HIV/AIDS epidemic in Belarus

Julia Dabravolskaj, MDBelarusian State Medical University

“Bare” Statistics

•11.5 thousands of registered HIV+ people•≈45% live in Gomel region •>70% of new cases – reproductive age

group•Unprotected sex – main route of

transmission (80% of new cases)

Clinical issues• Atypical presentation of OIs –> HIV-infection

is difficult to diagnose• IRIS• Difficulties in HIV/HCV treatment• Methodone and HAART inconsistence• Fast development of new treatment strategies

– not all specialists consider updates• Low consistency between specialists• Unsolved issues on care of elderly HIV+• Low rates of disclosure

HAART issuesWhat is done• 4274 patients initiated HAART• 80.2% adherent in 1-year term• 23.6% new cases – AIDS (late presentation)

What should be done• 8790 patients should initiate HAART

Global Fund Grant is expiring.

Life-time treatment of 1 HIV+ person costs ≈$35,000.

Policy issues:• No laws that would allow stigmatization, but at

the same time – no laws that might punish for discrimination

• No laws that might clarify issues serodiscordant couples face

• According to laws – sexual active HIV+ person ‘commits a crime’ without considering additional facts (condom use, rape etc.)

• Government should provide an HIV+ person with necessary treatment, however, it’s often impossible due to economic factors

Effective management of HIV/AIDS epidemic include:•High quality diagnostic tests•Free access to HAART•Psychological support

If one of the key elements is affected …

Thank you for attention!