HIV/AIDS in the Western Balkans: Priorities for Early Prevention in a High-Risk Environment

In recent years, Europe and Central Asia has experienced the world’s fastest growing HIV/AIDS epidemic. Yet, in the Western Balkan countries the HIV prevalence rate is under 0.1 percent, which ranks among the lowest. This may be due to a low level of infection among the population—or partly due to inadequate surveillance systems. All major contributing factors for the breakout of an HIV/AIDS epidemic are present in the Western Balkans. HIV/AIDS disproportionably affects youth (80 percent of HIV-infected people are 30 years old or younger). Most of the Western Balkan countries have very young populations, which have been affected by the process of social transition, wars, unemployment and other factors. Among youth, there is generalized use of drugs and sexual risk behavior. Therefore, the number of cases of HIV has been increasing, especially in Serbia, and the incidence of Hepatitis C has clearly increased, which suggests that sharing of infected needles is practiced by injecting drug users. Apart from human suffering, an HIV/AIDS epidemic can have a significant impact on costs of care for individuals, households, health services and society as a whole. This study has found weak public health systems and gaps in financing and institutional capacity necessary to implement evidence-based and cost-effective HIV/AIDS Strategies. Political commitment must increase for action to occur promptly. Prevention interventions are cost effective and, in the short term, affordable with own-country resources. Medium- and long-term interventions would require donor assistance. Longer-term interventions would aim at preventing poverty, exclusion and unemployment, for example, by empowering young people to participate in the regional and global labor market.