Human immunodeficiency virus and sexually transmitted diseases between the vulnerable populations in Kazakhstan

Abstract

The human immunodeficiency virus (HIV) epidemic continues to expand in Eastern Europe and Central Asia according to UNAIDS data (2012, Geneva). The rate of new HIV infections AIDS – related mortality has increased by 25 % from 2001 to 2009 in Kazakhstan (WHO data, 2012). The number of new HIV infections among newly diagnosed patients attributed to heteroand homosexual contact has been steadily increasing. There is also higher rate of HIV among Injecting Drug Users. There is an increase incidence of co-infections especially sexually transmitted diseases. In fact, comorbid STIs increase patients' susceptibility of acquiring and transmitting HIV (Guenthner PC , Secor WE, Dezzutti CS., 2005; Kissinger P, Amedee A, Clark RA, et al. , 2009). HIV/AIDS shares transmission characteristics with other sexual and blood-borne agents. Higher sexual mixing rates and lack of condom use are conspicuous risk factors (Vermund et al. 2009). However, while all groups are affected by HIV, some are more vulnerable than others: sex workers (SWs), men who have sex with men (MSM), injecting drug users (IDU). All these findings determined to set up the goal of this research. The purpose of the study is еpidemiologic situation of human immunodeficiency virus (HIV/AIDS) and related STIs in the Republic of Kazakhstan and in some vulnerable population groups to HIV infection. Materials and methods. To study the dynamics of HIV/STIs in Kazakhstan (cumulatively) an analysis of 2012–2013 years statistics was conducted. Testing for HIV/STI of blood samples of the vulnerable groups was carried out in the laboratories of AIDS centers. The algorithm of confirming the diagnosis of HIV infection included a twofold enzyme immunoassay (EIA) study of blood samples. Samples with positive results of the first EIA were retested using expert test systems; in case with a positive result of the second EIA a confirmatory test was conducted using a method of HIV-1 Western blot in the reference laboratory of the Republican AIDS Center. Results. At the beginning of 2015 in Kazakhstan there were cumulatively recorded 24,216 cases of HIV infection, the rate of HIV prevalence in the population amounted to 128. By gender: HIV-infected total 22,109; among them 14,683 – men (66.4 %), 7,426 – women (33.6 %). By age: there was a predominance of people of a young, productive and reproductive age, of years from 15 to 39 (79.3 %). As far as the mode of HIV transmission is concerned a parenteral way is prevailing (intravenous drug use among IDUs) – 58.3 %, a heterosexual way – 36.3 % (women – 62 %, men – 38 %), a homosexual way – 0.9 %. Dynamics show increase of a sexual transmission of HIV (2014 – 59.8 %, a parenteral transmission – 31.7 %). The conducted analysis showed a median HIV prevalence among people who inject drugs (80.9 % and 85.2 %, years 2012–2013 respectively), sex workers (15 % and 12.3 %, years 2012–2013 respectively) and men who have sex with men (4 % and 2.5 %, years 2012–2013 respectively). Among SWs and homosexuals syphilis was diagnosed only in 13.2 % of all cases, more often among the sex workers (15 %) than among men who have sex with men (8.5 %).