US embassy cable - 05BRATISLAVA229

UNCLAS  BRATISLAVA 000229 
 
SIPDIS 
 
 
E.O. 12958: N/A 
TAGS: KHIV, PGOV, PHUM, PREF, LO 
SUBJECT: SLOVAKIA'S HIV/AIDS SITUATION: WELL-POSITIONED FOR 
THE FUTURE 
 
1. Summary: Although the country's low rate of registered 
HIV/AIDS cases hampers social awareness, a three-year 
National Prevention Plan (NPP), improved school programs, and 
NGO outreach efforts demonstrate Slovakia's dedication to 
public education in preventative measures and risks 
associated with the disease.  Free anonymous testing centers 
and governmental focus on advanced medical care are further 
indications that Slovakia is seriously concerned about 
HIV/AIDS. However, related issues -- such as the 
psychological impact on patients and public awareness 
campaigns to reduce the stigma of the disease -- lack 
attention and funding. End Summary. 
 
INCIDENCE RATE 
-------------- 
 
2. Slovakia boasts one of the lowest HIV/AIDS rates in Europe 
with only 207 cases registered since 1985 in a population of 
5.4 million people. Seventy-six of these were foreigners, the 
majority of whom returned to their home countries following 
diagnosis.  Statistics for 2004 indicate only 107 Slovaks are 
currently living with HIV/AIDS. Eighty percent of the 
infected are men. The main mode of transmission was through 
homosexual (63.4 percent) and heterosexual (26.0 percent) 
contact. Many of those affected are sex workers.  The 
remaining 14 cases were connected with intravenous drug use 
(2 cases), blood transfusion (1 case), and unidentified 
reasons (8.4 percent). Seven women testing positive were 
pregnant, and the Slovak medical community is proud that 
proper and timely care blocked transmission from mother to 
child in all cases. 
 
3.  NGOs estimate that the reported figures are understated 
due to limited appointment schedules for anonymous testing, 
inconvenient travel time to testing centers (only three exist 
in the country), reluctance to seek non-anonymous testing 
with general practitioners, and failure to account for 
individuals who seek anonymous testing in Vienna and 
Budapest.  In addition, although laws mandate that the actual 
test be free of charge, and testing centers abide by this 
rule, many general practitioners still charge fees for 
extracting blood, or their office visit fee for performing 
blood tests.  These costs may deter some Slovaks from seeking 
a blood test. 
 
4. The medical community is concerned that HIV/AIDS rates may 
increase in the future with the opening of borders to EU 
countries and the rapid rise in cases among Slovakia's 
neighbors, especially Ukraine.  However, the prevalence of 
HIV/AIDS has remained steady throughout the past three years 
with an average registration of ten new HIV cases and three 
new AIDS cases annually.  In 2004, the government only 
identified nine new HIV cases with no new AIDS cases 
reported. 
 
NPP AND EDUCATIONAL OUTREACH 
---------------------------- 
 
5. The GOS's NPP for 2004 to 2007 focuses on prevention, 
testing, and medical care to reduce the potential spread of 
HIV/AIDS. Funding from governmental agencies supports 
prevention strategies, including educational programs such as 
the "Play against AIDS" performed in middle and high schools, 
distribution of printed pamphlets designed to increase 
awareness among teenagers and university students, as well as 
specific strategies for higher risk individuals, including IV 
drug users and impoverished minority communities. 
 
6. Governmental efforts are further supported by NGO 
assistance.  For example, in 2004, ODYSEUS, an NGO 
specializing in outreach to sex workers and IV drug users, 
held several festivals to educate these high risk groups, to 
provide limited testing, and to distribute clean needles and 
condoms.  The Slovak Red Cross and the Association Against 
AIDS also combined efforts to provide youth educational 
prevention programs. 
 
TESTING/MEDICAL CARE 
-------------------- 
 
7. Slovakia offers anonymous testing at three clinics 
strategically located in each region of the country (in the 
cities Bratislava, Kosice, and Banska Bystrica), although 
these clinics only provide testing at limited hours.  For 
example, the facility in Bratislava only offers testing from 
8:00 a.m. to 10:00 a.m. three days per week.  One NGO 
criticized this system because many workers are unable to 
access the clinic during those times.  In addition, all 
general practitioners can provide testing, and gynecologists 
must offer pregnant women free testing.  However, in a 
country consisting of numerous small villages with close-knit 
family communities, individuals have expressed concerns to 
NGOs that physicians would pass test result information to 
family members and friends. 
 
 
8. Upon diagnosis of HIV/AIDS, medical care costs within 
Slovakia are covered in full under current insurance plans. 
According to the Director of the National Program for AIDS 
Prevention, Dr. Emil Tomasek, the medical facility designated 
for treatment is modern, medical care incorporates the most 
recent scientific advancements, and an ample supply of the 
necessary drugs is available.  Tomasek attributed the 
consistently declining rate of AIDS and resulting deaths 
since 2000 to this advanced medical care. 
 
PUBLIC STIGMA 
------------- 
 
9. Slovakia has not yet addressed public stigma often 
associated with those who test positive.  HIV/AIDS victims 
are protected from revealing their status, and employers 
cannot ask whether an individual has tested positive. 
However, outside the legal arena, the low prevalence rate 
ensures that the vast majority of Slovaks has never 
personally met anyone with HIV/AIDS to engender sympathy or 
understanding.  Currently, the media and NPP do not focus on 
improving attitudes or public opinion regarding HIV/AIDS but 
center on prevention strategies and medical care. The stigma 
can be exacerbated by racial biases. 
 
10. NGOs commented that the government, while providing 
excellent medical care, does not address psychological 
concerns, stigma against patients, and internal feelings of 
isolation.  Due to the low number of cases, self-help groups, 
group counseling opportunities, or other common methods for 
psychological assistance are non-existent.  NGOs hope to 
improve this situation through outreach at HIV/AIDS 
prevention festivals and promotion of informal group meetings 
among known diagnosed individuals. NGOs expressed doubts that 
vital funding from international sources and private 
organizations to bolster improvements in these areas will be 
available given the low prevalence levels. 
THAYER 
 
 
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