Provision of care for people with HIV migrating from Ukraine: preparing for a long-term response
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Review
PubMed
40176534
PubMed Central
PMC11970604
DOI
10.1097/qad.0000000000004147
PII: 00002030-202505010-00001
Knihovny.cz E-resources
- MeSH
- Anti-Retroviral Agents therapeutic use supply & distribution MeSH
- Health Services Accessibility * MeSH
- HIV Infections * drug therapy diagnosis epidemiology MeSH
- Humans MeSH
- Transients and Migrants * statistics & numerical data MeSH
- Armed Conflicts MeSH
- Delivery of Health Care * organization & administration MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Geographicals
- Ukraine epidemiology MeSH
- Names of Substances
- Anti-Retroviral Agents MeSH
Russia's invasion and war in Ukraine have caused a major humanitarian crisis among Ukrainian citizens, but also specifically affected diagnosis and provision of HIV care. As Ukraine remains the country with the second highest (after Russia) HIV incidence in Europe, the forced migration resulting from the war has required urgent and targeted responses to allow for uninterrupted access to medical care and antiretroviral drug supply in neighboring countries and beyond. Response and integration of people with HIV (PWH) has been swift across European countries, but several challenges remain. Key challenges relate to the expansion of unstigmatized HIV testing to tackle late diagnoses, development of legal frameworks allowing for access to medication not registered or under patent protection in other European countries, diagnosis and treatment of key comorbidities including tuberculosis (TB) and hepatitis C virus (HCV), vaccination programs, and continued surveillance for drug resistance and changes in molecular epidemiology.
Department of Adults' Infectious Diseases Medical University of Warsaw
Department of Medicine 1 Bonn University Hospital Bonn
European Centre for Disease Prevention and Control Stockholm Sweden
See more in PubMed
UNHCR. Refugees from Ukraine recorded in Europe. https://data.unhcr.org/en/situations/ukraine. [Accessed 15 January 2025].
The Council of the European Union. Council Directive 2001/55/EC of 20 July 2001 on minimum standards for giving temporary protection in the event of a mass influx of displaced persons and on measures promoting a balance of efforts between Member States in receiving such persons and bearing the consequences thereof. Official Journal of the European Union. https://eur-lex.europa.eu/eli/dir/2001/55/oj/eng 2001. [Accessed 15 January 2025].
European Centre for Disease Prevention, Control World Health Organisation - Europe. HIV/AIDS surveillance in Europe 2024 – 2023 data. Copenhagen: WHO Regional Office for Europe; https://www.ecdc.europa.eu/en/publications-data/hiv-aids-surveillance-europe-2024-2023-data 2024. [Accessed 15 January 2025].
Kuchukhidze G, Otani M, Bivol S, Noori T. Refugees from Ukraine receiving antiretroviral therapy in destination countries and territories of the World Health Organization European Region, including EU/EEA countries, February 2022 to March 2023. Euro Surveill 2024; 29:pii=2300567. https://doi.org/10.2807/1560-7917.ES.2024.29.24.2300567. PubMed PMC
UNAIDS. Situation report. Two years on: UNAIDS supports Ukraine's commitment to the HIV response. https://www.unaids.org/en/War-Ukraine-special. 2024. [Accessed 15 January 2025].
The Ukrainian Public Health Center. https://phc.org.ua/kontrol-zakhvoryuvan/vilsnid/statistika-z-vilsnidu. 2024. [Accessed 15 January 2025].
World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK572729/. 2021. [Accessed 15 January 2025].
Wiginton JM, Booth R, Eaton LA, Smith LR, da Silva CE, Patterson TL, et al. . Injection drug use and sexual risk behaviors among people who inject drugs in Ukraine: a random-intercept latent transition analysis. AIDS Behav 2023; 27:3012–3026.. PubMed PMC
Serwin K, Chaillon A, Scheibe K, Urbańska A, Aksak-Wąs B, Ząbek P, et al. . Circulation of HIV-1 A6 variant in the East border of European Union - dynamics of the virus transmissions between Poland and Ukraine. Clin Infect Dis 2023; 76:1716–1724.. PubMed
Schapiro JM. Dynamics of human immunodeficiency virus Type 1 A6 variant transmissions between Poland and Ukraine. Clin Infect Dis 2023; 76:1725–1726.. PubMed
Cutrell AG, Schapiro JM, Perno CF, Kuritzkes DR, Quercia R, Patel P, et al. . Exploring predictors of HIV-1 virologic failure to long-acting cabotegravir and rilpivirine: a multivariable analysis. AIDS 2021; 35:1333–1342.. PubMed PMC
Vasylyeva TI, Liulchuk M, Friedman SR, Sazonova I, Faria NR, Katzourakis A, et al. . Molecular epidemiology reveals the role of war in the spread of HIV in Ukraine. Proc Natl Acad Sci U S A 2018; 115:1051–1056.. PubMed PMC
