THE MAIN RISK FACTORS AND THEIR IMPACT ON THE HIV/TUBERCULOSIS EPIDEMIC

With the HIV epidemic progression, an increase of HIV/tuberculosis co-infection in relation to a number of interrelated risk factors is becoming actual everywhere. The aim of the descriptive analytical study is a comprehensive and interdisciplinary assessment of risk factors that increase or decrease the spread of the dual HIV/tuberculosis infection at the current stage in the North-West of Russia, as a pilot region. Materials and Methods. Research methods included socio-demographic, economic and epidemiological analysis, ranking, correlation and expert assessment. The basis of the socio-demographic and economic analysis was information from the state statistics on the regions of North-West of Russia, of the epidemiological analysis – reporting forms of Rosstat on tuberculosis, HIV-infection and HIV/tuberculosis coinfection, including data on the economic and human resources of the tuberculosis control system, information from analytical reports on supervising activities in the regions of the North-West of Russia during 2007-2017. The correlation dependence between the studied parameters was determined by the Spearman coefficient. Results. In the North-West of Russia, there is a statistically significant relationship between the spread of HIV/tuberculosis co-infection and the epidemiological factor in general (0.627, p<0.039) and the HIV epidemic, as a mono-disease in particular (0.731, p<0.011). The tuberculosis epidemic does not play a significant role in the complex of epidemiological factors (0.332, p>0.319) and does not make a statistically significant contribution to the HIV/tuberculosis epidemic (0.127, p>0.710). The penitentiary system also has no statistically significant relation with the HIV/tuberculosis epidemic (0.233, p>0.490), however, the tuberculosis epidemic, as monoinfection (0.619, p<0.042) is significantly associated with the correctional system. Conclusion. To improve the HIV/tuberculosis epidemic situation, it is necessary to strengthen of HIV tackling measures, especially in the penitentiary system and strengthen the economic and human resources of the tuberculosis control system.