*   National Statistics Office of Georgia, January 2012
**  Georgian AIDS and Clinical Immunology Research Centre, December 1, 2012
*** 'Report on the Global AIDS Epidemic', UNAIDS, August 2008

The Republic of Georgia is located at the strategically important crossroads between the Russian Caucasus and the countries of the Middle East. The country is renowned for its unique cultural heritage that stretches back to the classical period, when the kingdoms of Colchis and Kartli-Iberia thrived on its territory. Over the intervening centuries, Georgia was the subject of a series of bitter rivalries, between the Persians, Arabs, Turks and Mongols. In the early 19th century, Georgia was absorbed into the Russian empire and subsequently held the status of a Soviet Republic up to the dissolution of the union in 1991. The current president Mikhail Saakashvili was swept to power during the ‘Rose Revolution’ of 2004 following the resignation of Eduard Shevardnadze amidst mass protests against electoral violations. Russia’s support for the breakaway regions of Abkhazia and South Ossetia has led to mounting tension in the region, which flared into open conflict between the two countries in 2008. 

Despite severe damage to the country’s economy caused by political and economic turbulence in the last 20 years, Georgia has maintained robust growth and financial stability with the help of the IMF and World Bank. The economy relies on agricultural exports, manganese and copper, alcoholic and non-alcoholic beverages, metals, machinery, aircraft and chemicals. Around 55% of the population earn their living from agricultural activities, much of which is subsistence farming, and around 31% of Georgians live below the poverty line. 

HIV Situation

Georgia is categorised as having a low-prevalence HIV epidemic (below 0.01%). According to government figures from March 2010, there are 2 318 people registered with HIV in the republic; UNAIDS estimates that the real figure is nearer 3 390 cases (taking into account the probable number of undetected cases). Despite these low figures, widespread drug use and mass population movements between high prevalence countries (such as Russia and Ukraine) put the country at high risk of an accelerating epidemic. 

Since 2004, the country has received two major grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria, which have been critical to scaling up the country’s National Response to HIV and AIDS. Significant progress has been made in treatment provision: UNAIDS recognises Georgia as a country that provides universal access to ART. However, despite good treatment availability, Georgia still has one of the highest rates of AIDS in Europe (4.1 in a 100,000 people, compared to an average of 1.5 in Eastern Europe as a whole) . Such a poor outcome for HIV patients is largely due to poor diagnostic capacity that results in delayed diagnoses, as well as poor management of treatment adherence and opportunistic infections.

In 2008-2009 the Georgian government has made a number of important policy changes that acknowledge the positive potential of harm reduction strategies. An important outcome has been the institution of state funding for methadone substitution therapy. However, highly restrictive drugs laws still present significant barriers to the implementation of HR interventions in both civil and correctional settings.