug use and sex trafficking  have a strong correlation in the spread of the virus.[13]  Other studies show that new infections increasingly result from heterosexual intercourse.[14]  It appears this is largely the case in the central region of Europe.[15] The WHO’s most current country reports indicate that for the year 2011, for example, where the mode of transmission is known, heterosexual transmission accounted for the larger proportion of new HIV infections in Moldova, 89%, compared to 9% for IDU[16]; Romania, 42% compared to 32% for IDU[17];  and Bulgaria, 44% compared to 31% for IDU[18].
 
 

[1] UNAIDS Global Fact Sheet, 2012.
[2] UNAIDS Report on the Global AIDS Epidemic, 2012.
[3] UNAIDS Report on the global AIDS Epidemic, 2008.
[4] UNAIDS Report on the global AIDS Epidemic, 2008.
[5] The AIDS Accountability Scorecard on Women 2009.
[6] Global Coalition on Women and AIDS, 2004.
[7] The AIDS Accountability Scorecard on Women 2009.
[8] UNAIDS Report on the Global AIDS Epidemic, 2012.
[9] UNAIDS Report on the Global AIDS Epidemic, 2012.
[12] World Health Organization Country reports, 2009. 
[15] Van der Laar, M.J., Likatavicius, G., Stengaard, A.R., Donoghoe, M.C. (2008). HIV/AIDS Surveillance in Europe: Update 2007.  Eurosurveillance, 13(50), 3.