As the conflict in eastern Ukraine grinds on, a hidden crisis that began long before the fighting is becoming increasingly severe. Ukraine has one of the highest rates of HIV/AIDS in Europe and, in the war-torn east of the country, the rates of HIV are increasing three times faster than in the rest of Ukraine. With Russia-backed separatists banning most international medical organizations and taking a harsh stance toward people living with HIV/AIDS, many who can, flee the region, becoming some of Ukraine's most vulnerable IDPs. Photographs by Misha Friedman. Reporting for this story was partially funded by the Pulitzer Center.
HIV: East Ukraine's Silent Crisis
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Olha has known about her HIV status for almost 20 years. She was a social worker, helping young women in her hometown Donetsk. But after she openly opposed the separatist regime, she was forced to flee, leaving all of her possessions behind. Her apartment is now occupied by separatists and she lives in a temporary shelter in Odesa. Olga admitted to photographer Misha Friedman that she has attempted suicide.
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Yana, an outreach worker, visiting an HIV positive patient being treated for tuberculosis in Donetsk. HIV sufferers are particularly susceptible to diseases such as TB, which is currently making a comeback in Ukraine's war zones.
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Tetyana, 33, with her three children. She contracted HIV from her husband, who was a drug user and died of complications from AIDS in January 2016. The family had fled its home during heavy fighting and Tetyana now lives in Kramatorsk, supported solely by NGOs and church groups. She is unable to work, as she is the only caregiver for her children.
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Viktoria, 48, is a social worker for women with HIV in Kramatorsk.
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Alla with her son after getting groceries paid for by an NGO that assists internally displaced people with drug problems. The HIV sufferer fled her home just outside of Donetsk during fighting and is now living with her son in Kramatorsk.
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Alla walks to her apartment after receiving her daily dose of methadone, a substitution therapy for drug users that separatists in eastern Ukraine have made almost impossible to get. The Russia-backed separatists have taken a hard line on drug addiction, in contrast with Kyiv's policy of making methadone available to those hoping to get off hard drugs.
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Svita is reunited with her husband, Oleksiy, in Kyiv after he spent months as a POW of Russia-backed separatists. He hid his HIV status from his captors and Svita managed to sneak his medications to him.
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Iryna, 28, fled the war from Yenakiyeve, a town now under separatist control in eastern Ukraine. The HIV sufferer is an intravenous drug user and receives substitution therapy, which was made illegal by separatists.
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Roza, an outreach worker for a small local NGO, is battling drug addiction as well as HIV. To fund her addiction, Roza was a sex worker and spent time in prison. Now she helps others from similar backgrounds.
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Yana (left), 40, with her social worker Olha. Yana was recently released from prison and Olha is helping her readjust to everyday life in Mariupol.
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At a warming station for the homeless, Olha listens to a young woman who was kicked out of home by her parents.