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HIV care in Central and Eastern Europe: How close are we to the target
D. Gokengin, C. Oprea, J. Begovac, A. Horban, AN. Zeka, D. Sedlacek, B. Allabergan, EA. Almamedova, T. Balayan, D. Banhegyi, P. Bukovinova, N. Chkhartishvili, A. Damira, E. Deva, I. Elenkov, L. Gashi, D. Gexha-Bunjaku, V. Hadciosmanovic, A....
Jazyk angličtina Země Kanada
Typ dokumentu časopisecké články
NLK
Directory of Open Access Journals
od 1996
Free Medical Journals
od 1996 do Před 1 rokem
Open Access Digital Library
od 1996-01-01
Open Access Digital Library
od 1996-07-01
ROAD: Directory of Open Access Scholarly Resources
- MeSH
- HIV infekce farmakoterapie epidemiologie imunologie virologie MeSH
- lidé MeSH
- počet CD4 lymfocytů MeSH
- RNA virová analýza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
OBJECTIVES: The aim of this survey was to describe the current status of HIV care in the countries of Central and Eastern Europe and to investigate how close the region is to achieving the UNAIDS 2020 target of 90-90-90. METHODS: In 2014, data were collected from 24 Central and Eastern European countries using a 38-item questionnaire. RESULTS: All countries reported mandatory screening of blood and organ donors for HIV. Other groups subjected to targeted screening included people who inject drugs (PWID) (15/24, 62.5%), men who have sex with men (MSM) (14/24, 58.3%), and sex workers (12/24, 50.0%). Only 14 of the 24 countries (58.3%) screened pregnant women. The percentages of late presentation and advanced disease were 40.3% (range 14-80%) and 25.4% (range 9-50%), respectively. There was no difference between countries categorized by income or by region in terms of the percentages of persons presenting late or with advanced disease. The availability of newer antiretroviral drugs (rilpivirine, etravirine, darunavir, maraviroc, raltegravir, dolutegravir) tended to be significantly better with a higher country income status. Ten countries reported initiating antiretroviral therapy (ART) regardless of CD4+ T cell count (41.7%), five countries (20.8%) used the threshold of <500 cells/μl, and nine countries (37.5%) used the threshold of <350cells/μl. Initiation of ART regardless of the CD4+ T cell count was significantly more common among high-income countries than among upper-middle-income and lower-middle-income countries (100% vs. 27.3% and 0%, respectively; p=0.001). Drugs were provided free of charge in all countries and mostly provided by governments. There were significant discrepancies between countries regarding the follow-up of people living with HIV. CONCLUSIONS: There are major disparities in the provision of HIV care among sub-regions in Europe, which should be addressed. More attention in terms of funding, knowledge and experience sharing, and capacity building is required for the resource-limited settings of Central and Eastern Europe. The exact needs should be defined and services scaled up in order to achieve a standard level of care and provide an adequate and sustainable response to the HIV epidemic in this region.
AIDS Control Centre Baku Azerbaijan
Centre for HIV AIDS Clinic of Infectious Diseases University Hospital Bratislava Slovakia
Clinic for Infectious Diseases and Febrile Conditions Skopje Former Yugoslav Republic of Macedonia
Clinical Centre Infectious Diseases Clinic University of Sarajevo Sarajevo Bosnia and Herzegovina
Community Development Fund Prishtina Kosovo
Hospital for Infectious Diseases in Warsaw Medical University of Warsaw Warsaw Poland
Infectious Disease Department Faculty of Medicine University Hospital Centre of Tirana Tiran Albania
Infectious Diseases AIDS and Clinical Immunology Research Centre Tbilisi Georgia
Institute of Public Health Podgorica Montenegro
Institute of Virology Ministry of Public Health of Uzbekistan Tashkent Uzbekistan
National Centre for Disease Control and Prevention of Armenia Yerevan Armenia
National Institute for Health Development Tallinn Estonia
National Institute of Public Health of Kosovo Prishtina Kosovo
Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases Sofia Bulgaria
Szent Laszlo Hospital Budapest Hungary
University of Zagreb School of Medicine University Hospital for Infectious Diseases Zagreb Croatia
Citace poskytuje Crossref.org
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- $a Gokengin, Deniz $u Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University Izmir, Turkey. Electronic address: deniz.gokengin@ege.edu.tr.
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- $a OBJECTIVES: The aim of this survey was to describe the current status of HIV care in the countries of Central and Eastern Europe and to investigate how close the region is to achieving the UNAIDS 2020 target of 90-90-90. METHODS: In 2014, data were collected from 24 Central and Eastern European countries using a 38-item questionnaire. RESULTS: All countries reported mandatory screening of blood and organ donors for HIV. Other groups subjected to targeted screening included people who inject drugs (PWID) (15/24, 62.5%), men who have sex with men (MSM) (14/24, 58.3%), and sex workers (12/24, 50.0%). Only 14 of the 24 countries (58.3%) screened pregnant women. The percentages of late presentation and advanced disease were 40.3% (range 14-80%) and 25.4% (range 9-50%), respectively. There was no difference between countries categorized by income or by region in terms of the percentages of persons presenting late or with advanced disease. The availability of newer antiretroviral drugs (rilpivirine, etravirine, darunavir, maraviroc, raltegravir, dolutegravir) tended to be significantly better with a higher country income status. Ten countries reported initiating antiretroviral therapy (ART) regardless of CD4+ T cell count (41.7%), five countries (20.8%) used the threshold of <500 cells/μl, and nine countries (37.5%) used the threshold of <350cells/μl. Initiation of ART regardless of the CD4+ T cell count was significantly more common among high-income countries than among upper-middle-income and lower-middle-income countries (100% vs. 27.3% and 0%, respectively; p=0.001). Drugs were provided free of charge in all countries and mostly provided by governments. There were significant discrepancies between countries regarding the follow-up of people living with HIV. CONCLUSIONS: There are major disparities in the provision of HIV care among sub-regions in Europe, which should be addressed. More attention in terms of funding, knowledge and experience sharing, and capacity building is required for the resource-limited settings of Central and Eastern Europe. The exact needs should be defined and services scaled up in order to achieve a standard level of care and provide an adequate and sustainable response to the HIV epidemic in this region.
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