Shymkent (Kazakhstan), Jan 1: Saule, a 27-year-old Kazakh biology graduate, has a job and a young daughter. No one knows she also has HIV.
''I haven't told anyone. I don't know how people might react,'' said Saule, her dark eyes watching intently through a slit in a scarf wrapped around her face for anonymity.
With HIV most prevalent in sub-Saharan Africa, sharp increases in Eastern Europe and Central Asia are often overlooked.
Yet there are some signs infection rates in this part of the world have risen by more than 50 percent since 2004, according to the Joint United Nations programme on HIV and AIDS.
This opens a new frontier to the epidemic in Kazakhstan where the World Bank says the number of registered cases has almost doubled each year since 2000.
In Saule's native town of Shymkent in southern Kazakhstan, HIV is something people are reluctant to discuss. As in many other parts of the former Soviet Union, the virus is little understood in this Central Asian state.
Discrimination and abuse are rife, and campaigners say little is being done to raise people's awareness.
Injecting drug use is the most common course of infection in Kazakhstan. Saule contracted the virus in 2003 from her husband, a once-successful athlete who became addicted to drugs.
''I discovered he was registered with an AIDS centre here. He didn't tell me. I didn't know,'' she said. ''When I found out I wanted to kill him, then myself.'' Drug-related abuse has always been a problem in Shymkent, a gritty industrial town lying on the main heroin trafficking route from Afghanistan to Europe, even in Soviet days.
But the issue sprang to the top of national agenda after more than 80 children contracted HIV in hospitals in the Shymkent region from transfusions of blood suspected of containing the virus.
Eight babies have died as a result, and the number of infected children is rising. Officials suspect rogue donors but it remains unclear what caused the outbreak, the first on this scale in Kazakhstan.
In a local blood donors' centre, walls are plastered with posters explaining what HIV is.
''World Health Organisation people were here a while back. But even they couldn't say what caused the outbreak,'' says Gulzhan, a lab worker. ''Everyone is nervous.''
Campaigners have criticised Kazakhstan, with its vast oil export revenues, for not doing enough to reconstruct its crumbling public health system, root out corruption and provide better safe-sex education at schools. One campaigner, Sagdat Masaurov, set up a charity known as Save Children from AIDS after his grandson, Baurzhan, contracted HIV in a hospital blood transfusion in Shymkent this year.
''It's not the HIV itself that is scary,'' said Masaurov.
''People stopped saying hello to me after I appeared on TV (speaking about HIV). My relatives stopped visiting me. I understand that.
It's just fear.
''People in the West live with HIV for years, they work, grow up, marry. We have to work more with our society, schools and journalists to create similar conditions here.'' CHILDREN PAY THE PRICE Infection levels in Central Asia have risen since the 1990s mainly among drug addicts, prison inmates and homeless people. Most hospitals were built in Soviet days and lack essential modern equipment. In-hospital infections have become widespread.
The UN children's fund, which has worked in Kazakhstan since 1995, believes the number of people living with HIV could be three times higher than the official total of about 7,000.
''These problems are not just here in Shymkent. It affects the whole of Kazakhstan,'' said Alena Sialchonak, a UNI