(UNAIDS) - In Eastern Europe 700,000 people are now living with HIV, compared with 420,000 just a year ago, according to the AIDS Epidemic Update: December 2000, released hre yesterday by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO).

"Most of these new infections are among injecting drug users," said Dr Peter Piot, Executive Director of UNAIDS. "In many of these countries, the fight against the epidemic is being waged against a backdrop of socio-economic turmoil. This instability fuels drug use and commercial sex, both of which increase the spread of HIV."

The situation is particularly dramatic in the Russian Federation, where new infections are higher this year than in all previous years of the epidemic combined. By the end of 1999 there were an estimated 130,000 people living with HIV in the country. That figure will rise to 300,000 by the end of this year.

Russia's first HIV epidemic among injecting drug users was noticed in 1996 in the port city of Kaliningrad. In just four years, the epidemic spread to over 30 cities right across Russia. In 1999-2000, a number of new HIV outbreaks among injecting drug users took place in major urban areas, including Moscow, St Petersburg and Irkutsk. To date 82 of the Russian Federation's 89 regions report HIV cases.

"Despite the rapid spread of HIV, Russia's epidemic is still at an early stage," said Dr Gro Harlem Brundtland, Director General of the World Health Organization. "The country has a window of opportunity during which it can still curb the spread of AIDS through effective interventions. So far, the epidemic in Russia has mainly been among drug users. But a second wave of HIV infections spread by sexual contact could follow the current drug-driven epidemic and in just three to four years, Russia may well have a generalized epidemic."

There is some good news in Eastern Europe, however. Increased efforts are being made throughout the region to raise awareness about AIDS. Belarus, for example, has involved nearly all ministries in its AIDS response. Prevention efforts among teenagers have been particularly successful. In Kazakhstan, a team of prevention officers delivers safer-sex information and condoms to sex workers. In Ukraine, a new law has endorsed the principle of voluntary HIV testing and broad AIDS education.

Some 5.3 million people worldwide were newly-infected with HIV in the course of 2000, bringing the total number of people living with HIV or AIDS to 36.1 million, up from 34.3 million last year. Since the epidemic started, 21.8 million people have died from AIDS.

Around the world, the epidemic varies. East Asia and the Pacific is still keeping the epidemic at bay, with some 130,000 new infections this year, bringing the number of infections to 640,000, or just 0.07% of the adult population.

In South and Southeast Asia, the prevalence rate - or percentage of those infected - is 0.56% and an estimated 700,000 adults, 450,000 of them men, have become infected this year. By the end of the year, the region will have approximately 5.8 million people living with HIV or AIDS. The epidemic arrived late in Asia and today the region accounts for 20% of all infections worldwide.

In Latin America and the Caribbean, the epidemic is complex, driven by heterosexual and homosexual sex and injecting drug use. Some 210,000 new infections were recorded this year, and 1.4 million people were estimated to be living with HIV/AIDS, up from 1.3 million a year ago. In the Caribbean, HIV infection rates continue higher than anywhere in the world outside Africa, although awareness about the epidemic is on the rise.

In the world's wealthier countries, prevention efforts have stalled. About 30,000 adults are believed to have become infected in Western Europe, and 45,000 in North America, the bulk of whom are thought to be injecting drug users. There are also signs that safer sex in gay communities is on the wane, leading to increased infections among homosexual men after many years during which the epidemic had remained stable or reduced.

This year's World AIDS Campaign, Men Make a Difference, recognizes men's enormous potential to make a difference in curbing HIV transmission and caring for infected or orphaned relatives. The epidemic affects both men and women but men's behaviour - often influenced by harmful cultural beliefs about masculinity - makes them the prime casualties of the epidemic. Some 2.5 million men aged 15-49 became infected during 2000. Men's behaviour also contributes to HIV infections in women, who may have less power to determine where, when and how sex takes place.