Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.
Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.
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乌克兰艾滋病毒流行速度放缓：来自病例报告和重点人群调查的证据，2005-2012 年。
DOI：
10.1371/journal.pone.0103657
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Rutherford GW
中科院分区：
文献类型：
--
作者：
Vitek CR;Čakalo JI;Kruglov YV;Dumchev KV;Salyuk TO;Božičević I;Baughman AL;Spindler HH;Martsynovska VA;Kobyshcha YV;Abdul-Quader AS;Rutherford GW
由于注射毒品者之间的广泛传播，乌克兰成为欧洲艾滋病毒流行最严重的国家。自2004年以来，预防工作的重点是重点人群;抗逆转录病毒疗法的覆盖率有所提高。最近的数据显示，到2011年，报告的艾滋病毒病例有所增加，特别是由于性传播，但也有迹象表明，潜在的流行病正在放缓。我们进行了数据三角测量，以更好地分析可用数据并为计划实施提供信息。我们回顾了2005年至2012年来自多个来源的数据，主要是国家艾滋病毒病例报告和重点人群的综合生物行为监测（IBBS）研究。每年报告的艾滋病毒病例在2011年以逐渐缓慢的速度增加，最近仅在年龄较大，免疫抑制程度较高的人群中增加; 2012年病例减少了2.7%。在25岁以下的妇女中，2008年后，产前筛查中异性性传播的病例和艾滋病毒流行率有所下降。报告的年轻PWID病例减少了四分之三。2011年，综合生物行为监测显示，与2009年相比，重点人群中年轻人的艾滋病毒流行率有所下降。女性性工作者（FSW）的艾滋病毒感染仍然与注射毒品（IDU）的个人历史密切相关。这一分析表明，乌克兰的艾滋病毒流行已经减缓，报告病例减少，确诊病例中老年人占主导地位。最近病例和流行率的下降使年轻PWID和妇女的发病率下降。异性恋男子和男男性行为者（MSM）的趋势不太清楚;需要进一步研究和加强对MSM的预防。FSW似乎有稳定的患病率，风险与IDU密切相关。目前的趋势表明，通过加强重点人群的预防和增加获得治疗的机会，乌克兰的疫情可以得到控制。
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. 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). 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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影响因子：
3.7
作者：
Des Jarlais DC;Feelemyer JP;Modi SN;Arasteh K;Mathers BM;Degenhardt L;Hagan H
通讯作者：
Hagan H
影响因子：
5.4
作者：
GREENLAND, S
通讯作者：
GREENLAND, S
影响因子：
3.6
作者：
Kruglov, Y. V.;Kobyshcha, Y. V.;Saldanha, V. P.
通讯作者：
Saldanha, V. P.
影响因子：
3.7
作者：
Duong YT;Qiu M;De AK;Jackson K;Dobbs T;Kim AA;Nkengasong JN;Parekh BS
通讯作者：
Parekh BS
影响因子：
3.8
作者：
Hamers, FF;Batter, V;Brunet, JB
通讯作者：
Brunet, JB