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Slowing of the HIV Epidemic in Ukraine: Evidence from Case Reporting and Key Population Surveys, 2005–2012

BACKGROUND: 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 thro...

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Autores principales: Vitek, Charles R., Čakalo, Jurja-Ivana, Kruglov, Yuri V., Dumchev, Konstantin V., Salyuk, Tetyana O., Božičević, Ivana, Baughman, Andrew L., Spindler, Hilary H., Martsynovska, Violetta A., Kobyshcha, Yuri V., Abdul-Quader, Abu S., Rutherford, George W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174506/
https://www.ncbi.nlm.nih.gov/pubmed/25251080
http://dx.doi.org/10.1371/journal.pone.0103657
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author Vitek, Charles R.
Čakalo, Jurja-Ivana
Kruglov, Yuri V.
Dumchev, Konstantin V.
Salyuk, Tetyana O.
Božičević, Ivana
Baughman, Andrew L.
Spindler, Hilary H.
Martsynovska, Violetta A.
Kobyshcha, Yuri V.
Abdul-Quader, Abu S.
Rutherford, George W.
author_facet Vitek, Charles R.
Čakalo, Jurja-Ivana
Kruglov, Yuri V.
Dumchev, Konstantin V.
Salyuk, Tetyana O.
Božičević, Ivana
Baughman, Andrew L.
Spindler, Hilary H.
Martsynovska, Violetta A.
Kobyshcha, Yuri V.
Abdul-Quader, Abu S.
Rutherford, George W.
author_sort Vitek, Charles R.
collection PubMed
description BACKGROUND: 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. METHODS AND FINDINGS: 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). CONCLUSIONS: 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.
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spelling pubmed-41745062014-10-02 Slowing of the HIV Epidemic in Ukraine: Evidence from Case Reporting and Key Population Surveys, 2005–2012 Vitek, Charles R. Čakalo, Jurja-Ivana Kruglov, Yuri V. Dumchev, Konstantin V. Salyuk, Tetyana O. Božičević, Ivana Baughman, Andrew L. Spindler, Hilary H. Martsynovska, Violetta A. Kobyshcha, Yuri V. Abdul-Quader, Abu S. Rutherford, George W. PLoS One Research Article BACKGROUND: 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. METHODS AND FINDINGS: 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). CONCLUSIONS: 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. Public Library of Science 2014-09-24 /pmc/articles/PMC4174506/ /pubmed/25251080 http://dx.doi.org/10.1371/journal.pone.0103657 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration, which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.
spellingShingle Research Article
Vitek, Charles R.
Čakalo, Jurja-Ivana
Kruglov, Yuri V.
Dumchev, Konstantin V.
Salyuk, Tetyana O.
Božičević, Ivana
Baughman, Andrew L.
Spindler, Hilary H.
Martsynovska, Violetta A.
Kobyshcha, Yuri V.
Abdul-Quader, Abu S.
Rutherford, George W.
Slowing of the HIV Epidemic in Ukraine: Evidence from Case Reporting and Key Population Surveys, 2005–2012
title 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_short 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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174506/
https://www.ncbi.nlm.nih.gov/pubmed/25251080
http://dx.doi.org/10.1371/journal.pone.0103657
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