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Ukraine - HIV/AIDS country profile

Ukraine (pop. 45 986 000)

By the end of 2006, Ukrainian authorities had reported a cumulative total of 91 057 HIV cases (excl. MTCT). They also reported that 17 281 of the infected individuals had developed AIDS by December 2006, and that 6161 had died. Ukraine reports the highest number of annual AIDS deaths in the European Region. In the majority of the cases, the decedents had not had access to antiretroviral therapy.

The percentage of IDUs among new HIV cases has been decreasing significantly (from 84% in 1997 to 56% in 2006), making the overall cumulative percentage of PLHIV infected by IDU stand now at 68% (excl MTCT). However the absolute number of HIV infections due to injecting drug use is still increasing. In 1998, Ukraine abolished mandatory HIV testing and introduced a voluntary nationwide testing and counselling service, which probably also contributed to the decrease in reported HIV infections among IDUs. The number of heterosexual cases is increasing year by year and it now makes up a higher proportion of the total. Among the cumulative reported HIV cases, 27% have been transmitted through heterosexual contact, whereas in 2006 the figure was 44% (excl. MTCT.)

The number of cases increased 150% during the two-year period December 2001 to December 2003. In 2006, Ukrainian authorities reported 13 256 new HIV cases (the highest reported incidence to date), 4536 new AIDS cases and 1549 AIDS deaths. The most affected regions are Dnipropetrovs'k, Donetsk, Odessa, Mikolaev, Autonomous Republic of Crimea and Kyiv city. Injecting drug use remains the most common mode of transmission. Sentinel HIV surveillance has been conducted among IDUs, sex workers and STI patients in several regions since 1999. Data from the most recent studies in 2006 identified HIV prevalence rates among IDUs between 18%-62.8%, with the highest figures in Nikolayev, Odessa, Simferopol and Kyiv and the lowest in Sumy. Prevalence rates among SWs ranged between 4%-31% in 2006. Significant overlap exists between the IDU and sex work population and data from 2006 showed HIV prevalence rates varies from 6% in Kyiv to 50% in Poltava among SWs who inject drugs. HIV coinfection rates among patients with other STIs varies from 1% in Sumy to 5.7% in Kyiv, Odessa and Kherson. Only limited data is available on HIV prevalence among MSM.

In 2006, 95% of all pregnant women were tested for HIV. The high take-up is due to a combination of factors: the integration of government programmes for preventing HIV infection in infants, a universal opt-out strategy for voluntary counselling and testing during pregnancy, and the provision of antiretroviral prophylaxis. In all, 91% of the 2575 HIV-positive women who delivered in 2006 received antiretroviral prophylaxis to prevent vertical transmission during pregnancy and delivery. By the end of 2006, the cumulative number of children born to HIV-positive mothers was 13 647. In 2006 alone, HIV positive mothers gave birth to 2822 infants of which 168 were infected with HIV. The reported cumulative number of MTCT cases in Ukraine was 1367, with extra 4 611 still pending of diagnosis confirmation.

In Ukraine, HIV testing is offered free of charge and 1 701 242 people were reported tested for HIV in 2006. According to national HIV testing policies, partner notification was mandatory, but not anonymous. HIV testing is systematically offered to prisoners, military recruits, pregnant women and IDUs. People seeking long-term visa or citizenship in Ukraine are required to have an HIV test taken.

During 2006, approximately 72 000 PLHIV were seen for medical care in Ukraine. In 2003, only 37 persons were on HAART provided by 50 facilities. As of May 2007, this number had increased to 5572 individuals being treated at 50 HAART providing facilities (1776 infected through IDU and 46 prisoners).

Updated 1 December 2007

References

1. European Centre for Epidemiological Monitoring of AIDS (EuroHIV). HIV/AIDS surveillance in Europe: end-year report 2006. Saint-Maurice, Institut de Veille Sanitaire, 2007 (No. 75).

2. Sexually transmitted infections/HIV/AIDS programme. WHO/Europe survey on HIV/AIDS and antiretroviral therapy: 31 December 2006. Copenhagen, WHO Regional Office for Europe; 2007.

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