GLOBAL HEROIN USE FUELS AIDS EPIDEMIC

BARCELONA, Spain -- From the jungles of southeast Asia to the streets of
Moscow, the AIDS virus is riding on the back of a global heroin epidemic
and taking root among the most populous nations on Earth.

The link between HIV infection and injection drug use was one of the
earliest discoveries of the epidemic. But it is only recently that disease
trackers have detected signs of a rapidly spreading drug-related outbreak
in Eastern Europe and Asia that threatens to reach into the general population.

"Central Asia is a bomb waiting to explode," said Kasia
Malinowska-Sempruch, a native of Poland who directs a drug-related AIDS
program for the Open Society Institute, which urges that the world adopt
"harm reduction" tactics such as needle exchange programs that are credited
with rolling back an outbreak of HIV among drug users in San Francisco.

The highest increases in the rate of HIV infections are in the former
Soviet Union. As many as 840,000 Russians are estimated to have the AIDS
virus, the great majority drug-related cases.

A quarter-million Ukrainians are HIV-positive, the highest infection rate
in Europe. Three out of 4 infections are among drug users or their sexual
partners, and rates of pregnant women with HIV are rising.

Malinowska-Sempruch delivered a spellbinding speech Tuesday at the 14th
International AIDS Conference, warning of the growing menace of AIDS.

"The world celebrated with us when the Berlin Wall fell and then left us
alone to deal with the consequences. AIDS and drug use are the issues that
will define whether or not we reverse the tide of economic and social
disruption in this generation. If the world is unable or unwilling to turn
its attention to this region and offer help, the consequences will be
horrific."

Estimates are that 1 percent of the population of the Commonwealth of
Independent States, which includes most of the former Soviet Union, uses
injection drugs.

"More than 90 percent of new HIV cases in Moscow are related to injection
drug use," said Ilona van de Braak of the AIDS Foundation East-West. Young
people in Moscow are experimenting with drugs, and there is little aversion
to injecting drugs because Russian medicine has often favored the syringe
over the pill, she said.

"Drug use started with the Soviet Union collapse," said Lily Hyde of the
International HIV/AIDS Alliance.

Drug-related AIDS epidemics are turning up along the heroin trade routes
from Afghanistan to Burma. Already, at least 4 million are believed
infected in India.

In China, pockets of drug-driven outbreaks have turned up in seven
provinces, with infection rates among heroin users approaching 70 percent.

Indonesia, which had seemed immune to the epidemic, is now seeing high
rates of HIV in urban areas where drug use thrives.