All the more according to statistics gays is far from being the first of affected by this infection group of the population in Ukraine.

But AIDS insensibly expands. Alas.

And we aspire to be objective, to open, instead of to ignore, problems. Including a problem of AIDS. To prevent it, it is necessary to speak and to write about it now, not waiting a crash of thunder.

"PLAGUE" of XX century

Andriy Maymulakhin: Whether the situation of HIV/AIDS spreading in Ukraine are difficult? Please, tell the last statistical data and what "the groups of risk " are now allocated?

Elena Elenko: The situation of a HIV-infection in Ukraine has lately become complicated very much. In comparison with 1987, when the first cases of a HIV-infection were registered, morbidity with it has grown, practically, in 100 times. By the end of 1997 in our country is registered more than 26 thousand of HIV-infected and more than 300 patients with AIDS.

There are registered 10 HIV-infected persons in Lugansk and 371 ones in Lugansk area by the end of the last year.

But the point is that for a HIV-infection is characteristic the so-called phenomenon of iceberg. That is we see only a top part, therefore these figures can easily be increased in ten, even hundred times and then we shall receive a more-less real picture.

Drug addicts now are the most numerous "group of risk" and since 1996 there registered outburst of HIV spreading there.

Besides, in "groups of risk" we selects people conducting chaotic sexual life. It is prostitutes, homosexuals - persons who have numerous sexual and often casual liaisons.

But that is the characteristic feature of the recent time that common population, not belonged to any from the listed groups, begins to be involved in epidemic. All of us live not on the Moon.

The HIV-infection belongs to so-called "behavioral diseases", and it is rather social than medical problem. And if the person would not change the behavior, we cannot to cope with this illness by medical ways. Not to be ill with AIDS is only possible in the case not to catch it! All have to know it. Medicine is not able yet to cure AIDS!

A.M.: How a person can pass testing for HIV in your center? Whether will be keeps anonymousness of the tested person and confidentiality of the results?

E.E.: Any person can come to us and, at his (from here and below "his" and "her", etc., are interchangeable) desire, to pass anonymous tests for HIV. That person gets a usual number which corresponds to number in the laboratory registry and further he passes under this number. In the event that the result for HIV has appeared positive, we not demand of the person that he has to informed us the nameplate data, and we try to convince him/her that the further qualified help he can receive only in our center. Therefore it is his interest to maintain the relations with us. Here is observed anonymousness up to the end, while patient does not want to come out.

The inspection for HIV is still carried out free.

A.M.: If it is not secret, what percent of the tests is positive, which have remained anonymous?

E.E.: From 10 persons in Lugansk - 4 are anonymous.

A.M.: The person had come to you, was tested. All is good, if the analysis is negative. And if it is positive, what then?

E.E.: Even when we take blood, we prepare the patient for possible positive result. And if it is actually so we farther give a post-test consultation for such patient. We tell him how it is necessary to lead a regular life. This person obligatorily gives the receipt that he is made known about his HIV-infection. In this receipt it is underlined that he bears the legal responsibility for distribution of HIV being fully aware.

A.M.: Whether there are applied in our country to treatment of the patients with AIDS the world achievements of medicine in this field? For example, cocktail from three medicines, used recently in worldwide practice, which has shown very good efficiency?

E.E.: The state has not means to buy import preparations for treatment of HIV-infected. They cost very expensive. The rate of treatment for a HIV- infected person with antivirus cocktail in America come to about 20-40 thousands dollars a year.

We use a whole complex of medical preparations of home manufacture. Until recently the state provided money for treatment of HIV-infected people, but now the question is put that the treatment of such patients will be carried out for their personal account.

A.M.: What about psychological support of the HIV-positive people? How much are they socially adapted in our society? Whether are they outcasts?

E.E.: The society is still not ready to live beside HIV-infected people. We find that there is no understanding even in family, when the person's own parents, brothers, sisters avoid the close person, leave contacts with him.

