HIV/AIDS wrought devastation in Romania in the 1980s and 1990s. The HIV problem was exposed after the 1989 revolution that brought communism crashing down. Romanians, who had been shielded from the truth by a tightly controlled media, were as shocked by the extent of the disease in their country as the outside world was.
The victims were mostly small children infected in hospitals. Poor sterilisation facilities and dubious medical practices, such as dodgy blood transfusions, were largely to blame.
Those that did not die were often ostracised. One HIV-positive woman, now 21, told me that her neighbours knew about her condition before she did: it was openly written on her medical documents. At school they teased her as sidoasa—a slang expression for an AIDS sufferer.
She had probably been infected in hospital as a small child, a year or two after the death of Ceauşescu. But she was only tested at around the age of ten, after she started developing strange illnesses in her lungs.
Hers is a typical story. But Romania's treatment of HIV/AIDS has improved in the last decade, after long protests from victims' families. Questions are still occasionally asked about some medical services, but the most dangerous practices have been eradicated. The woman is now on regular anti-retroviral treatment, and the levels of the virus in her blood are undetectable. She has a young son, who, thanks to good medical supervision during pregnancy and since, is HIV-negative.
Identifying someone as HIV-positive without their consent can now lead to five years in prison. Doctors have learned to use cryptic medical codes rather than disease names on official documents. Mother-to-child transmission of the virus has been drastically reduced by simple measures like proper screening of pregnant mothers, delivery by Caesarian section and avoiding breastfeeding.
Antiretroviral treatment is free and available to those who need it. Death rates have plummeted. In fact, Romania is now often cited as an example to other poor countries with major HIV/AIDS problems.
Yet a substantial number of Romanians with HIV still don't know it. The generation infected in the 1980s and 1990s is now at reproductive age, and new cases are still appearing across the country, often years after infection. Health workers say sexual transmission is now the most common method.
With Romania undergoing painful economic restructuring, campaigners say funding for public education on HIV/AIDS has largely dried up. It was always a hard sell in a country terrified of the disease. Many Romanians remain ignorant of the most basic facts.
Public-health workers say that, with Romania now an EU member, this represents a danger not just to Romanians but potentially to its neighbours. “HIV doesn't have borders," says Angela Achitei, president of Alaturi de Voi ("Close to You"), an organisation providing work for HIV-positive people in the northeastern city of Iasi. Romanians working overseas are at particular risk, as they often cannot access local health services.
The sex industry has flourished in Romania, just as it has across the ex-communist world. Yet health workers say prostitutes are probably not the greatest risk. After all, they have a professional interest in knowing how to avoid infection. A bigger problem is a silent pool of HIV-positive people who do not realise that they and their sexual contacts are at risk.
Alaturi de Voi once handed out free condoms and organised free HIV testing in discos in Iasi, home to many students. It was a big hit. It reached the target audience and the owners got a full club to boot. But the money is no longer there.