COURSE FEATURES EPIDEMIC PROCESS HIV INFECTION IN KHARKIV REGION

Introduction. In the context of the transformation of the
spheres of human living epidemic HIV-infection continues.
According to the intensity of the epidemic process of HIVinfection,
Ukraine takes one of the first places among the
European countries. The epidemic process of the infection is
concentrated mainly on the high-risk groups, and there is
uneven prevalence. Besides in most cases this distribution
can not be explained by the social and economic
characteristics of certain territories. Kharkiv region belongs
to the territory of Ukraine with the lowest prevalence level of
HIV-infection. Though in terms of the social and economic
crisis due to hostilities in the east of the country, which the
region borders, the epidemic situation may significantly
become worse. Work objective: to study the peculiarities of
the course of the epidemic process of HIV-infection for the
period from 1987 till 2015 in Kharkiv region that will
improve the epidemiological surveillance of the infection and
develop appropriate preventive measures in modern
conditions. Material & methods. The studies were
conducted in Kharkiv region, which is a big industrial and
administrative center. The city of Kharkiv is located at the
crossroads of drug trafficking from Asia and Russia. The
reportings and analytics of the Kharkiv regional center for
prevention and control of AIDS and the Ministry of Health of
Ukraine for the period of 1987 – 2015 were used in the
research. The analysis of incidence of HIV prevalence,
structure of transmission routes and sex-age groups were
carried out using descriptive and evaluative and analytical
ways of epidemiological research method. Results &
discussion. During 1987 – 2015 in Kharkiv region there were
officially registered 7868 cases of HIV-infection what was
equal to 4.0 % of the registered cases in Ukraine. Since 1996
a marked upward tendency of the incidence of HIV infection
in Kharkiv region (growth rate – +7.0 %), and on the whole
in Ukraine (growth rate – +14.0 %). Herewith of incidence of
HIV-infection in the region were lower than on the whole in
Ukraine (accordingly 2.4 – 23.7 and 10.6 – 47.1 per 100 000
population). Almost all of the administrative territories of
Kharkiv region have been involved into the epidemic process
of HIV-infection, but in districts of the region the incidence
of HIV-infection, AIDS and mortality were in 1.4 – 2.7 times
higher than in Kharkiv itself. The measures directed at the
prevention of HIV-infection in the groups of risk were
actively being taken during the supervision in the region. Due
to the collaboration of the executive authorities and local
government, departmental structures, medical community and
public organizations directed at the suspension of HIVinfection/
AIDS epidemic in the region we managed to
stabilize a little an epidemical situation on HIV-infection. For
the period of 1987 – 2015 in the region there was defined the
increase in the number of the infected women (from 12.9 %
to 41.0 %) and the decrease of the number of men (from 87.1
% to 59.0 %) what led to the change of the ratio of the
number of women with the number of men in accordance
with 1:7 (1996) and 1:1.5 (2015). There were adult patients
with HIV-infection (79.5 – 84.9 %) in 4 - 5 times more than
children under the age of 14 (15.1 – 20.5 %). The largest
proportion of HIV-infected people in the age group of 25 –
49 years (60.0 – 72.2 %) and the lowest – 15 – 17 years (0.1
– 1.0 %). In different periods of the current epidemic process
of HIV-infection the ratio of parenteral, sexual and vertical
routes of transmission considerably changed. At the
beginning of the epidemic the incidence level of HIVinfection
has been significantly affected by the drugs
spreading and an increase in vulnerable groups of injecting
drug users. Thus, in 1996 the part of the sexual route of
transmission was equal to 5.7 % cases, whereas the part of
parenteral one consists of 77.1 % cases. Taking effective
preventive measures against drug abuse has led to the
decrease in the incidence of HIV-infection among this group
of risk and changes of transmission routes. In 2015 in the
structure of the leading transmission routes there were (22.6
± 1.8) % of parenteral and (56.9 ± 2.1) % of sexual cases
(p<0.05). These data indicate that the implementation tract
infection due to injecting drug use leads to a concentrated
stage of the HIV epidemic. At the same time the increase in
the proportion of sexual transmission increase in the number
of infected women indicate a threat to the output of the
epidemic risk groups to the general set of the population.
Conclusions. 1. The incidence of HIV-infection in the region
was in several times lower than on the whole in Ukraine
(accordingly 2.4 - 23.7 and 10.6 - 47.1 per 100 000
population). 2. Carried out research in the region revealed the
peculiarities of the epidemic process of HIV-infection. So the
level of growth of newly registered cases of HIV-infection
from 0.1 per 100 000 population in 1995 to 20.5 per 100 000
population in 2015 was set (the growth rate was +7.0 %); a
gradual change in the sexual spectrum of HIV-infected
people (women from 12.9 % to 41.0 % and men from 87.1 %
to 59.0 %) and the structure of the leading transmission
routes (parenteral from 77.1 % to 22.6% and sexual from 5.7
% to 59.6 %); involvement in the epidemic process of all age
groups with a predominance of the most working-age
population 25 – 49 years. 3. The HIV epidemic is
concentrated on the most vulnerable groups of population,
but there is a risk of generalized spreading of HIV among the
population. 4. Epidemiological surveillance of HIV infection
must be adapted to the local epidemiological conditions, and
preventive measures aimed at the timely detection of
infection cases and the suspension of the epidemic.