I have such patient who merely comes to me to talk. He tells me his dreams, feelings... The point is that the service of the psycho-social help for such people is still not created.

We even come across such cases when the medical workers, by finding out about the diagnosis of a patient, refuse to render the help to him.

Well and certainly, diagnosis of HIV-infection is the large psychological shock for a person. A patient often cannot overcome it, he considers that all is over - end of life, nobody needs him. Also it is usual that a HIV- infected person let himself go both drugs, and alcohol, and further chaotic sexual life. The person breaks, becomes isolated in himself, and does not try at all to search for exit from the situation in which he has appeared.

We certainly try to help to our patients in the psychological course but probably there will pass a lot of time while both the HIV-infected ones and the society will learn to live each near to other.

A.M.: What kind of difficulties crops up in your center's activity?

E.E.: As well as in the whole public health services they are material. If there were means, it would be possible to carry out more information and educational actions, propaganda campaigns.

As it is mostly a social problem, so it should be solved not only by public health services, but also many other departments. In particular, national education, service of the social help for youth, Internal Affairs Administration - they have to work in close contact with us but they leave this problem. It is possible to do even if something by common efforts, while solely medical workers would not cope with this problem.

A.M.: How do you think, the reorganization of National Committee for Preventive Measures for Drug Addiction and AIDS has brought rather positive or negative for struggle with spreading of HIV epidemic in Ukraine?

E.E.: My personal opinion, it is large damage for struggle with this problem. Ukraine was sole country of CIS that created such service under the President. It was a separate structural division which was engaged in this question in a complex. The point is that in many western countries this task is solved in the same way.

As it is a social problem, such high rank of Committee allowed to get various state structures to take part in its solution, to require realization of the recommendations, specifications. When now this question has been given up to Ministry of Health Service I do not think that it will benefit. We have legalized this problem as purely medical.

A.M.: You are a doctor-epidemiologist. How do you think, whether can HIV virus mutate in such way that the ways of its spreading will change and it will become more infectious?

E.E.: This virus is quite changeable - that is why specific means of treatment and preventive maintenance are not created till now. Taking it into account, its evolution, there is not excluded such opportunity that the ways of transferring will change. With this virus all is possible.

A.M.: In our country the gay community is just at a stage of formation. But together with it, along with formation of a tolerant society, development of economics focused on various groups of the people, undoubtedly, there will come such sadly become famous in the west for distribution of HIV-infection attributes as sex-industry, gay-baths, "dark rooms".

How do you think, whether will come together to us along with formation of gay community in the country also AIDS in large scales?

E.E.: It is difficult to tell. The point is that, this way and that, homosexuals meet. Though at present they meet not in gay-baths but in entrances, on casual apartments or elsewhere, it already takes place right now. So I think, if there will be such industry, it will not play any essential role in distribution of a HIV-infection.

Maybe it even will be on advantage, because when a problem is legalized, on the surface, it is always easier to supervise, in such places it will be easier to carry out an information work. Probably then also homosexualists will be interested in supervising the situation to know the condition of the health, condition of health of the partner.

A.M.: If to compare Ukraine with, for example, USA or Africa, the spreading of HIV-infection is less here, not that huge scales of affection as there at all. Today already there are available also successfully being developed new preparations against this disease. The special network of medical establishments - a barrier against AIDS - has been created, part of which is your center. There are taken into account the bitter results of the last years - there carries on the propaganda against sexual dissipation, drug addiction, the supervision over blood-donors, etc.

How do you think, whether the danger of AIDS in national scales has already passed Ukraine?

E.E.: No. Has not passed. Now we have the first wave, behind it the second comes nearer and we still have not reached the peak. All the misfortune that this process is completely beyond the control and beyond the regulation. It is a behavioral disease and if will not radically change consciousness of the population, we cannot do anything for a while yet.

A.M.: Thank you very much for the interview.

We in edition have received for free distribution together with 4-th number of the magazine condoms LifeStyles.

Here is a small present for the employees of your center. I hope you will like these condoms. But they should be used until the end of this month.