Homophobia and a “Soviet hangover” are driving HIV infections in parts of Eastern Europe and Central Asia, according to David Furnish, AIDS campaigner and Sir Elton John’s husband.

While the rate of new HIV infections is decreasing globally – falling 40 per cent since its peak in 1997 - certain areas of the world are witnessing increasing rates.

The highest rate of new infections is in Eastern Europe and Central Asia – ahead of the Middle East and the Caribbean. Between 2010 and 2018, the region saw a 29 per cent annual increase in new HIV infections.

Deaths from AIDs have increased by roughly 300 per cent in the last 20 years in Eastern Europe and Central Asia, and it is often within already marginalised communities that HIV rates can snowball.

Having recently visited Armenia with Sir Elton, ahead of the launch of the Foundation’s new programme in the region, RADIAN – in which they have partnered with pharmaceutical company Gilead – Furnish said they saw firsthand how prejudice was allowing HIV and AIDs rates to continue to rise.

Despite a widespread “sense of optimism and growth and amazing energy, some of the things from Soviet occupation – like homophobia – are hanging around in a major way,” Furnish tells The Independent.

Independent campaign with the Elton John AIDS Foundation Show all 10 1 /10 Independent campaign with the Elton John AIDS Foundation Independent campaign with the Elton John AIDS Foundation Sir Elton John and Evgeny Lebedev The Independent has launched it's Christmas charity appeal for essential HIV testing around the world with the Elton John AIDS Foundation. Funds raised will pay for those at risk to be able to get tested, and will make sure they have access to the treatment they need. Sir Elton John and Evgeny Lebedev with their HIV test swabs at the Ponce Centre in Atlanta Jeremy Selwyn Independent campaign with the Elton John AIDS Foundation Elton John and Andrew Williams Andrew Williams had never heard of the word HIV when he tested positive. It was his mother who had forced him to go to the doctor where he got the diagnosis that he thought was a death sentence. At that time he was in a wheelchair. It was the unbearable itching of his back that finally got him to get medical help but, he discovered, he not only had HIV but diabetes, high blood pressure and kidney disease. That was two years ago. This week, as the 31-year-old joined Sir Elton John and Evening Standard and The Independent owner Evgeny Lebedev in Atlanta to witness the revolutionary new breakthroughs against the disease at the city’s Grady Ponce De Leon Centre, there was no need for a wheelchair. Nor, he now knew, was there any need for fear Jeremy Selwyn Independent campaign with the Elton John AIDS Foundation Evgeny Lebedev and Andrew Williams Within two months of starting the latest antiretroviral drugs, the virus in his body had become undetectable in his blood. Not only is he now healthy, partly due to the drugs and partly due to the healthy lifestyle adopted for his other illnesses, but he can virtually not pass the infection to other people. He feels, he says, “reborn”. “I have a reason to live,” he explained, “and that is to help people who were like me – and to show you’re going to be OK.” Jeremy Selwyn Independent campaign with the Elton John AIDS Foundation It was a message so stark in its optimism that it reduced Sir Elton to tears. He knows first-hand the realities of what, in the past, an HIV diagnosis can mean. When he started his Elton John AIDS Foundation in the US in 1992, it was because his friends were dying and he wanted to do what he could, anything that he could, to help. “When we set up the Elton John AIDS Foundation we were delivering meals to people’s doors,” he said. “[The stigma meant] they would not go outside. We have come a long way.” Jeremy Selwyn Independent campaign with the Elton John AIDS Foundation But part of the reason for his tears was not only happiness at Andrew’s story. It was also the knowledge that, despite all the advances that have been made, the fight is far from won – indeed, in some parts of the world, things are getting worse. Sir Elton John with everyone at the Ponce Centre in Atlanta Jeremy Selwyn Independent campaign with the Elton John AIDS Foundation It is why he and Mr Lebedev had come to Atlanta to mark the first day of our Christmas Appeal, for that city, sadly, is one place where the situation is not only getting worse but, as those at the centre made clear, dramatically so. Jeremy Selwyn Independent campaign with the Elton John AIDS Foundation Sir Elton John with Vic Mensa at the Ponce Centre Jeremy Selwyn Independent campaign with the Elton John AIDS Foundation Sir Elton John with his HIV test swab In Atlanta, one of America’s richest cities and the home of such international corporate giants as Coca-Cola and CNN, if you are a gay black man in 2018 then, unbelievably, you still have a one in two chance of being diagnosed as HIV positive during your lifetime. Jeremy Selwyn Independent campaign with the Elton John AIDS Foundation Elton John with the mayor of Atlanta, Keisha Lance Bottoms Jeremy Selwyn Independent campaign with the Elton John AIDS Foundation Elton John talks at the Ponce Centre Jeremy Selwyn

“And those are the sorts of things that drive HIV infections. The people that we met on the ground have been bullied and beaten up.”

When groups such as LGBT+ individuals – with trans people facing specific prejudices – or intravenous drug users already feel stigmatised and excluded by society, they are less likely to get tested, and less likely to have access to healthcare, and are therefore unable to get treatment, Furnish explains.

Medical advances in recent years have meant that HIV viral loads can be sufficiently suppressed so that if someone knows their positive status and is treated for it, they cannot pass the virus on.

And Furnish links the homophobia in former Soviet countries to the situation in Russia today, where state policies have allowed space for an increase in anti-gay attacks – an issue Sir Elton has been vocal about.

“The homophobia that hangs around in Russia,” Furnish says, is “fuelled by policies that are making the situation much, much worse. It’s given homophobes permission to feel more aggressive and empowered.

“Anywhere in the world where we see LGBT people being marginalised, where their rights are being taken away or oppressed, when you stigmatise LGBT people, you invariable see an increase in infections… but you also see general rates increase.”

This is all the more frustrating, he explains, as HIV has become a completely treatable condition.

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“When I started this journey with Elton 26 years ago, we had nothing in our arsenal but palliative care, but now we have all the medical tools at our finger tips to treat it… and when you see the rates increasing, it’s just like, ‘why is this happening at all?’”

But Furnish also sees reason for hope. Twenty years ago, when he and Sir Elton first visited Kiev, the HIV/AIDs situation there was “frightening.” He vividly recalls visiting an orphanage of HIV-positive children, which the Foundation was supporting.

“That orphanage is now closed. And those children are now adults, living full lives, they’re on medication, they’re not cut off from society,” he says.

What they learned in Ukraine – the importance of working with local groups on the ground to empower the HIV-positive community – they now hope to replicate across the region with RADIAN.