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dc.creatorRozanova, Julia
dc.creatorZeziulin, Oleksandr
dc.creatorRich, Katherine M.
dc.creatorAltice, Frederick L.
dc.creatorKiriazova, Tetiana
dc.creatorZaviryukha, Irina
dc.creatorSosidko, Tetiana
dc.creatorGulati, Komal
dc.creatorCarroll, Constance
dc.creatorShenoi, Sheela V.
dc.identifier.citationRozanova J, Zeziulin O, Rich KM, Altice FL, Kiriazova T, Zaviryukha I, et al. (2021) An expanding HIV epidemic among older adults in Ukraine: Implications for patient-centered care. PLoS ONE 16(9): e0256627.
dc.description.abstractIntroduction: The Eastern Europe and Central Asian (EECA) region has the highest increase in HIV incidence and mortality globally, with suboptimal HIV treatment and prevention. All EECA countries (except Russia) are low and middle-income (LMIC). While LMIC are home to 80% of all older people living with HIV (OPWH), defined as ≥50 years, extant literature observed that newly diagnosed OPWH represent the lowest proportion in EECA relative to all other global regions. We examined HIV diagnoses in OPWH in Ukraine, a country emblematic of the EECA region. Methods: We analysed incident HIV diagnoses from 2015–2018 and mortality trends from 2016–2018 for three age groups: 1) 15–24 years; 2) 25–49 years; and 3) ≥50 years. AIDS was defined as CD4<200cells/mL. Mortality was defined as deaths per 1000 patients newly diagnosed with HIV within the same calendar year. Mortality rates were calculated for 2016, 2017, and 2018, compared to age-matched general population rates, and all-cause standardized mortality ratios (SMRs) were calculated. Results: From 2015–2018, the proportion of OPWH annually diagnosed with HIV increased from 11.2% to 14.9% (p<0.01). At the time of diagnosis, OPWH were also significantly (p<0.01) more likely to have AIDS (43.8%) than those aged 25–49 years (29.5%) and 15–24 years (13.3%). Newly diagnosed OPWH had the same-year mortality ranging from 3 to 8 times higher than age-matched groups in the Ukrainian general population. Conclusions: These findings suggest a reassessment of HIV testing, prevention and treatment strategies in Ukraine is needed to bring OPWH into focus. OPWH are more likely to present with late-stage HIV and have higher mortality rates. Re-designing testing practices is especially crucial since OPWH are absent from targeted testing programs and are increasingly diagnosed as they present with AIDS-defining symptoms. New strategies for linkage and treatment programs should reflect the distinct needs of this target population.
dc.format.extent12 pages
dc.relation.ispartofFaculty/ Researcher Works
dc.relation.haspartPLoS One, Vol. 16, No. 9
dc.relation.isreferencedbyPublic Library of Science
dc.rightsAttribution CC BY
dc.subjectHIV diagnosis and management
dc.subjectHIV epidemiology
dc.subjectVirus testing
dc.subjectAge groups
dc.subjectDeath rates
dc.subjectMedical risk factors
dc.titleAn expanding HIV epidemic among older adults in Ukraine: Implications for patient-centered care
dc.type.genreJournal article
dc.ada.noteFor Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact
dc.description.schoolcollegeLewis Katz School of Medicine
dc.temple.creatorGulati, Komal

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