Trends in morbidity, prevalence and mortality from HIV infection and tuberculosis in the regions of Russia in the XXI century
Abstract
According to official data from Rospotrebnadzor, more than 1 million people with HIV infection (HIV) live in Russia, while the number of both new infections and deaths has been continuously increasing over the past two decades. According to the same data, in 50% of registered patients HIV infection is combined with tuberculosis (TB), and in more than half of those who died from HIV there was a clinical picture of progressive tuberculosis.
This paper presents the results of a spatial analysis of the epidemiological situation with HIV infection and tuberculosis, including an attempt to determine the relationship between the development of the HIV and tuberculosis epidemic at the regional level. Regional trends differ among themselves in most of the positions considered: the dynamics of the incidence, prevalence and mortality from these infections is heterogeneous, and the regions literally replace each other in the "leading" positions every year, which adds complexity to the identification of the key factors affecting these indicators. Macro-level analysis of the relationship between the prevalence of and mortality from HIV infection and tuberculosis showed that while it is impossible to unequivocally determine what exactly the HIV mortality rate depends on, it definitely depends on the degree of HIV prevalence in the territory of the subject. At the same time, it was not possible to find a sufficiently reliable relationship between the prevalence of antiretroviral therapy (ART) and mortality from HIV, which can serve as indirect evidence not only of the insufficient spread of ART (in Russia in 2019, only half of HIV-positive patients received therapy), but also of its insufficient effectiveness, for example, due to too late detection of HIV or initiation of therapy.
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References
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