SLOVAKIA'S HIV/AIDS SITUATION: WELL-POSITIONED FOR

UNCLAS BRATISLAVA 000229

SIPDIS


E.O. 12958: N/A
TAGS: KHIV PGOV PHUM PREF LO
SUBJECT: SLOVAKIA'S HIV/AIDS SITUATION: WELL-POSITIONED FOR
THE FUTURE


1. Summary: Although the country's low rate of registered
HIV/AIDS cases hampers social awareness, a three-year
National Prevention Plan (NPP),improved school programs, and
NGO outreach efforts demonstrate Slovakia's dedication to
public education in preventative measures and risks
associated with the disease. Free anonymous testing centers
and governmental focus on advanced medical care are further
indications that Slovakia is seriously concerned about
HIV/AIDS. However, related issues -- such as the
psychological impact on patients and public awareness
campaigns to reduce the stigma of the disease -- lack
attention and funding. End Summary.

INCIDENCE RATE
--------------


2. Slovakia boasts one of the lowest HIV/AIDS rates in Europe
with only 207 cases registered since 1985 in a population of
5.4 million people. Seventy-six of these were foreigners, the
majority of whom returned to their home countries following
diagnosis. Statistics for 2004 indicate only 107 Slovaks are
currently living with HIV/AIDS. Eighty percent of the
infected are men. The main mode of transmission was through
homosexual (63.4 percent) and heterosexual (26.0 percent)
contact. Many of those affected are sex workers. The
remaining 14 cases were connected with intravenous drug use
(2 cases),blood transfusion (1 case),and unidentified
reasons (8.4 percent). Seven women testing positive were
pregnant, and the Slovak medical community is proud that
proper and timely care blocked transmission from mother to
child in all cases.


3. NGOs estimate that the reported figures are understated
due to limited appointment schedules for anonymous testing,
inconvenient travel time to testing centers (only three exist
in the country),reluctance to seek non-anonymous testing
with general practitioners, and failure to account for
individuals who seek anonymous testing in Vienna and
Budapest. In addition, although laws mandate that the actual
test be free of charge, and testing centers abide by this
rule, many general practitioners still charge fees for
extracting blood, or their office visit fee for performing
blood tests. These costs may deter some Slovaks from seeking
a blood test.


4. The medical community is concerned that HIV/AIDS rates may
increase in the future with the opening of borders to EU
countries and the rapid rise in cases among Slovakia's
neighbors, especially Ukraine. However, the prevalence of
HIV/AIDS has remained steady throughout the past three years
with an average registration of ten new HIV cases and three
new AIDS cases annually. In 2004, the government only
identified nine new HIV cases with no new AIDS cases
reported.

NPP AND EDUCATIONAL OUTREACH
--------------


5. The GOS's NPP for 2004 to 2007 focuses on prevention,
testing, and medical care to reduce the potential spread of
HIV/AIDS. Funding from governmental agencies supports
prevention strategies, including educational programs such as
the "Play against AIDS" performed in middle and high schools,
distribution of printed pamphlets designed to increase
awareness among teenagers and university students, as well as
specific strategies for higher risk individuals, including IV
drug users and impoverished minority communities.


6. Governmental efforts are further supported by NGO
assistance. For example, in 2004, ODYSEUS, an NGO
specializing in outreach to sex workers and IV drug users,
held several festivals to educate these high risk groups, to
provide limited testing, and to distribute clean needles and
condoms. The Slovak Red Cross and the Association Against
AIDS also combined efforts to provide youth educational
prevention programs.

TESTING/MEDICAL CARE
--------------


7. Slovakia offers anonymous testing at three clinics
strategically located in each region of the country (in the
cities Bratislava, Kosice, and Banska Bystrica),although
these clinics only provide testing at limited hours. For
example, the facility in Bratislava only offers testing from
8:00 a.m. to 10:00 a.m. three days per week. One NGO
criticized this system because many workers are unable to
access the clinic during those times. In addition, all
general practitioners can provide testing, and gynecologists
must offer pregnant women free testing. However, in a
country consisting of numerous small villages with close-knit
family communities, individuals have expressed concerns to
NGOs that physicians would pass test result information to
family members and friends.



8. Upon diagnosis of HIV/AIDS, medical care costs within
Slovakia are covered in full under current insurance plans.
According to the Director of the National Program for AIDS
Prevention, Dr. Emil Tomasek, the medical facility designated
for treatment is modern, medical care incorporates the most
recent scientific advancements, and an ample supply of the
necessary drugs is available. Tomasek attributed the
consistently declining rate of AIDS and resulting deaths
since 2000 to this advanced medical care.

PUBLIC STIGMA
--------------


9. Slovakia has not yet addressed public stigma often
associated with those who test positive. HIV/AIDS victims
are protected from revealing their status, and employers
cannot ask whether an individual has tested positive.
However, outside the legal arena, the low prevalence rate
ensures that the vast majority of Slovaks has never
personally met anyone with HIV/AIDS to engender sympathy or
understanding. Currently, the media and NPP do not focus on
improving attitudes or public opinion regarding HIV/AIDS but
center on prevention strategies and medical care. The stigma
can be exacerbated by racial biases.


10. NGOs commented that the government, while providing
excellent medical care, does not address psychological
concerns, stigma against patients, and internal feelings of
isolation. Due to the low number of cases, self-help groups,
group counseling opportunities, or other common methods for
psychological assistance are non-existent. NGOs hope to
improve this situation through outreach at HIV/AIDS
prevention festivals and promotion of informal group meetings
among known diagnosed individuals. NGOs expressed doubts that
vital funding from international sources and private
organizations to bolster improvements in these areas will be
available given the low prevalence levels.
THAYER


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