THE RISK of HIV outbreaks has increased in Ukraine as a result of the movements of displaced HIV-infected people caused by the ongoing conflict in the region, according to a team led by scientists from Oxford University and Public Health England. The findings reinforce previous studies showing how the spread of HIV in the Western world mirrors geopolitical events.
By reconstructing viral migration patterns through the analysis of genetic sequences, the team discovered that the spread of HIV in Ukraine correlated to the war-related movement of 1.7 million people between 2012 and 2015. The areas in which the virus was mainly exported from were two cities in Eastern Ukraine not controlled by the Ukrainian government since 2014. The migration tended to be westwards, with the main recipients being areas that have a high prevalence of risky sexual behaviour. Overall, evidence was found for spatial redistribution of pre-existing infections, rather than new transmissions.
Effective Prevention Strategies
However, the team believe that the analysis shows that efforts need to be made, with the help of international support, to stop the spread of the disease, which has increased the chances of a public health emergency. It is hoped that the study will also provide greater understanding of how HIV is disseminated, leading to new strategies that can protect the public from the infection. Dr Jonathan Pearce, Medical Research Council (MRC), commented: “Studies that shed light on how a disease is spread are important to enable development of effective prevention strategies. In this example, we see how the displacement of people as a result of man-made disaster, war, is contributing to the increased spread of HIV in Ukraine. This understanding will help officials shape public health practices to better manage and prevent HIV infection.”
Another issue to emerge from the study was that of virus resistance, which could become a major problem in Ukraine in the near future in this context. The team observed in 2015 that the prevalence of virus resistance against drugs used for pre-exposure prophylaxis, a treatment utilised as an important public health strategy to control the spread of HIV, was 34%. Further studies are required to confirm this observation.
James Coker, Reporter
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