HIV infection rates rising fast

Four years ago, Petr Sobek was like most anyone else - he knew HIV existed, but didn't pay much attention to it.

"I thought it could not happen to me, and it was my mistake that I allowed myself to have sex without a condom," the 39-year-old Sobek said, sitting in the garden at Lighthouse (Dům světla), the Prague 8 HIV/AIDS prevention and treatment center where he now works and lives.

Sobek is one of a growing number of HIV-positive Czechs, with annual new cases occurring at four times the rate they did a decade ago. In July, for the third consecutive month, 20 new HIV cases were diagnosed, bringing the number of HIV/AIDS cases diagnosed from January to July this year to 118, according to Džamila Stehlíková, the national manager for the HIV/AIDS program in the Czech Republic. In July, five new cases of full-blown AIDS were diagnosed, she said.

If growth continues at the same pace for the rest of the year, new HIV cases this year will top 200 nationwide, a 400 percent increase over 10 years ago. Over the same period, government spending on HIV/AIDS prevention has dropped precipitously. In 2010, the Health Ministry has earmarked 3.5 million Kč ($179, 212), less than 15 percent of what it spent in 2001.

In short, experts say, by slashing funding for prevention, education and treatment over the past decade, the government has accelerated the spread of the deadly virus.   

The total number of HIV/AIDS cases recorded in the Czech Republic since monitoring began in 1985 now stands at 1,462 HIV-positive, with 312 cases that have progressed to AIDS. The virus has killed 160 people. Half of all those diagnosed with HIV/AIDS, around 700, live or lived in Prague.

New cases this year will equate to about 14 percent of all cases since monitoring began. 

In 2010, government funding for prevention programs was budgeted at 7 million Kč - 1.5 million Kč less than in 2009 - but that number was further halved to 3.5 million Kč during additional rounds of budget cuts, Stehlíková said.

Miroslav Hlavatý, director of Lighthouse, said that in 1996, during the early years of government-funded HIV/AIDS prevention programs, the government provided 66.9 million Kč of funding.

"The difference is pretty high, and it almost threatens the existence of such organizations that work with HIV/AIDS," Hlavatý said, adding that he thinks the number of HIV/AIDS cases is actually much higher as most still go unreported and undiagnosed. With the exception of one educational program financed primarily by the European Union, about 75 percent of Lighthouse's annual budget depends on funding from the Health Ministry. The rest of the money comes from donors, but increased dependence on the private sector creates serious problems, Hlavatý said.

"Companies are afraid to give money to HIV/AIDS programs because they don't want to be connected with it," he said.

Hana Malinová, executive director for Bliss Without Risk, a nongovernmental organization that works with female sex workers to address HIV/AIDS, estimates there are 10,000 sex workers in the Czech Republic and says her organization does not have enough funding to offer sufficient preventive health services.

"For a very long time, we've had low numbers of HIV cases, so it's thought it's not necessary to take more care," Malinová said. "The good situation is not manna from heaven - it is the hard work of prevention teams."

And here, experts say, is the problem. Relative success fighting HIV/AIDS in the developed world in the later 1990s and early 2000s has lulled people into a false sense of security, allowing HIV/AIDS to make a comeback. 

Bliss Without Risk received no money from the Health Ministry this year, and Malinová said money from other ministries, the city of Prague and the EU Social Fund was strictly limited to specific projects.

Recent successes in combating and limiting HIV/AIDS cases among intravenous drug users are in jeopardy because of a funding crunch, said Viktor Mravčík, head of the Czech National Monitoring Center for Drugs and Drug Addiction. The number of people contracting HIV through injecting drugs decreased to seven cases in 2009 from 17 in 2007.

"However, the 2010 situation shows that money is not enough to buy [clean] syringes to distribute to drug users, so there are limitations and constraints that could lead to a worsening of the situation," Mravčík said.

Awareness among the general public about the spread of HIV/AIDS is the other main problem, agency workers say, because while the numbers do reflect some clear "risk groups," the tendency for officials to emphasize those groups is dangerous.

"Unfortunately, we still talk about risk groups, so we still talk about gays and those who use drugs, and this makes heterosexuals and non-drug users think HIV infection cannot happen to them," Hlavatý said.

Sobek says he is shocked by the ignorance among young people.

"Young girls think [birth control] pills will save them from getting HIV," he said. "They just don't have a clue."

An estimated 57.5 percent of those with HIV in the Czech Republic are men who have sex with men, while 30.5 percent are heterosexuals. Two and a half percent are drug users. The majority of those contracting HIV are between the ages of 20 and 29, Hlavatý said.

While budget cuts have left education and prevention lacking, the upside of national HIV/AIDS policy is that those who are diagnosed do receive treatment, according to the United Nation's 2010 Country Progress Report on HIV/AIDS. People living with HIV/AIDS in the Czech Republic receive treatment at seven centers around the country, which is fully covered by health insurance. Those with uncertain legal status in the country get treatment covered by the national AIDS prevention budget.

Patients who choose alternative regiments of treatment provide a co-payment and can sometimes receive help from the World Health Organization, Hlavatý said.

HIV testing is free and obligatory for all pregnant women, as well as screening of all blood and organs to be donated, and HIV testing for all others is partially subsidized, the report said.

The main problem is not the treatment of the virus, Sobek said, but whether people are willing to dedicate time, effort and money to prevent it. 

"People don't consider it a big problem," Sobek said. "They don't realize it's still incurable. ? It really cannot be cured, and they will never be healthy again."

- Klára Jiřičná, Filip Šenk and Walter Novak contributed to this report.

 More on this story: 

Postview: HIV rates an epidemic in bad governance 

Cat Contiguglia can be reached at
ccontiguglia@praguepost.com