Trends in HIV prevalence among people injecting drugs, men having sex with men, and female sex workers in Ukraine

Dumchev, Kostyantyn; Sazonova, Yana; Salyuk, T.; Varetska, Olga

doi:10.1177/0956462418784096

Cited by 26 publications

(33 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our GMRF-based analysis, with its large decrease in R e (t), does not align with either the prevalence data or any analysis performed by Vasylyeva et al (2016) [60]. While both our HSMRF-based and GMRF-based models estimated R e (t) < 1 throught the 2000s, there is no evidence from HIV prevalence that the epidemic is decreasing [63,64]. Examining the posterior distribution on phylogenies provides some insight into this apparent conflict: there are few infections inferred to have happened post-2000, and thus there is no information suggesting that R e (t) > 1 in this period.…”

Section: Parameter Prior Rolecontrasting

confidence: 63%

Locally adaptive Bayesian birth-death model successfully detects slow and rapid rate shifts

Magee

Höhna

Vasylyeva

et al. 2019

Preprint

View full text Add to dashboard Cite

Birth-death processes have given biologists a model-based framework to answer questions about changes in the birth and death rates of lineages in a phylogenetic tree. Therefore birth-death models are central to macroevolutionary as well as phylodynamic analyses. Early approaches to studying temporal variation in birth and death rates using birth-death models faced di culties due to the restrictive choices of birth and death rate curves through time. Su ciently flexible time-varying birth-death models are still lacking. We use a piecewiseconstant birth-death model, combined with both Gaussian Markov random field (GMRF) and horseshoe Markov random field (HSMRF) prior distributions, to approximate arbitrary changes in birth rate through time. We implement these models in the widely used statistical phylogenetic software platform RevBayes, allowing us to jointly estimate birth-death process parameters, phylogeny, and nuisance parameters in a Bayesian framework. We test both GMRF-based and HSMRF-based models on a variety of simulated diversification scenarios, and then apply them to both a macroevolutionary and an epidemiological dataset. We find that both models are capable of inferring variable birth rates and correctly rejecting variable models in favor of e↵ectively constant models. In general the HSMRF-based model has higher precision than its GMRF counterpart, with little to no loss of accuracy. Applied to a macroevolutionary dataset of the Australian gecko family Pygopodidae (where birth rates are interpretable as speciation rates), the GMRF-based model detects a slow decrease whereas the HSMRF-based model detects a rapid speciation-rate decrease in the last 12 million years. Applied to an infectious disease phylodynamic dataset of sequences from HIV subtype A in Russia and Ukraine (where birth rates are interpretable as the rate of accumulation of new infections), our models detect a strongly elevated rate of infection in the 1990s.

show abstract

Section: Parameter Prior Rolecontrasting

confidence: 63%

Locally adaptive Bayesian birth-death model successfully detects slow and rapid rate shifts

Magee

Höhna

Vasylyeva

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…This sharp increase largely occurred in two regions, Kyiv and Lviv, which may indicate an ongoing outbreak, especially among young MSM. Other evidence supports this possibility, including a high HIV incidence rate estimated from LAg assay testing of specimens from the 2013 MSM integrated bio-behavioral survey (IBBS) (19) and increased HIV prevalence in younger MSM according to the 2015 and 2013 IBBS surveys (12). Importantly, this trend was not signi cant in the o cial reports and veri ed registration records owing to the substantial degree of misclassi cation.…”

Section: Discussionmentioning

confidence: 99%

“…These trends and the fact that the absolute number and rate of new HIV infections started decreasing in 2012, following the overall trend in Eastern Europe (excluding Russia)(5), may suggest that injecting drug use is no longer, and that transmission among MSM is not yet, a major factor in the Ukrainian HIV epidemic. Additionally, the high proportion of cases attributed to heterosexual exposure and declining levels of HIV among female sex workers (12) would support directing resources toward prevention of heterosexual transmission in the general population. However, if the magnitude of misclassi cation of the mode of transmission is as signi cant as previous evidence suggests, these conclusions would be invalid.…”

