Objective: to justify the main directions of optimizing the medical care system for HIV-infected military personnel of the Ministry of Defense of Russia on the basis of studying the clinical, epidemiological and social characteristics of. servicemen.The materials consisted of 188 case histories of servicemen undergoing examination and treatment in the only specialized department for military medical examination and treatment of the Ministry of Defense of Russia. In the processing and analysis of data we used modern methods of descriptive statistics.Results of the study. HIV infection rate of the servicemen in Russian Federation is at a consistently low level. HIV-positive servicemen are characterized by: sexual heterosexual way of infection; high social status (income, education, housing conditions), low prevalence of associated pathology. Access of most HIV-positive military personnel to dispensary observation (76,6%) and receiving antiretroviral therapy (66,1%) in the centers for the Prevention and Control of AIDS and Infectious Diseases has already been implemented, despite the lack of a regulatory framework of the Russian Ministry of Defense. A high level of adherence to dispensary observation and receiving antiretroviral therapy (about 95%) was noted in HIV-positive military personnel. Ensuring the legitimate access of HIV-infected military personnel to antiretroviral therapy practically does not require an increase in funding.

Aim. In this study we evaluated clinical effectiveness and safety of nebulized prostacyclin in patients with Novel Coronavirus Disease (SARS-CoV-2). Materials and methods: We have included 44 male patients with moderate PCR confirmed SARS-CoV-2 infection in this study. Control group consisted of 23 patients treated with nebulized prostacyclin (PGI2). besides standard therapy. We compared intensiveness and duration of infectious intoxication syndrome, duration of fever, cough as well as SpO2 level, complete blood count and chemokine status values. Results: Statistically significant difference in duration of fever, cough, intensiveness and duration of infectious intoxication syndrome were observed. Lymphocyte and platelet counts were significantly higher in control group We have also noticed significantly lower level of proinflammatory mediators and C4-complement component in control group. Only 1 adverse effect associated with inhaled prostacyclin was reported. Conclusion. Nebulized prostacyclin showed therapeutic efficacy and good safety profile in adults with moderate COVID-19.

More than 1,7 million people, 770 thousand people from HIV infection, died from tuberculosis worldwide in 2018. In accordance with the United Nations Sustainable Development Goals and the World Health Organization’s strategy to fight tuberculosis, all countries need to reduce the incidence of tuberculosis by 80% and reduce the death rate from tuberculosis by 90% by 2030. According to the Joint United Nations programme on HIV/AIDS (UNAIDS) goals of «90–90–90», countries should achieve the following indicators by 2020: «90% of people living with HIV infection should know their HIV status; 90% of those who know about their HIV infection should receive treatment, and 90% of those who are being treated should not have their viral load determined». Socially significant diseases are a serious problem for the Russian Federation (RF). The RF is one of 30 countries with a high incidence of tuberculosis and ranks 3rd place in multidrug-resistant tuberculosis and 6th place in the prevalence of HIV infection. Socially significant diseases present a serious problem for the Armed Forces of the RF. 150 new cases of tuberculosis, over 50 cases of HIV infection are diagnosed every year among military personnel of the RF Armed Forces.The purpose of the study is to analyze the current epidemiological situation of tuberculosis and HIV infection in the armed forces of the Russian Federation and foreign armies, to generalize domestic and foreign experience in the organization of medical care for military personnel with these diseases.Data from reports of the medical service and a review of domestic Russian and foreign medical literature allowed us to assess TB and HIV sickness rate among military personnel in the RF and foreign states, as well as to characterize the current system of medical care for this category of patients.

The goals of the research are to determine the latent morbidity and financial losses of the Russian Ministry of Defense due to the dismissal of service members with HIV infection at symptomatic stages; to establish the supposed clinical and pharmacoeconomic effectiveness of the early detection and treatment of service members.The materials compile 379 case histories of patients of the only specialized department for HIV-positive military personnel in the Armed Forces for 2017–2019, as well as various reporting forms. The study uses the following methods for the analysis: Markov chains are employed to calculate QALYs (Quality Adjusted Life Years), “cost-effectiveness”, and “willingness to pay”. The research compares two competitive models: “Current Situation” - without the introduction of algorithms for early detection and treatment of HIV infection, and “Prognosis” - with the introduction of these algorithms.The following results are obtained: implementing a mandatory triennial screening for HIV-antibodies among military personnel allows to raise the detection of HIV-positive military personnel in the early stages of the disease by 55%. At the same time, early administered antiretroviral therapy prevents the progression of HIV infection, while the number of military personnel who have reached symptomatic stages of HIV infection and the number of deaths decreases by 35,6% and 80,2% (six-fold), respectively. The economic effectiveness of these measures includes a reduced cost of treatment and an increased length of military service. The sensitivity analysis of the method shows that the proposed measures remain pharmacoeconomically highly effective with a wide variability of the initial data.Conclusion. The results of the study demonstrate that a significant improvement of the epidemiological situation in the field of HIV infection in the Armed Forces is achievable at very low economic costs. With the full implementation of the proposed measures, the cohort of military personnel of the Armed Forces is able to achieve the World Health Organization’s “90-90-90”criteria of in 3–5 years.

Introduction. 44 cases of HIV-infection among the homeless were registered in Saint Petersburg in 2021. At the same time, it is known that the case reporting and medical treatment in Russia are limited by the lack of required document minimum among a large number of them — passport and compulsory medical insurance policy. The cohort of the homeless is heterogeneous and in many countries the predominant risk factors of HIV infection and prevalence are different. So far, the studies of HIV spread among the homeless in Russia are rare.Objective. Assess the prevalence of HIV infection among the homeless in Saint Petersburg.Materials and methods. Cross-sectional study was carried out among the homeless in «places of attraction»: heating points, overnight shelters, care services from May, 24th to October, 1st 2021 and involved 199 participants. There was questionnaire and rapid HIV antibody testing in capillary blood by the set «Wondfo HIV 1,2». The study was completed anonymously.Results. When examining HIV infection was detected in 9 out of 199 participants — 4.5% (CI 95% [1.61%, 7.39%]), thus, HIV prevalence among the homeless is on average higher than in Saint Petersburg (0.81%) and the country (0.78%). The factors, associated with HIV infection, are the use of injection drugs: odds ratio of prevalence in the adjusted model adjusted prevalence ratio (APR)=4.3 (p<0.05, CI 95% [1.1, 17.5]) and incarceration: APR=9.4 (CI 95% [1.1, 82.2]).Conclusion. The results obtained and the factors, defined in the study of risk factors for infection, allow to determine the main directions of HIV prevention among the homeless and to highlight the need for attributing the cohort of the homeless to the «key» population group along with others.