High Percentage of Recent HIV Infection Leading to Onward Transmission in Odessa, Ukraine Associated with Young Adults

Abstract

The proportion of new HIV diagnoses between May and December 2009 across Odessa recently-infected was estimated using the BED-CEIA assay. Logistic regression models were used to explore factors associated with testing as recent. Of 1,313 newly-diagnosed individuals, 321 (24 %) were classified as recent. Recent infection was less likely among older adults [odds ratio (OR) = 0.70 per 10-year increase, 95 % CI 0.60-0.82]. Compared to men residing in Odessa city, women in rural Odessa and non-resident men were more likely to be recently-infected (OR 1.85, 1.26-2.71 and 2.83, 1.15-6.97, respectively). Reason for test was not associated with recent infection. In sensitivity analysis, after excluding individuals tested due to clinical indications, the proportion recently-infected and the association with age remained virtually unchanged. Our findings suggest a high risk of onward transmission, particularly in younger age groups. These findings highlight the need for tailored prevention strategies and ongoing RITA testing to monitor and evaluate effectiveness of prevention programmes.

A Phylogenetic Analysis of Human Immunodeficiency Virus Type 1 Sequences in Kiev: Findings Among Key Populations

“…Odessa showed a higher risk of recent infection among younger people (29) and younger adults in our data were more likely to be recently-infected (17) We found low levels of TDR (2.1%), which would be expected as estimated ART coverage in…”

“…There are also high levels of recent infection among MSM with approximately one in four new diagnoses in Odessa and Kiev shown to be recently infected, and MSM disproportionately represented in both new diagnoses and recent infection (17,18,29). A 2011 bio-behavioural study of MSM in Ukraine showed low HIV testing rates, limited access to prevention programs, and high levels of sexual mixing with female heterosexuals, and with sex workers of both sexes (30).…”