The impact of people who inject drugs on the development of the HIV/AIDS epidemic in Ukraine

А.M. Scherbinska, M.H. Liulchuk, N.O. Babiy, V.V. Kirpicheva, L.I. Hetman, T.V. Grytsenko, O.V. Molchanets


Background. The current epidemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in Ukraine is characterized by a significant decrease in the role of people who inject drugs in the epidemic process. Preventive programs play an important role in this because they are widely implemented among injecting drug users, including opioid substitution therapy programs. The purpose of this study was to identify the impact of people who inject drugs on the spread of HIV at the present stage of the HIV/AIDS epidemic in Ukraine. Materials and methods. An epidemiological analysis of statistical reports over recent years was performed on the spread of HIV among people who inject drugs in different regions of Ukraine. The structure of the HIV-1 population circulating in Ukraine was determined using heteroduplex mobility assay with electrophoresis. Results. Based on an analysis of the incidence rate of HIV among people who inject drugs, their active role was revealed in the HIV epidemic process in Ukraine, despite the general trend towards a decrease in the incidence of HIV infection in this high risk group (1.67, 1.41, 1.36 % in 2015–2017, respectively). An insufficient amount of testing for HIV antibodies was shown in people from high risk populations in the whole country (from 3.5 % in the Transcarpatian region to 35.3 % in Kyiv) and a low percentage of HIV testing among people who use drugs, averaging at 12.4 % (data for the country in 2016). In some large regions (Dnipropetrovsk region, Kyiv) and in some regions of Western and Central Ukraine (Volyn, Ternopil, Khmelnytskyi regions), there is a tendency to an increase in the incidence of HIV infection among this group of people. Opioid substitution therapy did not have fully anti-epidemic effects due to the low coverage (from 7 to 43.6 % of the registered target group). Conclusions. The structure of HIV-1 population that circulated in Ukraine in the 1990s, when injecting drug users accounted for more than 80 % of HIV-positive people, and circulates at the current stage of the epidemic is characterized by a stable dominance of HIV-1 subtype A.


HIV epidemic; people who inject drugs; opioid substitution therapy; HIV 1 subtype structure


Nizova NM, Sergeyeva TA, Soroka IZ, et al. HIV infection in Ukraine. Newsletter 47. Kyiv: ICF Alliance of Public Health; 2017. 192 p.

Dumchev K, Sazonova Ja, Varec'ka O, Smyrnov P. Trends in the incidence of HIV infection among IDUs, MSM and MSM who are clients of prevention programs in Ukraine. Profilaktychna medycyna (epidemiologija, mikrobiologija, virusologija, parazytologija, infekcijni hvoroby). 2016;(27):53-54. (in Ukrainian).

Saad MD, Shcherbinskaya AM, Nadai Y, et al. Molecular epidemiology of HIV Type 1 in Ukraine: birthplace of an epidemic. AIDS Res Hum Retroviruses. 2006 Aug;22(8):709-14. doi: 10.1089/aid.2006.22.709.

Zelenska MV, Eshchenko OG, Demchenko IL. Actual questions of implementation substitution maintenance therapy in Ukraine. Tuberculosis, Lung Diseases, HIV Infection. 2015;(21):30-46. (in Ukrainian).

World Health Organization. Consolidated guidelines on HIV testing services: 5Cs: consent, confidentiality, counselling, correct results and connection 2015. Geneva: WHO Press; 2015. 188 p.

Mathers BM, Degenhardt L, Phillips B, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. Lancet. 2008 Nov 15;372(9651):1733-45. doi: 10.1016/S0140-6736(08)61311-2.

Vuilleumier S, Bonhoeffer S. Contribution of recombination to the evolutionary history of HIV. Curr Opin HIV AIDS. 2015 Mar;10(2):84-9. doi: 10.1097/COH.0000000000000137.

Requejo H. Worldwide molecular epidemiology of HIV. Rev Saude Publica. 2006 Apr;40(2):331-45. doi: /S0034-89102006000200023.

Nabatov AA, Kravchenko ON, Lyulchuk MG, Shcherbinskaya AM, Lukashov VV. Simultaneous introduction of HIV type 1 subtype A and B viruses into injecting drug users in southern Ukraine at the beginning of the epidemic in the former Soviet Union. AIDS Res Hum Retroviruses. 2002 Aug 10;18(12):891-5. doi: 10.1089/08892220260190380.

Vasylyeva TI, Liulchuk M, Friedman SR, et al. Molecular epidemiology reveals the role of war in the spread of HIV in Ukraine. Proc Natl Acad Sci U S A. 2018 Jan 30;115(5):1051-1056. doi: 10.1073/pnas.1701447115.

Gräf T, Machado Fritsch H, de Medeiros RM, Maletich Junqueira D, Esteves de Matos Almeida S, Pinto AR. Comprehensive Characterization of HIV-1 Molecular Epidemiology and Demographic History in the Brazilian Region Most Heavily Affected by AIDS. J Virol. 2016 Aug 26;90(18):8160-8. doi: 10.1128/JVI.00363-16.

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