No abstract

The HIV epidemic is concentrated mainly among key groups, and people who inject drugs (PWID) have an important place among them. HIV incidence among PWID and the total Minsk population in 2010-2019 fluctuated within the range of 10.27 (2013)-160.76 (2015) cases per 1000 PWID and 9.63 (2012)—41.00 (2015) per 100 000 of Minsk population. Average long-term incidence rates were 51.61 per 1000 PWID and 22.42 per 100 000 of Minsk population, respectively. The analyzed time interval characterized by a long-term trend towards an increase in morbidity in both analyzed groups with an average growth rate of 17.25 % (p < 0.01) and 12.62 % (p < 0.05). There is a direct linear dependence between the HIV incidence in the total Minsk population and the HIV morbidity among PWID (R2 = 0.96, p < 0.01). The presence of autocorrelation in the data series (0.52 and 0.43, respectively) indicates a high potential effectiveness of prevention programs among PWID, which will affect the HIV incidence rates of the total Minsk population also.

In recent years, the number of people involved in the use of illicit drugs has been actively growing. Drug use is associated not only with a large amount of medical aspects, but also with a number of social problems, such as convictions, employment, etc. The study presents an analysis of medical, social and epidemiological indicators, as well as their dynamic change during 2010-2019 in the population of drug users in Minsk. It was revealed that more than half of registered drug users suffer from the opioid drugs use and characterized by a gradual increase in the proportion of persons using psychostimulants. The majority of persons who were registered with the Healthcare Institution «City Clinical Narcological Dispensary» had secondary education and were single. There was an increase in the share of the working drug users (up to 48.65% (CI 47.31-49.99%, p < 0.05) in 2019) in the social structure. The proportion of drug users convicted more than 2 times in 2010-2019 has significantly increased to 35.95% (CI 34.67-37.25%, p < 0.05) in 2019. The share of drug users who underwent hospital treatment significantly increased by the 2015 and was 32.15% (CI 30.96-33.36%, p < 0.05), but in 2019 this indicator decreased to 17.48% (CI 16.47-18.52%, p < 0,05).

Objectives. To identify the medico-social and epidemiological peculiarities of HIV-infected people injecting drugs (PWID) at the stage of joining the opioid substitution therapy (OST) program, who adopted it in 2019 in the city of Minsk. Material and methods. The data of the primary accounting documentation of the Health Care Institution «City Clinical Narcological Dispensary» and the Health Care Institution «City Clinical Infectious Diseases Hospital» of PWID HIV-infected patients were analyzed on joining the opioid substitution therapy program who adopted it in 2019 in the city of Minsk (n=91). Results. It has been found that the largest proportion of the OST program participants constituted males (73.63%) aged 36 years and older (73.62%); 64.84% of them were convicted more than 3 times, 83.52% were not officially married, 64.84% were officially unemployed. The median experience of using opioid drugs made up 21 (19-24) years. Almost ½ (46.15%) of HIV-infected drug users were members of OST program for 3 (1-5) years in 2019. Most of the OST program participants (83.52%) had up to 3 periods without drug use, while in 54.95% of them these breaks were due to serving a sentence, and in 21.98% because of undergoing rehabilitation. Lifestyle changes and socialization in society were authentically the most significant reasons and motives for the participation of PWID HIV-infected persons in the OST program in Minsk (p<0.05). The analysis of the comorbidity rate showed that all the participants in the studied group were infected with viral hepatitis C, 6.59% - with hepatitis B against the background of hepatitis C virus (HCV), and 1.01% - with hepatitis D. Conclusions. The revealed medical, social and epidemiological features of HIV-infected PWID persons at the stage of joining the opioid substitution therapy program will make it possible to increase the efficiency of providing medical care to opioid drug users with HIV infection and parenteral viral hepatites and extend the coverage of the studied contingent by this program.