Education And Debate

Discrimination against people with HIV and AIDS in Poland

BMJ 1994; 308 doi: (Published 30 April 1994) Cite this as: BMJ 1994;308:1145
  1. Renee Danziger, research fellowa
  1. a Health Policy Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  1. Correspondence to: 19 Primrose Hill Road, London NW3 3DG.
  • Accepted 25 January 1994

The recent increase in HIV seroprevalence in Poland, particularly among injecting drug users, has been accompanied by widespread discrimination against people affected by HIV and AIDS. As in other countries, this discrimination may be attributed to a large extent to fear and ignorance about HIV and AIDS together with pre-existing prejudices against the people who are most commonly associated with the epidemic. In Poland extreme hostility towards drug users combined with the powerful influence of a traditional Catholic church have so far impeded effective education about HIV and AIDS and anti-discrimination strategies.

Infection with the human immunodeficiency virus (HIV) has spread rapidly in Poland in recent years, the cumulative total of reported cases having risen from 435 in 1990 to 2476 in 1992 (Piotr Jaworski, personal communication). Reported cases represent only a fraction of the actual total, which has been estimated at between 10 000 and 20 000.1 The AIDS epidemic in Poland has been characterised by widespread discrimination against people affected by HIV and, though piecemeal efforts have been made to reduce discrimination, the development of an effective anti-discrimination strategy has been impeded by a complex web of cultural, social, and political pressures.

Injecting drug use and homosexuality

The HIV epidemic in Poland is closely associated with drug use, over 70% of reported cases of infection being among injecting drug users. HIV prevalence among this group rose from 0.8% in 1988 to 8.7% in 1989 and to 20% in 1991.2 3

Three factors help to explain the rapid transmission of HIV among drug users in Poland: the easy availability and wide use of cheap, home produced heroin known as kompot; a strong tradition of syringe sharing; and a general shortage of disposable needles and syringes.

Most addicts in Poland are homeless, unemployed, and unskilled.4 They are widely perceived as irresponsible and …

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