Background: The increase in the number of HIV-infected women of fertile age, as well as their reproductive plans to have healthy children, was the reason for studying the features of reproductive health disorders and comorbid conditions in women with HIV infection. Methods and Results: Women meeting the inclusion criteria were divided into two groups: Group 1 included 27 HIV-infected women (average age of 30.8±2.9 years) with reproductive disorders; Group 2 included 23 HIV-infected women (average age of 31.4±7.1 years) without reproductive disorders. In study groups, the main route of HIV transmission was sexual contact. When assigning women to a particular category (fertile or infertile), the WHO classification of fertility was used: fertile, presumably fertile, primarily infertile, secondarily infertile, women with unknown fertility. There was a statistically significant difference in the incidence of medical abortion in the HIV-infected women with secondary infertility [14(60.9%)], compared to Group 2 [8(29.6%)] (P=0.026). There were no statistically significant differences in the incidence of chronic co-morbidities (ENT disorders, gastritis/duodenitis, pancreatitis, cystitis, viral hepatitis (B, C), papillomavirus infection) in Groups 1 and 2 (P>0.05). The incidence of pelvic inflammatory diseases was 2 times higher in Group 1 than in Group 2. No statistically significant differences in the incidence of uterine myoma, chronic cervicitis, chronic endometritis, vulvovaginal candidiasis,, and cervical dysplasia were found. A significant prevalence of chronic salpingo-oophoritis, secondary dysmenorrhea, secondary amenorrhea, opsomenorrhea, and secondary oligomenorrhea was detected significantly more frequently in Group 1 than in Group 2. The syndrome of hyperprolactinemia was also 2.6 times more frequent in Group 1 than in Group 2. Reproductive disorders in HIV-infected women were associated with a high incidence of STI combinations (trichomoniasis, gonorrhea, syphilis, chlamydia). Conclusion: Early detection of menstrual dysfunctions, prevention of abortion and sexually transmitted diseases, and timely treatment of infertility, are essential for women living with HIV.

Background. Incidence and prevalence of socially significant infectious diseases are the most important indicators of the quality of life and sanitary and epidemiological well-being of the population.The aim is to identify structural, quantitative and dynamic features of incidence and prevalence of socially significant infectious diseases among the population in the post-Soviet period (on the example of the Irkutsk region).Methods. The materials of the forms of federal statistical observation № 2, № 12, databases posted on the websites of the Federal State Statistics Service, the Unified Interdepartmental Information and Statistical System, the Center for Demographic Research of the Russian School of Economics were used in the study. An epidemiological analysis of morbidity indicators and a comparative assessment with the average Russian data have been carried out. Trend analysis was performed by linear regression analysis using the SPSS software (IBM Corp., USA).Results. The highest levels of tuberculosis prevalence in the Irkutsk region were noted in the period from 1999 to 2013 (352.1–436.9 0/0000). The incidence rate of syphilis increased by 1997 to the maximum value – 431.4 0/0000; in subsequent years, the incidence rate decreased, amounting to 28.8 0/0000 in 2019. Very high incidence rates of gonorrhea, trichomoniasis, chlamydia were noted in the region until the end of the 2000s. The dynamics of the prevalence of HIV infection since 1999 was characterized by a rapid increase in the indicator (in 2018 – 1995.0 0/0000), which made the region one of the most unfavorable in the country for this type of pathology. Thus, in the Irkutsk region since the second half of the 1990s until the late 2000s – early 2010s there was a pronounced increase in the incidence of socially significant infectious diseases to very high values, significantly exceeding the national average. In the subsequent period (2012–2019), there was a consistent decrease in the incidence rate.Conclusion. The quality of life of the population of Siberia in the post-Soviet period suffered to the greatest extent. This led to a rapid increase in the levels of morbidity with socially significant infectious diseases. A transition to the state model of the advanced development of human potential is required to reduce morbidity to an acceptable level.

An anonymous survey was conducted, covering the issues of reproductive attitudes and contraceptive behavior in 50 women (mean age of 30.9±4.5 years) and 35 men (mean age of 31.1±3.2 years) with HIV infection of stages 4B and 4C. The study was carried out using a structured questionnaire that included questions about age, marital status, methods of contraception, reproductive plans, and reproductive and medical history. An anonymous interview with 85 HIV-infected respondents revealed that most of the women (82.0%) had contracted HIV through heterosexual contact, while in the men, the parenteral route of HIV infection predominated (57.1%) (P=0.0126). Statistically significant differences were found between the rate of single women and men: 21(42%) women versus 2(5.7%) men (P<0.001). An analysis of contraceptive behavior revealed statistically significant differences: 26% of the women and 8.6% of men (P<0.05) did not use any methods of contraception with regular or irregular sexual life. The majority of respondents used a barrier method of contraception and coitus interruptus. The vast majority of women (80%) had a desire to have children in an indefinite future, as opposed to 37.1% of the men (P<0.001). About 11.4% of men and 10% of women (P>0.05) definitely did not plan pregnancy in the future, mainly because of their unsatisfactory financial situation and the presence of a current HIV infection. Forty-two percent of the women did not undergo periodic medical examinations by a gynecologist or other specialists, and 44% of them indicated the reason for the lack of visits to the doctor as an unsatisfactory attitude of medical personnel towards them. The results obtained are important for the development of optimal medical care that alleviates the burden of HIV infection. In addition to medical care, health care providers must consider social and psychological needs to help HIV patients improve their health, including their sexual and reproductive health.