Research of medical and social portrait of the patient and priority among schemes of the antiretroviral therapy in the national regional AIDS centers

Abstract

To achieve the purpose of the UNAIDS «90–90–90» in fighting against the epidemic of HIV/AIDS in Ukraine, among other things, an actual task nowadays is the research of medical and social portrait of people with HIV (PWH) to find ways to raise their motivation for testing and treatment, as well as special features of appointment the antiretroviral therapy (ART) in national health care facilities (HCF) based on real data. It became the purpose of the research. The object of the analysis was a sample of 1 200 control cards (of clinical supervision of an HIV-infected person) (form № 030-5/o) of patients, who were consisting on the account in the HCF, which conduct medical surveillance of PWH, 12 regions of Ukraine: Odessa, Kiev, Mykolaiv, Kherson, c. Kiev, Zaporizhia, Vinnytsia, Rivne, Kharkiv, Lviv, Ternopil, Ivano-Frankivsk on July–September 2016. In each center have been processed 100 cards of patients who received ART. Cards for retrospective analysis have been determined by random selection and with the closure of the personal data.

In this study we used an analytical, systematic and logical, ABC analysis as main research methods.

According to the results of a retrospective analysis, we have a portrait of the HIV-positive person on ART. It is equally male (51%) or female (49%), aged 31–50 years (76%). If the person is older, the chances of living in areas of higher HIV prevalence increases in Odessa, Mykolaiv, Dnipro regions. In 67% of cases the person is in 3^rd or 4^th clinical stages and 84% is workable with unlimited activity and high adherence to ART (93%). The person at 59% will require the prevention or treatment of tuberculosis, because 15% gets the prevention of tuberculosis or received it during the current year; one third likely that it had previously been an injection drug user (29%) or are infected with hepatitis C virus (32%). There is a lack of unified approaches to completing the Control cards of the oversight of an HIV-infected person by specialists of the national AIDS centers, and not observed the same criteria in the prescribing ART to patients in the regions of Ukraine. And the priority schemes of ART in Ukraine is outlined in 6 combinations: 1l – TDF + FTC + EFV (26,6%), 1D – AZT + ZTS + LPV/r (17,5%), 1A – AZT + ZTS + EFV (13%), 1P – TDF + ZTS + EFV (of 9.84%), 1o – TDF + FTC + LPV/r (8,92%), 1P – AVS + ZTS + LPV/r (6,5%), which made the group A by prescribing according to the Pareto approach, because they took totally 82% of patients.