AIDS

PROBLEM

AIDS has the potential to be a serious problem in the near future in Georgia, and it is a problem of high concern to the Partnership. A knowledge-attitudes and behavior survey among high school students in Tbilisi was carried out in April 1997. The results of this study were presented at the XII International Conference on AIDS. Four in-country lectures on HIV/AIDS have been conducted for physicians in Georgia at the Ministry of Health, at the Infectious Diseases hospital in Tbilisi, at the Dusheti District Hospital and at the Pasanauri District Hospital, and two lectures have been given on HIV/AIDS to medical students in Georgia.

The HIV epidemic is still in its infancy in Georgia but there are indications of a potentially explosive course in the near future. Georgia was the first ex-Soviet Union country to begin HIV/AIDS surveillance, in 1984, and the Center for HIV and Clinical Immunology was established and funded in 1989. Since that time, a total of 61 cases of HIV infection have been reported. Of these, 21 were reported in 1997 and 13 have been reported in the first four months of 1998 (34 out of the total of 61). This suggests an exponential growth in the epidemic, much as was seen in Thailand earlier in the decade and more recently in the Ukraine. In addition, UNAIDS has estimated a total of 1000-1500 infections in Georgia. The relationship between drug abuse and blood borne diseases is best demonstrated in the HIV-infected population of Georgia: 63.9% of identified HIV cases are attributable to IDU, 20% of cases have evidence of hepatitis C, and 30% have evidence of hepatitis B. Given the coexistence of multiple factors that enhance the spread of HIV, Georgia faces a crisis. The U.S. delegation felt that efforts must be concentrated in the above areas in a concerted and organized manner. HIV/AIDS is receiving some support from CRDF funds and active collaborations are underway. Further efforts must be directed towards the prevention, diagnosis and treatment of hepatitis, STDs, and IV drug use. Coordination of efforts between the various Georgian Institutes must occur and collaborations must involve all relevant parties in Georgia. NIAID should work with NIDA in research areas that overlap the interests of both Institutes, such as the prevention and treatment of Hepatitis B and C. Georgia provides the ideal setting to develop a health services research program to evaluate the best methodologies to treat drug-using populations who are infected with multiple emerging diseases. Finally, a disease and high-risk behavior surveillance system should be established in Georgia, and drug abuse training should be provided to investigators working in the area of emerging infectious diseases. (This paragraph taken from 'US-Georgia Joint Symposium: Research Opportunities in HIV/AIDS, Emerging Infectious Diseases and Immunodeficiencies.' June 17, 1998.NIAID/NIH)

Adding to the concerns about AIDS, there appears to be an epidemic of sexually transmitted disease in all three Caucasus republics of Georgia, Armenia and Azerbaijan. Some small studies show a prevalence rate of 50% of STDs in women of childbearing age in Armenia and Azerbaijan. Trichimonas and chlamydia account for 40%, and syphilis and gonorrhea for 10% of this figure. There is a corresponding increase in birth defects and infertility. These same results may apply to Georgia also, but there have been no studies.

ACCOMPLISHMENTS

A knowledge-attitudes and behavior survey among high school students in Tbilisi was carried out in April of 1997. The results of this study were presented at the XII International Conference on AIDS.

An application to the World AIDS Foundation for the support of a counseling and testing center in Tbilisi was submitted and it was successfully funded with $50,000 USD.

Four in-country lectures on HIV/AIDS have been conducted for physicians in Georgia at the Ministry of Health, at the Infectious Diseases hospital in Tbilisi, at the Dusheti District Hospital and at the Pasanauri District Hospital.

Lectures have been given on HIV/AIDS to medical students in Georgia.

A study of HIV seroprevalence among patients with tuberculosis was conducted in collaboration with Dr. Henry Blumberg and the Georgian TB Institute.

Drs. del Rio and Blumberg participated the week of May 12th-16th an NIAID/NIH sponsored seminar entitled 'HIV/AIDS and emerging infections in the Caucasus region'

FUNDING

AIDS International Training and Research Grant: $300,000

PUBLICATIONS AND PRESENTATIONS

del Rio C, Saluja R, Gvetadze R, Tsertsvadze T. Knowledge, attitudes and practices (KAP) about HIV/AIDS and sexuality among high school students in Tbilisi, Georgia. Presented at the "XII International Conference on AIDS", Geneva, Switzerland, July 1998. (Abstract # 14116)

Gvetadze R, Shartava T, Badridze N, del Rio C, Nelson KE. Prevalence and Incidence of HIV In Selected Populations in the Republic of Georgia. Clin Infect Dis 1999; 29(4): 1027. Presented at the 37th Annual Meeting of the Infectious Diseases Society of America, Philadelphia, PA, Nov 1999.

Tservatze T, Gvetadze R, Gagua M, Tsintsadze M, Nelson KE, del Rio C. Risk Factors for HIV-Infection At A Couseling and Testing Center in Tbilisi, Georgia. Clin Infect Dis 1999; 29(4): 1029. Presented at the 37th Annual Meeting of the Infectious Diseases Society of America, Philadelphia, PA, Nov 1999.

Baker JC et al.: Seroprevalence of HIV and HCV infection among patients with tuberculosis in the Republic of Georgia. (presentation)

MORE INFORMATION

Carlos Del Rio <cdelrio@emory.edu>

Tengiz Tsertsvadze <aids@access.sanet.ge>, <geoaids@nilc.org.ge>

LINKS:

Georgian AIDS and Clinical Immunology Research Center
[http://www.aids.gol.ge/]

Emory AIDS International Training and Research Program (AITRP)
[http://www.sph.emory.edu/AITRP/]

Division of Infectious Diseases, Emory University School of Medicine
[http://www.emory.edu/ID/]

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