Section: Introductionmentioning

confidence: 99%

Improved ascertainment of modes of HIV transmission in Ukraine indicates importance of drug injecting and homosexual risk

Dumchev

Kornilova

Kulchynska³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: It is important to understand how HIV infection is transmitted in the population in order to guide prevention activities and properly allocate limited resources. In Ukraine and other countries where injecting drug use and homosexuality are stigmatized, the information about mode of transmission in case registration systems is often biased.Methods: We conducted a cross-sectional survey in a random sample of patients registered at HIV clinics in seven regions of Ukraine in 2013-2015. The survey assessed behavioral risk factors and serological markers of viral hepatitis B and C. We analyzed the discrepancies between the registered mode of transmission and the survey data, and evaluated trends over three years.Results: Of 2,285 participants, 1,032 (45.2%) were females. The proportion of new HIV cases likely caused by injecting drug use based on the survey data was 59.7% compared to 33.2% in official reporting, and proportion of cases likely acquired through homosexual transmission was 3.8% compared to 2.8%. We found a significant decrease from 63.2% to 57.5% in the proportion of injecting drug use-related cases and a steep increase from 2.5 to 5.2% in homosexual transmission over three years. Conclusions: The study confirmed the significant degree of misclassification of HIV mode of transmission among registered cases. The role of injecting drug use in HIV transmission is gradually decreasing, but remains high. The proportion of cases related to homosexual transmission is relatively modest, but is rapidly increasing, especially in younger men. Improvements in ascertaining the risk factor information are essential to monitor the epidemic and to guide programmatic response.

show abstract

“…These trends and the fact that the absolute number and rate of new HIV infections started decreasing in 2012, following the overall trend in Eastern Europe (excluding Russia) (5), may suggest that injecting drug use is no longer, and that transmission among MSM is not yet, a major factor in the Ukrainian HIV epidemic. Additionally, the high proportion of cases attributed to heterosexual exposure and declining levels of HIV among female sex workers (12) would support directing resources toward prevention of heterosexual transmission in the general population.…”

Section: Introductionmentioning

confidence: 99%

Improved ascertainment of modes of HIV transmission in Ukraine indicates importance of drug injecting and homosexual risk

Dumchev

Kornilova

Kulchynska³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background It is important to understand how HIV infection is transmitted in the population in order to guide prevention activities and properly allocate limited resources. In Ukraine and other countries where injecting drug use and homosexuality are stigmatized, the information about mode of transmission in case registration systems is often biased. Methods We conducted a cross-sectional survey in a random sample of patients registered at HIV clinics in seven regions of Ukraine in 2013-2015. The survey assessed behavioral risk factors and serological markers of viral hepatitis B and C. We analyzed the discrepancies between the registered mode of transmission and the survey data, and evaluated trends over three years. Results Of 2,285 participants, 1,032 (45.2%) were females. The proportion of new HIV cases likely caused by injecting drug use based on the survey data was 59.7% compared to 33.2% in official reporting, and proportion of cases likely acquired through homosexual transmission was 3.8% compared to 2.8%. We found a significant decrease from 63.2% to 57.5% in the proportion of injecting drug use-related cases and a steep increase from 2.5 to 5.2% in homosexual transmission over three years. Conclusions The study confirmed the significant degree of misclassification of HIV mode of transmission among registered cases. The role of injecting drug use in HIV transmission is gradually decreasing, but remains high. The proportion of cases related to homosexual transmission is relatively modest, but is rapidly increasing, especially in younger men. Improvements in ascertaining the risk factor information are essential to monitor the epidemic and to guide programmatic response.

show abstract

Trends in HIV prevalence among people injecting drugs, men having sex with men, and female sex workers in Ukraine

Cited by 26 publications

References 9 publications

Locally adaptive Bayesian birth-death model successfully detects slow and rapid rate shifts

Locally adaptive Bayesian birth-death model successfully detects slow and rapid rate shifts

Improved ascertainment of modes of HIV transmission in Ukraine indicates importance of drug injecting and homosexual risk

Improved ascertainment of modes of HIV transmission in Ukraine indicates importance of drug injecting and homosexual risk

Contact Info

Product

Resources

About