UNGASS Un General Assembly Special Session UNICEF United Nations International Children ’ s Fund USAID United States Agency for International Development VCT Voluntary Counseling and Testing

Acknowledgements The authors would like to acknowledge the World Bank Resident Missions in Bulgaria, Romania, and Croatia for their assistance in securing access to resources and information in each country, in particular Peter Pojarski (Bulgaria), Silviu Radulescu (Romania), and Indira Konjhodizic (Croatia). The authors greatly appreciate the data, review, and general assistance provided by Ministry of Health and academic leaders in all of the countries, including Tonka Finally, the leadership and assistance of the UN thematic groups on AIDS in each country is gratefully acknowledged, especially that provided by Manoela Grozdanova of Bulgaria, Eduard Petrescu of Romania, Jadranka Mimica of Croatia, and Jean-Paul Grund in Vienna. However, valuable assistance was provided by many other NGOs, academic institutions, and other UN organizations, and these are listed in Appendix B. Authors alone are responsible for the conclusions and views in this document. Executive Summary 7 Epidemiology and Operational Research 7 Health Care and Social Support Systems viii Health Communications and Promotion viii Civil Society and Advocacy viii Non-lending Activities iii Introduction iii Overview 4 Situation Analysis and Evaluation 9 Romania 9 1. Current state of the epidemic. Croatia 0 1. Current state of the epidemic: 0 2. Strategies and interventions in place 16 3. Current World Bank activities and possible HIV/AIDS interventions: 19 Epidemiology 20 Health Care and Social Support Systems 20 Health Communications and Promotion 20 Civil Society and Advocacy 21 Bulgaria 23 1. Current state of the epidemic: 23 2. Strategies and interventions in place: 23 3. Current World Bank activities and possible HIV/AIDS interventions: 26 In June, 2002, the countries of Southeastern Europe (SEE) re-committed themselves to scale up action on the prevention and treatment of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) in the sub-region (Annex A). Given the rapid increase in the rate of HIV infection in Eastern Europe in general and the generally similar risk conditions for low HIV prevalence SEE populations, this commitment is timely in terms of preventing a more widespread epidemic. It should also be recognized by the World Bank as a call to action to support these countries through the application of its comparative advantage in both lending and non-lending activities. The purpose of this paper is to review the current status of the AIDS epidemics in three countries of the Sub-region (Bulgaria, Croatia, and Romania which constitute the ECC05 Country Department of the World Bank), to evaluate the …