AIDS Threat Hangs Over Georgia

The street outside Tbilisi's circus has long been the marketplace for male and female prostitutes. Recently the phrase "Beware, AIDS!" appeared, written in metre-high letters, on a granite wall. But not long afterwards, the last word was rubbed out and someone wrote instead in white paint, "Beware, beauties!"

"AIDS? As far as I know, as a rule, people are no longer dying from it," said Vakhtang, a student. "And as that's so, you don't have to take precautions." Dato, another student, said, "I don't like using contraceptives. Apart from anything else they still don't save you from AIDS."

These two examples vividly support the fears of World Health Organization experts that young people in Georgia do not appreciate the risk the HIV virus poses them.

"Georgian society is badly informed about the problem of AIDS and has not yet understood the danger of this crisis," said Maia Tsintsadze, an epidemiologist with the Centre for Infectious Pathologies, AIDS and Clinical Immunology of Georgia. "Proof of that is the fact that only two or three people a day come to us to have blood tests."

Officially, Georgia has 284 people registered as being HIV-positive. Eighty-eight per cent of them are men and 71 per cent are drug users. However, WHO specialists estimate that the real figure for those afflicted by the virus is probably more than 2,000.

In the rest of the world, the taboo of AIDs is disappearing - but not in Georgia. The first organisation of HIV-sufferers is due to open here soon, but its members will be anonymous. The problem is that Georgians suffering from the virus run the serious risk of ostracism, dismissal from work or even physical violence from a society that still strongly disapproves of them.

"It's hard for people to have a good attitude to a person, who is infected with the AIDS virus," said Father Bessarion, a priest in a Tbilisi church. "A believer understands it as God's punishment. I understand them. If a person is sick with this disease, then the reason is inside him." Bessarion said that another priest had even refused confession to an HIV-positive man, although he himself would not have done so.

"In Samegrelo, neighbours burned down the house of an HIV-positive man," said Marina Dgebuadze, another epidemiologist with the AIDS centre. "He was the second person to be officially registered in Georgia. The sick hide their names and categorically refuse to talk to the press."

One HIV-positive Georgian did however agree to talk to IWPR. This woman, who declined even to give her initials, was infected in Kiev, where she worked in a trading company and decided to return home to Georgia, where her son and daughter live.

"I live and I am constantly afraid that my neighbours, friends and colleagues will find out about my disease," she said. "What will they do to me? Sack me from work, stop talking to me, perhaps even set fire to my apartment. I am not sure that the authorities won't force me to return to Ukraine. I am very afraid. I am 40-years-old and soon I will have a grandson. The thought that I will nurse him gives me great pleasure, but will they allow me to do it."

The women complained of another problem that fear of disclosure brought: she needed medicines, but was afraid to apply for them and lose her anonymity.

Currently, the most popular anti-AIDS treatment is the so-called "triad", consisting of three separate drugs. In 1998, the Georgian government agreed to give five AIDS sufferers a course of this treatment, at a cost of 10-15 thousand US dollars a year. They are still receiving the drugs, but no money has been forthcoming for another 20-100 people, who also want to be treated. The latter have to wait in a queue, until either the five patients receiving the cure die or the government supplies more money.

The government is financing some prophylactic programmes to stop people being infected in the first place. In particular, blood donors are required to be tested for HIV. "But that is not good enough," said Ketevan Stvilia, head of the AIDS centre's prophylactic department. "We need to test all pregnant women and, better still, all hospital in-patients, as happened in the USSR."

Stilvia said that her centre needed about four million lari (a little under two million US dollars) to function properly, but currently received less than half that sum.

Much of that money has gone on free condoms. "Over the past two or three years, we have given out up to one million contraceptives. We have sent them out into the regions and given them to people who come to take tests," said Dgebuadze.

"When the contraceptives ran out people came to us for a long time and were very indignant when we turned them away. But as a result, we received a lot of phone calls and young people asked our advice on which contraceptives were the best and where they should buy them. It is as though we became experts on condoms."

In one sense, Georgia is better off than most people expected a few years ago. In 1995, international health experts predicted that the number of HIV-positive people in the country would rise to 20,000 by the year 2000.

However, the fact that that prediction was exaggerated was a matter of luck and poor forecasting, rather than preventative measures, said Dgebuadze. "God spared us," she said.

"Today the situation seems to be under control," added Stvilia. "But our capabilities are very limited." She pointed out that in Russia and the Ukraine, the AIDS problem, which had seemed to be quite small in the mid-Nineties, suddenly spiralled out of control a few years later.

"If the same thing happens here, a state like ours simply won't be able to cope with an AIDS epidemic. We can't wait for a miracle. All the more so because the social background in Georgia is the same as in Russia and Ukraine: drug-addiction, prostitution, homosexuality and a migrating population."

Nata Mumladze and Giga Chikhladze are freelance journalists, based in Tbilisi.