PLoS ONE (Jan 2014)

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

  • 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

DOI
https://doi.org/10.1371/journal.pone.0103657
Journal volume & issue
Vol. 9, no. 9
p. e103657

Abstract

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BackgroundUkraine 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 findingsWe 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 ConclusionsThis 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.