According to the official statistics, in the period of 1987–2016 there were 297,424 cases of HIV registered in Ukraine, including 92,897 AIDS cases and 41,710 cases of AIDS-related deaths. As of 1 January 2017, 132,945 people living with HIV were registered for medical follow-up in healthcare facilities of the AIDS service (HIV prevalence – 313.3 per 100,000 population) and 38,730 people living with AIDS (AIDS prevalence – 91.3 per 100,000 population). The highest HIV prevalence rates were registered in Odesa (830.2 per 100,000 population), Dnipropetrovsk (815.1), Mykolaiv (728.4), Kherson (399.3), Kyiv (373.4), and Chernihiv (364.2) regions and in Kyiv city (409.5). In the structure of HIV transmission, sexual route is continuing to grow (61.6%).
Many years of experience in effective implementation of prevention programs in most vulnerable populations allowed achieving a downward trend in the epidemic dynamics in Ukraine and its decrease, first of all among injecting drug users. An effective strategy of HIV response in key populations was developed, which includes combination of three components, each of which has an impact on the epidemic dynamics and treatment success.
First – much lower rates of HIV infections are registered among regular clients of prevention projects as compared to new clients, which proves the efficacy of prevention approaches. In 2016, such services were provided to 225 thousand drug users, 35,953 sex workers and 38,181 men who have sex with men.
Second – improved HIV case finding through assisted testing and reaching new clients, who have not been covered by prevention programs before and were not aware of their HIV status. In 2016, 228 thousand people were tested for HIV in Alliance programs, with 3.7 thousand positive results.
Third – early start of ART and support of treatment adherence among HIV-positive members of key populations. Case management allowed demonstrating significant increase in the number of patients seeking treatment. In 2016, 2.9 thousand clients living with HIV were registered for further medical follow-up and started ART.
Military and political conflict in the east of Ukraine and annexation of Crimea made a strong influence on monitoring of the epidemiological situation in those regions. Currently, registration of HIV cases and laboratory monitoring of patients are complicated in Donetsk and Luhansk oblasts and are not reported to the national level at all by healthcare institutions in Crimea and Sevastopol. Such situation leads to increased internal migration among PLWH from the occupied areas of Ukraine to other regions of the country.
Thus, according to the data of the Public Health Center of the Ministry of Health of Ukraine, as of 1 January 2017, 1,614 people living with HIV arrived from the areas temporary not controlled by the Ukrainian government and got registered for medical follow-up in healthcare facilities of the AIDS service in other regions of the country, including 1,207 people (74.8%) from Donetsk oblast, 298 people (18.5%) from Luhansk oblast and 109 people (6.7%) from Crimea.
* without data from the temporarily occupied territory of Crimea since 2014 and areas of the military conflict in the east of Ukraine – since 2015