The countries of the CIS are. Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russian Federation, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. Eastern Europe contains Bulgaria, Czechoslovakia, Hungary,Poland, Romania, and the countries resulting from the break up of former Yugoslavia. The collapse of the USSR and the communist systems in the late 1980s and early 1990s has had profound social, economic and political consequences for the two regions. The most significant consequence relating to HIV/AIDS is the opening of the region's borders, making it much easier for populations to migrate. Prior to this time, people were restricted within country borders. Available research shows a serious lack of information and awareness about HIV/AIDS in these two regions, particularly in countries of the CIS. Nor is there evidence of coordinated programmes shared between AIDS and STD services within the countries. Labour migration is common in the CIS, but has taken dramatic proportions in countries wracked by armed conflicts such as Armenia, Georgia and Tajikistan. The number of CIS refugees and persons in refugee-like situations was 870,000 between 1989 and 1996 and there are large numbers of "internally displaced people" in places such as in Chechnya (which is de jure part of Russia). Young people form an important part of the migration flow in the CIS. No in-depth research appears to have been done on the prevalence of HIV/AIDS among migration populations in the CIS. Among the general populations, however, the number of HIV-positive cases has increased rapidly since 1995, particularly among the Injecting Drug User (IDU) population. Alarming rises in STD rates, especially in syphilis and gonorrhoea, have also been noted in the region during the 1990s. No written information is available on prevention, diagnostic or counselling services for migrants in the CIS, and there do not seem to be any formal programmes specifically targetting them. Moreover, services available to the general public are not "migrant-friendly" for a variety of reasons. For instance, Russia's new system of anonymous dermato-venereology clinics are fee-based. People without money are still expected to use the old clinics and produce identity papers, thereby risking legal constraints and sanctions if they have an STD. Except for the former Yugoslavia and Romania, the countries of Eastern Europe have been free from wars and disasters during the 1990s and for that reason do not have large mobile populations. Although levels of HIV infection in the general population remain very low in Eastern Europe, testing of pregnant women, blood donors and others shows that the virus is becoming increasingly common in some places. Of equal concern is a dramatic increase in other sexually transmitted diseases, especially syphilis. In all Eastern European countries, treatment of HIV/AIDS cases is expensive. If the patient has no legal status in the country, such as a residence permit, treatment may be refused. Given the lack of knowledge and the potential for rapid escalation of the epidemic among migrant populations (as seen in other parts of the world), epidemiological and quantitative research on HIV/AIDS and migrants is urgently needed in both regions. Qualitative research must also be under taken in order to better understand the course of the epidemic among different migrant groups. This is necessary because each situation and each community may be different and have unique needs.
