Even before the war, UNAIDS reported a quarter of a million Ukrainians suffering from HIV. And unlike elsewhere in Europe, where the infections are predominantly among homosexual men, the virus in Ukraine has mainly spread among heterosexual men and women (and drug users). Without prevention, the number of infections can also quickly get out of hand via vaginal sex, says Kai Jonas, professor of Applied Psychology.
As the Ukrainian men are joining in the war, chances are great that the virus will spread throughout the host countries via the women. “About 40 per cent of these women don’t even know that they are HIV-positive. And if they are aware, treatment in a country such as Poland is not matter of course. With 1.5 million refugees, care there is inadequate. Moreover, there are now twice as many people with HIV in that country who are in need of treatment."
Sex work
Jonas estimates that the number of HIV infections will rise by 30 per cent in the Netherlands. “In 2020, the Netherlands registered 411 new cases. For 2022, based on the present number of refugees, you can most likely add 150 Ukrainian women to that number.”
These are small numbers, but the virus can spread quickly. “In Poland, an increase in the number of infections can already be observed, while you can only diagnose HIV after ninety days. So, in the first days of the war, shortly after the first refugees set foot on Polish soil, the virus began to spread. Partly because some women ended up as sex workers.”
HIV treatment centres
What to do in the Netherlands? “Because of the decentralised accommodation, you have to inform carers such as GPs about the problem. Then, because an HIV test is not compulsory here, you have to hope that they can convince Ukrainian women to have themselves tested and if necessary, start treatment. There is a technique for this, motivating interviews, which we are now going to adapt to this target group and have it translated into Ukrainian, so that an interpreter also chooses the right words.”
Furthermore, Jonas and his Maastricht colleague Sarah Stutterheim, are working on brochure material and a video to prevent stigmatisation. “This is meant for carers and Dutch people who had a spare bedroom and welcomed the Ukrainians into their home. They don’t need to be afraid of becoming infected with the HIV virus and keep cleaning the toilet seat or buying new cutlery. Or worse, putting their guests back on the streets. They would do better to arrange transport to one of the twelve HIV treatment centres in the Netherlands. Ukrainians can report in there without a referral.”
Lastly, the Maastricht professor and a colleague from Rotterdam are trying to estimate what the Netherlands can expect. “HIV care is expensive, costing ten thousand euro per patient every year. With 150 women, that therefore comes down to 1.5 million each year, and the number of refugees increases every week.”