Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.

<h4>Background</h4>Ukraine developed Europe's most severe HIV epidemic due to widespread transmission among persons who inject drugs (PWID). Since 2004, prevention has focused on key populations; antiretroviral therapy (ART) coverage has increased. Recent data show increases in repo...

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Autores principales: Charles R Vitek, Jurja-Ivana Čakalo, Yuri V Kruglov, Konstantin V Dumchev, Tetyana O Salyuk, Ivana Božičević, Andrew L Baughman, Hilary H Spindler, Violetta A Martsynovska, Yuri V Kobyshcha, Abu S Abdul-Quader, George W Rutherford
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spelling oai:doaj.org-article:8b898f16725b427a903500be0196eb1e2021-11-25T05:59:30ZSlowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.1932-620310.1371/journal.pone.0103657https://doaj.org/article/8b898f16725b427a903500be0196eb1e2014-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0103657https://doaj.org/toc/1932-6203<h4>Background</h4>Ukraine developed Europe's most severe HIV epidemic due to widespread transmission among persons who inject drugs (PWID). Since 2004, prevention has focused on key populations; antiretroviral therapy (ART) coverage has increased. Recent data show increases in reported HIV cases through 2011, especially attributed to sexual transmission, but also signs of potential epidemic slowing. We conducted a data triangulation exercise to better analyze available data and inform program implementation.<h4>Methods and findings</h4>We reviewed data for 2005 to 2012 from multiple sources, primarily national HIV case reporting and integrated biobehavioral surveillance (IBBS) studies among key populations. Annually reported HIV cases increased at a progressively slower rate through 2011 with recent increases only among older, more immunosuppressed individuals; cases decreased 2.7% in 2012. Among women <25 years of age, cases attributed to heterosexual transmission and HIV prevalence in antenatal screening declined after 2008. Reported cases among young PWID declined by three-fourths. In 2011, integrated biobehavioral surveillance demonstrated decreased HIV prevalence among young members of key populations compared with 2009. HIV infection among female sex workers (FSW) remains strongly associated with a personal history of injecting drug use (IDU).<h4>Conclusions</h4>This analysis suggests that Ukraine's HIV epidemic has slowed, with decreasing reported cases and older cases predominating among those diagnosed. Recent decreases in cases and in prevalence support decreased incidence among young PWID and women. Trends among heterosexual men and men who have sex with men (MSM) are less clear; further study and enhanced MSM prevention are needed. FSW appear to have stable prevalence with risk strongly associated with IDU. Current trends suggest the Ukrainian epidemic can be contained with enhanced prevention among key populations and increased treatment access.Charles R VitekJurja-Ivana ČakaloYuri V KruglovKonstantin V DumchevTetyana O SalyukIvana BožičevićAndrew L BaughmanHilary H SpindlerVioletta A MartsynovskaYuri V KobyshchaAbu S Abdul-QuaderGeorge W RutherfordPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 9, p e103657 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Charles R Vitek
Jurja-Ivana Čakalo
Yuri V Kruglov
Konstantin V Dumchev
Tetyana O Salyuk
Ivana Božičević
Andrew L Baughman
Hilary H Spindler
Violetta A Martsynovska
Yuri V Kobyshcha
Abu S Abdul-Quader
George W Rutherford
Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.
description <h4>Background</h4>Ukraine developed Europe's most severe HIV epidemic due to widespread transmission among persons who inject drugs (PWID). Since 2004, prevention has focused on key populations; antiretroviral therapy (ART) coverage has increased. Recent data show increases in reported HIV cases through 2011, especially attributed to sexual transmission, but also signs of potential epidemic slowing. We conducted a data triangulation exercise to better analyze available data and inform program implementation.<h4>Methods and findings</h4>We reviewed data for 2005 to 2012 from multiple sources, primarily national HIV case reporting and integrated biobehavioral surveillance (IBBS) studies among key populations. Annually reported HIV cases increased at a progressively slower rate through 2011 with recent increases only among older, more immunosuppressed individuals; cases decreased 2.7% in 2012. Among women <25 years of age, cases attributed to heterosexual transmission and HIV prevalence in antenatal screening declined after 2008. Reported cases among young PWID declined by three-fourths. In 2011, integrated biobehavioral surveillance demonstrated decreased HIV prevalence among young members of key populations compared with 2009. HIV infection among female sex workers (FSW) remains strongly associated with a personal history of injecting drug use (IDU).<h4>Conclusions</h4>This analysis suggests that Ukraine's HIV epidemic has slowed, with decreasing reported cases and older cases predominating among those diagnosed. Recent decreases in cases and in prevalence support decreased incidence among young PWID and women. Trends among heterosexual men and men who have sex with men (MSM) are less clear; further study and enhanced MSM prevention are needed. FSW appear to have stable prevalence with risk strongly associated with IDU. Current trends suggest the Ukrainian epidemic can be contained with enhanced prevention among key populations and increased treatment access.
format article
author Charles R Vitek
Jurja-Ivana Čakalo
Yuri V Kruglov
Konstantin V Dumchev
Tetyana O Salyuk
Ivana Božičević
Andrew L Baughman
Hilary H Spindler
Violetta A Martsynovska
Yuri V Kobyshcha
Abu S Abdul-Quader
George W Rutherford
author_facet Charles R Vitek
Jurja-Ivana Čakalo
Yuri V Kruglov
Konstantin V Dumchev
Tetyana O Salyuk
Ivana Božičević
Andrew L Baughman
Hilary H Spindler
Violetta A Martsynovska
Yuri V Kobyshcha
Abu S Abdul-Quader
George W Rutherford
author_sort Charles R Vitek
title Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.
title_short Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.
title_full Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.
title_fullStr Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.
title_full_unstemmed Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.
title_sort slowing of the hiv epidemic in ukraine: evidence from case reporting and key population surveys, 2005-2012.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/8b898f16725b427a903500be0196eb1e
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