December 1 – AIDS Day. HIV infection, relevance in Ukraine and the world.

HIV infection is a disease caused by the human immunodeficiency virus (HIV), which attacks and suppresses the human immune system. HIV is transmitted through contact with the blood, secretions and mucous membranes of patients. Also, one of the leading ways of transmission is sexual. Unfortunately, there are cases of infection from mother to child during pregnancy, childbirth or breastfeeding. Transmission of infection does not occur through kissing, hugging or sharing food.

HIV attacks cells of the immune system, in particular CD4 cells, which leads to a decrease in a person’s immune defenses. Such patients become vulnerable to various infectious and oncological diseases, which progress in a severe form.

Despite significant progress in treatment and prevention, HIV infection remains a serious problem for many countries and citizens around the world. According to the World Health Organization (WHO), as of 2022, approximately 39 million people are living with HIV. The largest number of cases is registered in the African region. In 2022, 630,000 people in the world died from various causes related to HIV infection.

WHO, the Global Fund and UNAIDS have developed a global HIV strategy to end the HIV epidemic by 2030. To achieve this goal, 95% of all people living with HIV must know their status, 95% of them must receive antiretroviral therapy (ART), 95% of HIV-infected people on ART must achieve a reduction in their viral load, which will contribute to the improvement of their health status and, which is extremely important, to reduce the risk of further transmission of HIV. In 2022, these figures were 86% [73%–>98%], 89% [75%–>98%] and 93% [79%–>98%], respectively.

According to the Public Health Center of the Ministry of Health of Ukraine, at the end of 2021, there were about 245,000 people living with HIV in Ukraine. According to estimates, during the fight against the HIV/AIDS epidemic, the joint efforts of the state, the public sector and with the technical support of international partners achieved tangible successes, and the epidemic began to recede. Thanks to large-scale prevention programs, compared to 1999, the number of HIV infections per year has decreased by 5 times, and the annual number of deaths due to AIDS, thanks to diagnosis and access to treatment, has decreased by 5.5 times over the past 15 years. Most people at high risk of HIV infection were covered by prevention programs, and more than 150,000 people living with HIV received the treatment they needed.

The war has led to a humanitarian crisis, causing significant damage to the healthcare infrastructure in Ukraine and large-scale disruptions in the provision of social and medical services. Security problems were compounded by difficulties in the supply of necessary medical materials, which negatively affected the work of laboratories and limited diagnostic services. This caused difficulties in timely replenishment of medicines and threatened to interrupt treatment for 130,000 patients.

The Public Health Center of the Ministry of Health of Ukraine urgently took a number of measures, developed mechanisms to provide patients with ART. At the end of the year, more than 121,000 people living with HIV received therapy.

In 2022, 12,212 newly diagnosed cases of HIV infection and 1,293 deaths caused by HIV infection were officially registered in Ukraine. Prevalence of HIV infection per 100,000 population. (according to dispensary records) ranges from 84.2 in the Ternopil region to 1164.3 in the Odesa region. However, it should be noted that the data obtained in 2022 do not reflect the real state of health of the population due to limitations in the possibilities of recording cases and forming relevant reports against the background of war.

In September 2023, 1,002 new cases of HIV infection were officially registered in Ukraine, 287 patients were diagnosed with AIDS, and 111 people died.

Despite military actions, Ukraine continues to work to raise awareness of HIV infection, improve access to preventive measures and treatment, including ART. However, it is necessary to help ensure the coverage of vulnerable, stigmatized and other hard-to-reach population groups, to prepare future medical workers to provide high-quality services in connection with HIV to all those who need them.

In 2023, taking into account the crucial contribution of various communities to the fight against HIV, as well as health care around the world, the theme of World AIDS Day is formulated as “Community Leadership”.

As stated in the WHO Bulletin, “World AIDS Day is an occasion to reflect on the successes already achieved, to inform the public about the challenges that remain to be solved in order to achieve the goal of eliminating the AIDS epidemic by 2030, and to encourage all stakeholders to redouble their joint efforts and achieve success in struggle”.