Antiretroviral Therapy in the Context of Effectiveness Realization of HIV/AIDS Prevention in Zhytomyr Region

The article presents analysis of the availability and effectiveness of ART realization for HIV/AIDS patients in Zhytomyr region during 2009-2016. In order to identify regional needs for antiretroviral therapy and provide substantiated recommendations for the formulation of national and regional programs we conducted the evaluation of HIV/AIDS programs implemented in Zhytomyr region. It is an important step in developing the national and regional HIV/AIDS prevention program for 2019-2023, which should be in line with UNAIDS strategy to accelerate prevention of HIV/AIDS. The approach to assessing regional HIV/AIDS prevention programs combined WHO recommendations, analysis of impact indicators, cascading analysis and conducted in this research. We carried out the analysis and synthesis of routine epidemiological surveillance data, HIV/AIDS epidemic forecasting in the SPECTRUM program for 2009-2016 to identify trends in epidemiological indicators. The cross-sectional service cascade for PLWH reflects the implementation of preventive and therapeutic programs taking into account evaluation data and is based on routine monitoring indicators for testing, treatment and laboratory support for PLHIV. The introduction of ART in the region contributed to reduction in mortality among IDUs and among PLHIV with co-infection TB/HIV, but does not lead to desirable changes, since overall mortality from HIV-infection continues to remain high. The proportion of people, who were on medical records and received ART, has risen but not close to the target and does not allow to be properly influenced to the epidemic. Detection and taking for medical observation of patients in the late stages of HIV and limited access to ART are the main causes of high mortality in the region. The coverage of high-quality measures to prevent mother-to-child transmission of HIV has been achieved. There is not enough access to ART for key population groups. The coverage of PLHIV in care and support services on the basis of NGO does not correspond to the target value and requires further practical attention. At the moment, the region has not come close to reaching any of the criteria of the strategy Fast-track. Only a third of the estimated number of PLHIV is not aware of their positive HIV status. Only 39% of all HIV-positive people receive ART and only 31% of them have uncertain viral load levels. The prospect of further research is seen in formulating recommendations for ART services for developing the national and regional HIV/AIDS programs for 2019-2023 on the basis of the obtained data.