Spanning 11 times zones, and reaching from the Baltic and Black Seas in the West to the Pacific Ocean in the East, this region extends from the Arctic Ocean in the north to the Afghan, Chinese and Mongolian borders in the south. Its rich diversity features more than 300 ethnic and language groups, a vast array of climates and ecosystems rich in natural resources, and a multitude of political, economic and social issues. Current estimates place the total population for all 15 countries at approximately 270 million people. Despite broad differences, many people refer to themselves as Russian speaking.

AFEW is currently active in six countries: Ukraine, GeorgiaKazakhstan, Kyrgyzstan, Russia and Tajikistan

Despite the late appearance of HIV, countries in this region are now experiencing some of the fastest growing HIV epidemics faced globally. UNAIDS currently estimates that more than 1.5 million people are living with HIV in the region—although official figures still only reach the hundreds of thousands.

HIV has disproportionately affected young people across the region, many of whom engage in injecting drug use. Coupled with relatively little knowledge of how HIV is transmitted and how to engage in safer sexual and injecting practices, the HIV epidemics in individual countries continue to grow unabated. HIV has affected these countries in different ways and at different times, appearing first in Eastern Europe and gradually spreading into the Caucasian and Central Asian Republics.