Health systems' responses to 25 years of HIV in Europe: Inequities persist and challenges remain
Europe is currently experiencing the fastest rate of growth of HIV of any region of the world. An analysis of policy and health system responses to the HIV epidemic in Europe and central Asia (hereafter referred to as Europe) over the last 25 years reveals considerable heterogeneity. In general, while noting hazards of broad generalisations and the differences that exist across countries in a particular grouping, effective policies to control HIV have been implemented more widely in western than in central and eastern Europe. However, the evidence suggests persistence of inequalities in access to preventive and treatment services, with those at highest risk, such as commercial sex workers, prisoners, intravenous drug users, and migrants often particularly disadvantaged, despite many targeted programmes. Responses in individual countries, especially in the early stages of the epidemic, were influenced by specific cultural and political factors. Strong leadership and active involvement by civil society organisations emerge as important factors for success but also a limiting factor to the response observed in eastern Europe, where civil society or NGO culture is weak as compared to western Europe. Scaling up of effective responses in many countries in eastern Europe will be challenging--where increased financial resources will have to be accompanied by broader changes to health system organization with greater involvement of the civil society in planning and delivery of client-focused services.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Postma, Maarten J. & Tolley, Keith & Leidl, Reiner M. & Downs, Angela M. & Beck, Eduard J. & Tramarin, Andrea M. & Flori, Yves A. & Santin, Miguel & Antonanzas, Fernando & Kornarou, Helen & Paparizos,, 1997. "Hospital care for persons with AIDS in the European Union," Health Policy, Elsevier, vol. 41(2), pages 157-176, August.
- Atun, Rifat Ali & Menabde, Nata & Saluvere, Katrin & Jesse, Maris & Habicht, Jarno, 2006. "Introducing a complex health innovation--Primary health care reforms in Estonia (multimethods evaluation)," Health Policy, Elsevier, vol. 79(1), pages 79-91, November.
- Danziger, Renée, 1996. "Compulsory testing for HIV in Hungary," Social Science & Medicine, Elsevier, vol. 43(8), pages 1199-1204, October.
- Barnett, Tony & Whiteside, Alan & Khodakevich, Lev & Kruglov, Yuri & Steshenko, Valentyna, 2000. "The HIV/AIDS epidemic in Ukraine: its potential social and economic impact," Social Science & Medicine, Elsevier, vol. 51(9), pages 1387-1403, November.
- Danziger, Renée, 1999. "The social impact of HIV testing: a comparative analysis of Britain and Sweden," Social Science & Medicine, Elsevier, vol. 48(3), pages 293-300, February.
- Stimson, Gerry V., 1995. "Aids and injecting drug use in the United Kingdom, 1987-1993: The policy response and the prevention of the epidemic," Social Science & Medicine, Elsevier, vol. 41(5), pages 699-716, September.
- Dijkgraaf, Marcel G. W. & Luijben, August H. P. & Postma, Maarten J. & Borleffs, Jan C. C. & Schrijvers, August J. P. & Jager, Johannes C., 1996. "Lifetime hospitalization profiles for symptomatic, HIV-infected persons," Health Policy, Elsevier, vol. 35(1), pages 13-32, January.
- Danziger, Renee, 1997. "HIV prevention in Hungary," Health Policy, Elsevier, vol. 40(3), pages 231-236, June.
- Petchey, Roland & Williams, Jacky & Farnsworth, Bill & Starkey, Ken, 1998. "A tale of two (low prevalence) cities: social movement organisations and the local policy response to HIV/AIDS," Social Science & Medicine, Elsevier, vol. 47(9), pages 1197-1208, November.
- Smyth, Fiona, 1998. "Cultural constraints on the delivery of HIV/AIDS prevention in Ireland," Social Science & Medicine, Elsevier, vol. 46(6), pages 661-672, March.
- Haour-Knipe, Mary & Fleury, Francois & Dubois-Arber, Francois, 1999. "HIV/AIDS prevention for migrants and ethnic minorities: three phases of evaluation," Social Science & Medicine, Elsevier, vol. 49(10), pages 1357-1372, November.
- Kupek, Emil & Dooley, Mary & Whitaker, Luke & Petrou, Stavros & Renton, Adrian, 1999. "Demographic and socio-economic determinants of community and hospital services costs for people with HIV/AIDS in London," Social Science & Medicine, Elsevier, vol. 48(10), pages 1433-1440, May.
- Spire, Bruno & Duran, Ségolène & Souville, Marc & Leport, Catherine & Raffi, François & Moatti, Jean-Paul, 2002. "Adherence to highly active antiretroviral therapies (HAART) in HIV-infected patients: from a predictive to a dynamic approach," Social Science & Medicine, Elsevier, vol. 54(10), pages 1481-1496, May.
When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:86:y:2008:i:2-3:p:181-194. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)or ()
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.