Strategy of planning HIV/AIDS fight in Ukraine: a review

V. Stepanenko, S. Ivanov, V. Kamenev
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Abstract

HIV epidemic in Ukraine remains a nationwide problem. The current epidemiological situation does not yet give grounds to talk about a significant decrease in the load associated with HIV/AIDS in Ukraine. Predicting the further spread of the epidemic throughout the country is becoming more and more complicated due to the crisis socio-economic phenomena and the deterioration of the situation in the eastern regions of Ukraine. Objective — to substantiate the ways of optimization of monitoring, diagnosis and treatment of HIV infection as the basis for a strategy of overcoming the HIV/AIDS epidemic in the public health system in Ukraine; expanding treatment of HIV-infected patients using modern approaches and standards; volumes and algorithms of cooperation of specialists from different branches in the provision of treatment services to patients with skin diseases and sexually transmitted infections. Materials and methods. We analyzed: 1) documents of international policy in the field of public health; 2) the latest changes in the documents of the state policy in the field of health care of Ukraine; 3) international strategies and approaches to overcoming the HIV epidemic; 4) WHO strategies for applying public health approaches to tackling the HIV epidemic; 5) the dynamics of the incidence of skin and venereal diseases in Ukraine and the virtual creation of an epidemiological situation in the absence of integrative relations between individual health care services; 6) modeling and forecasting with account of all available relevant data as an important source of information for monitoring national and global HIV epidemics, as well as managing the prevention and treatment programs. Results and discussion. Based on the review of statistical information, key directions are presented for further strengthening of the system of monitoring and evaluation to strengthen the control over the HIV epidemic in Ukraine, as well as optimize specific treatment. At the present stage of the implementation of medical reforms, final revision and improvement are required of existing strategies and policies for organizing a response to the HIV epidemic in Ukraine, as well as the search for new ways and tools that can be mobilized in the health care system by increasing the efficiency of the use of existing resources, introducing new forms of management and coordination of actions. Conclusions. Bringing national standards in line with the best world practices in the field of HIV counteraction contributes to the effective planning of the need for specific therapy in order to ensure a sustainable response to the HIV epidemic in Ukraine, the use of a «treat all» approach with effective and safe antiretroviral therapy. The optimization is based on the principles of public health as having the highest priority and effectiveness in comparison with individual approaches to the prevention, treatment and support of people with chronic diseases. The principle of maintaining balanced treatment regimens helps to reduce dependence on donor funding in the context of limited resources in Ukraine, as well as ensure the achievement of Fast track goals and adherence to the UNAIDS strategy.
乌克兰艾滋病毒/艾滋病防治规划战略:审查
乌克兰的艾滋病毒流行病仍然是一个全国性的问题。从目前的流行病学情况来看,还没有理由说乌克兰与艾滋病毒/艾滋病有关的负担显著减少。由于危机的社会经济现象和乌克兰东部地区局势的恶化,预测这一流行病在全国进一步蔓延变得越来越复杂。目标-证实优化监测,诊断和治疗艾滋病毒感染的方法,作为乌克兰公共卫生系统克服艾滋病毒/艾滋病流行病战略的基础;使用现代方法和标准扩大对艾滋病毒感染者的治疗;不同部门的专家在为皮肤病和性传播感染患者提供治疗服务方面的合作数量和算法。材料和方法。我们分析:1)公共卫生领域的国际政策文件;2)乌克兰卫生保健领域国家政策文件的最新变化;3)克服艾滋病毒流行病的国际战略和办法;4)世卫组织采用公共卫生办法处理艾滋病毒流行问题的战略;5)乌克兰皮肤病和性病发病率的动态以及在个人保健服务之间缺乏综合关系的情况下实际上造成的流行病学状况;6)利用所有现有的有关数据进行建模和预测,作为监测国家和全球艾滋病毒流行情况以及管理预防和治疗方案的重要信息来源。结果和讨论。根据对统计资料的审查,提出了进一步加强监测和评价系统的关键方向,以加强对乌克兰艾滋病毒流行的控制,并优化具体治疗。在实施医疗改革的目前阶段,需要最后修订和改进组织应对乌克兰艾滋病毒流行的现有战略和政策,并通过提高现有资源的使用效率,采用新的管理和协调行动形式,寻找可以在卫生保健系统中动员的新方法和工具。结论。使国家标准与防治艾滋病毒领域的世界最佳做法保持一致,有助于有效规划具体治疗的需要,以确保对乌克兰的艾滋病毒流行病采取可持续的对策,即采用"治疗所有人"的办法,提供有效和安全的抗逆转录病毒疗法。与个人预防、治疗和支助慢性病患者的办法相比,公共卫生的原则是最优先和最有效的,这是优化工作的基础。维持平衡治疗方案的原则有助于在乌克兰资源有限的情况下减少对捐助资金的依赖,并确保实现快速通道目标和遵守艾滋病规划署战略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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