A huge HIV and Aids epidemic is on the brink of devastating former eastern-block countries, according to a report in the medical journal The Lancet.
Injecting drug users are fuelling HIV spread in Eastern Europe
Injecting-drug users and a rise in unsafe sex practices in former communist countries will soon cause a major HIV/Aids epidemic, say experts.
Eastern Europe and Central Asia have the fastest growing HIV epidemic in the world.
Figures from UNAIDS and the World Health Organisation show there are a million HIV positive individuals living in the former Soviet Union.
The authors of the report say that urgent action is needed to prevent further HIV spread in the region.
Drugs and prostitution
Social upheaval in the former communist block in the 1990s has led to rapidly declining socioeconomic conditions.
This, doctors say, has led to a sharp increase in substance abuse, prostitution and unsafe sex.
In view of the current levels of HIV prevalence, Eastern Europe will soon be confronted with a major AIDS epidemic.
Data collected from 27 countries in the former communist block shows that in countries like Estonia, the Ukraine, The Russian Federation and Kazakhstan, HIV has been spreading through intravenous drug use over the past five years.
But what is worrying doctors is that HIV is now being transmitted through heterosexual sex - particularly as many HIV positive drug users have unprotected sex with multiple partners.
The report recommends that HIV prevention programmes for injecting drug users should be made a priority in the area.
Doctors are worried that HIV cases might spread in a similar way to Spain and Portugal.
These were the countries in Western Europe with the highest numbers of HIV positive injecting drug users. But they also have the highest rates of HIV transmission through heterosexual sex.
In central Europe HIV incidence is much lower with almost half the cases found in Poland and a third in Romania.
Again, most are caused by sharing infected needles - mostly between drug users, but also in medical programmes by inadequately sterilised equipment.
But doctors say these relatively small numbers should not lead to complacence.
One of the authors of the report, Dr Françoise Hamers from the Insititut de Veille Sanitaire in France, said: "Rates of HIV in central Europe remain low at present, but behaviours that promote HIV transmission are present in all countries.
"Improved measures to prevent further HIV spread are urgently needed."
The report also emphasises the need to monitor economically motivated migration from eastern countries with the movement of infected individuals to Central and Western Europe also a growing concern.