Start Date:  Oct 2003   End Date:  Oct 2004   Status: Completed

Central Asia has been confronting four overlapping epidemics - drug use, sexually transmitted infections (STIs), HIV/AIDS and tuberculosis (TB). The drug use, HIV/AIDS and STIs epidemics are mainly among young adults, while the TB epidemic affects adults in their more economically productive years. Although the number of reported cases of HIV in Central Asia is still very low, the growth rate of the epidemic - from about 500 cases in 2000 to over 12,000 in 2004 - is a cause for serious concern. Central Asia lies along the drug routes from Afghanistan to Russia and Western Europe, and it is estimated that it has half a million drug users, of which more than half inject drugs. The majority of users are men under 35, although drug use is increasing rapidly among women. However, HIV infection incidence and prevalence are estimated to be several times higher than reported figures. The lack of accuracy in reporting stems from the lack of proper diagnostic systems and the absence of an efficient surveillance system.

Current and future epidemic outbreaks of HIV throughout the region may continue to be driven by a) the explosive growth in injecting drug and commercial sex work use; b) concurrent epidemics of sexually transmitted infections (STIs); c) economic and political migration; d) limited capacity of governments and civil society to implement effective preventive responses; and e) low levels of awareness of HIV and STIs and of knowledge about risk practices and protection. These conditions arise from economic decline since independence, as well as high volumes of illicit drug transit through the region and growth of local consumer markets for these drugs.


This study aimed to identify strategies for ensuring early and effective intervention to control the AIDS epidemic in Central Asia at national and regional levels, considering priorities based on global evidence. It also aims to inform the Bank's policy dialogue and the operational work to control HIV/AIDS in Central Asia, and to strengthen the regional partnership between governments, civil society, UN agencies, and multilateral and bilateral agencies to prevent HIV/AIDS and STIs.


We used three primary methods of data collection during the first six months of 2004: interviews with key informants; recording and analysis of government statistics and review of scientific and grey literature.

Main Findings


This major work supported by the World Bank has driven national and international policy on HIV/AIDS in the region.

Contact us

Project Lead: Professor Adrian Renton

Project Team:  

  • Joana Godinho, Human Development Department of the World Bank.
  • Adrian Renton, IHHD, UEL.
  • Viatcheslav Vinogradov, Center for Economic Research & Graduate Education, Czech Economic Institute.
  • Thomas Novotny, Institute for Global Health, University of California, San Francisco.
  • Mary-Jane Rivers, Delta Networks, New Zealand.
  • George Gotsadze, Curatio International Foundation.
  • Mario Bravo, The World Bank.
  • Funder: The World Bank
  • Project Partners: The World Bank

: "Reversing the Tide. Priorities for HIV/AIDS Prevention in Central Asia" (PDF)


Journal article:  Biblio details here:

For more information, contact: Adrian Renton

Adrian Renton