Although HIV prevalence is low in Macedonia, with only 151 people registered as living with HIV, these small numbers mask a complex picture, and one that is rapidly changing. In 2016, there were 40 new HIV diagnoses, the majority of them among men who have sex with men.
Macedonia is not alone in facing a rise in HIV cases. In many parts of Central and Eastern Europe, the rate of new infections is growing. Between 2010 and 2015, the region saw a 50 per cent rise in new HIV infections annually.
Another looming problem that threatens to send Macedonian HIV rates spiralling upwards is a funding crisis precipitated by donor cutbacks and political uncertainty. Between 2004 and 2016, Macedonian HIV programmes received almost $25 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Much of this money was channelled into HIV prevention, funding NGOs that target those deemed most vulnerable to infection – sex workers, people who inject drugs, men who have sex with men and prisoners. But in 2016 this funding was phased out and NGOs on the frontline are left hoping that the new government will deliver fully on a recent commitment to step in with similar levels of funding in 2018.
In the chasm left by the country’s public healthcare system, Macedonia’s sexual health and rights NGOs work tirelessly to plug the gap, often on a shoestring and in an increasingly uncertain funding landscape. HERA, IPPF's member in Macedonia, is a leading NGO providing free HIV testing services, sexual health support and advocacy. It works closely with smaller organisations around the country to ensure support for young people, sex workers, people who inject drugs and men who have sex with men. These NGOs are many people’s first port of call for HIV tests and other vital health care.
Photos: IPPF EN/Jon Spaull