Weibull Wärnberg A, Brännström J, Elvstam O, Gisslén M, Månsson F, Sönnerborg A, et al. . The molecular epidemiology of HIV-1 in Sweden 1996 to 2022, and the influence of migration from Ukraine. Euro Surveill 2023; 28:pii=2300224. https://doi.org/10.2807/1560-7917.ES.2023.28.48.2300224. PubMed PMC
Parczewski M, Jabłonowska E, Wójcik-Cichy K, Zhyvytsia D, Witak-Jędra M, Leszczyszyn-Pynka M, et al. . Clinical perspective on human immunodeficiency virus care of Ukrainian War refugees in Poland. Clin Infect Dis 2023; 76:1708–1715.. PubMed
Reyes-Urueña J, Marrone G, Noori T, Kuchukhidze G, Martsynovska V, Hetman L, et al. . HIV diagnoses among people born in Ukraine reported by EU/EEA countries in 2022: impact on regional HIV trends and implications for healthcare planning. Euro Surveill 2023; 28:pii=2300642. https://doi.org/10.2807/1560-7917.ES.2023.28.48.2300642. PubMed PMC
Serwin K, Scheibe K, Urbańska A, Aksak-Wąs B, Karasińska-Cieślak M, Ząbek P, et al. . Phylodynamic evolution of HIV-1 A6 sub-subtype epidemics in Poland. J Med Virol 2024; 96:e29482. PubMed
Croxford S, Stengaard AR, Brännström J, Combs L, Dedes N, Girardi E, et al. Late diagnosis of HIV: an updated consensus definition. HIV Med; n/a(n/a). PubMed PMC
Boesecke C, Schellberg S, Schneider J, Schuettfort G, Stocker H. Prevalence, characteristics and challenges of late HIV diagnosis in Germany: an expert narrative review. Infection 2023; 51:1223–1239.. PubMed PMC
Feiterna-Sperling C, Bethke H, Hofmann J, Krüger R. Refugees from Ukraine: children and adolescents with HIV in Germany. Lancet HIV 2023; 10:e81–e82.. PubMed
European Centre for Disease Prevention and Control WROfE. Tuberculosis surveillance and monitoring in Europe 2023 – 2021 data. 2023.
Stoycheva K, Cristea V, Ködmön C, Rosales-Klintz S, Zenner D, Vasiliu A, et al. . Tuberculosis in people of Ukrainian origin in the European Union and the European Economic Area, 2019 to 2022. Euro Surveill 2024; 29: PubMed PMC
Brinkmann F, Friedrichs A, Behrens GM, Behrens P, Berner R, Caliebe A, et al. . Prevalence of infectious diseases, immunity to vaccine-preventable diseases and chronic medical conditions among Ukrainian refugees in Germany - a cross sectional study from the German Network University Medicine (NUM). J Infect Public Health 2024; 17:642–649.. PubMed
Dohál M, Dvořáková V, Šperková M, Pinková M, Ghodousi A, Omrani M, et al. . Tuberculosis in Ukrainian war refugees and migrants in the Czech Republic and Slovakia: a molecular epidemiological study. J Epidemiol Glob Health 2023; 14:35–44.. PubMed PMC
Owczarzak J, Monton O, Fuller S, Burlaka J, Kiriazova T, Morozova O, et al. . Will you need this health at all? Will you be alive?’: using the bioecological model of mass trauma to understand HIV care experiences during the war in Ukraine. J Int AIDS Soc 2024; 27 (S3):e26307. PubMed PMC
Boiko DI, Shyrai PO, Mats OV, Karpik ZI, Rahman MH, Khan AA, et al. . Mental health and sleep disturbances among Ukrainian refugees in the context of Russian-Ukrainian war: a preliminary result from online-survey. Sleep Med 2024; 113:342–348.. PubMed
Asanov AM, Asanov I, Buenstorf G. Mental health and stress level of Ukrainians seeking psychological help online. Heliyon 2023; 9:e21933. PubMed PMC
Mehrab Z, Stundal L, Venkatramanan S, Swarup S, Lewis B, Mortveit HS, et al. . An agent-based framework to study forced migration: a case study of Ukraine. PNAS Nexus 2024; 3:gae080. PubMed PMC
Kohlenberger J, Buber-Ennser I, Pędziwiatr K, Rengs B, Setz I, Brzozowski J, et al. . High self-selection of Ukrainian refugees into Europe: evidence from Kraków and Vienna. PLoS One 2023; 18:e0279783. PubMed PMC
Kowalska, Samsonova O, Bienkowski C, Skrzat-Klapaczynska A, Bursa D. Continuum of HIV and hepatitis C care in the times of war, 19th European AIDS Conference, Warsaw, abstract PS7.O2, 2023. HIV Med 2023; 24 (S5):3–675..
Vasylyev M, Skrzat-Klapaczyńska A, Bernardino JI, Săndulescu O, Gilles C, Libois A, et al. . Unified European support framework to sustain the HIV cascade of care for people living with HIV including in displaced populations of war-struck Ukraine. Lancet HIV 2022; 9:e438–e448.. PubMed
Prusaczyk A, Bogdan M, Vinker S, Gujski M, Żuk P, Kowalska-Bobko I, et al. . Healthcare organization in Poland in light of the refugee crisis related to the military conflict in Ukraine. Int J Environ Res Public Health 2023; 20: PubMed PMC
Control, ECfDPa. Continuum of HIV care. Monitoring implementation of the Dublin Declaration on partnership to fight HIV/AIDS in Europe and Central Asia: 2022 progress report. Stockholm: ECDC; 2023.
Niedźwiedzka-Stadnik M, Nowakowska-Radziwonka E, Marzec-Bogusławska A. HIV infections and AIDS in Poland in 2020. Przegl Epidemiol 2022; 76:402–420.. PubMed
Parczewski M, Siwak E, Cielniak I, Bociaga Jasik M, Lara M, Leszczyszyn-Pynka M, et al. . Clinical characteristics and antiretroviral treatment efficacy among newly diagnosed migrants and refugees from Ukraine. HIV Med 2023; 24:3–675..
Wilczek NA, Brzyska A, Bogucka J, Sielwanowska WE, Żybowska M, Piecewicz-Szczęsna H, et al. . The impact of the war in Ukraine on the epidemiological situation of tuberculosis in Europe. J Clin Med 2023; 12:6554. PubMed PMC
Karsinska-Cieslak ML-P M, Aksak-Was B, Witak-Jedra M, Lenkiewicz F, Debowska A, Parczewski M. Features of latent tuberculosis among Ukrainian migrants and refugees entering HIV care in Poland. Poster MtE3. CC1 EACS Conference, Warsaw. EACS Abstracts. HIV Med 2023; 24:3–675..
Haberl CBA, Gunsenheimer-Bartmeyer B, Herrmann4 C S E, Koenigs K, Roemer P. Khaykin ORANGE STUDY: HIV patients frOm UkRAine – ContiNuum of care in Germany. Abstract eP.A.063. EACS Conference, Warsaw, 2023. HIV Med 2023; 24:3–675..
Robert Koch Institute. Epidemiologische Bulletin 47/2022. https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2022/47/Art_01.html?nn=2374210. [Accessed 15 January 2025].
https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2023/Ausgaben/47_23.pdf?__blob=publicationFile - Epidemiologisches Bulletin 47 |2023 23. November 2023. [Accessed 15 January 2025].
Massmann R, Groh T, Jilich D, Bartková D, Bartovská Z, Chmelař J, et al. . HIV-positive Ukrainian refugees in the Czech Republic. Aids 2023; 37:1811–1818.. PubMed PMC
Kowalska JD, Rukhadze N, Sojak L, Bociaga-Jasik M, Sedlacek D, Matulionyte R, et al. . Preliminary report on the provision of HIV care to war refugees with HIV who are migrating from Ukraine: data from the ECEE Network Group. AIDS 2022; 36:1887–1890.. PubMed
Biesiada A, Mastalerz-Migas A, Babicki M. Response to provide key health services to Ukrainian refugees: the overview and implementation studies. Soc Sci Med 2023; 334:116221. PubMed
World Health Organisation - Europe. Standardized protocol for clinical management and medical data-sharing for people living with HIV among refugees from Ukraine. World Health Organization. Regional Office for Europe. https://iris.who.int/handle/10665/353083. License: CC BY-NC-SA 3.0 IGO. 2022.
Nikitin BM, Bromberg DJ, Madden LM, Stöver H, Teltzrow R, Altice FL. Leveraging existing provider networks in Europe to eliminate barriers to accessing opioid agonist maintenance therapies for Ukrainian refugees. PLOS Glob Public Health 2023; 3:e0002168. PubMed PMC
European Comission. The 10-Point Plan: for stronger European coordination on welcoming people fleeing the war from Ukraine. https://home-affairs.ec.europa.eu/10-point-plan-stronger-european-coordination-welcoming-people-fleeing-war-ukraine_en. 2022. [Accessed 15 January 2025].
European Centre for Disease Prevention and Control. Preexposure Prophylaxis for HIV prevention in Europe and Central Asia. Monitoring implementation of the Dublin Declaration on Partnership to fight HIV/AIDS in Europe and Central Asia – 2023 progress report. https://www.ecdc.europa.eu/en/publications-data/hiv-pre-exposure-prophylaxis-prevention-dublin-declaration-2023 2024. [Accessed 15 January 2025].
Parczewski M, Cielniak I, Siwak E, Bociąga-Jasik M, Kalinowska-Nowak A, Rozpłochowski B, et al. . Late presentation and HIV-1 subtype diversity among Ukrainian migrants newly diagnosed with HIV in Poland. P180. Abstract Supplement HIV Glasgow 10–13 November, Glasgow, UK. Virtual J Int AIDS Soc 2024; 27:e26370. PubMed
Robert Koch Institute. Empfehlungen zu Präventions- und Gesundheitsangeboten für die aus der Ukraine Geflüchteten für HIV und andere sexuell und durch Blut übertragbare Infektionen. https://www.rki.de/DE/Themen/Gesundheit-und-Gesellschaft/Gesundheitliche-Einflussfaktoren-A-Z/F/Flucht-Gesundheit/Praeventions_Gesundheitsangebote_Gefluechtete_HIV.html 2024. [Accessed 15 January 2025].