Западная Сибирь является одним из основных регионов с большим количеством ВИЧ-инфицированных лиц. Участковые терапевты-ключевое звено, которое осуществляет первый контакт с ВИЧ-инфицированными. Однако пока не ясно, насколько врачи общей практики готовы к работе с ВИЧ-инфицированными лицами. В свою очередь, эффективное взаимодействие врача с пациентом может оказаться решающим в формировании позитивного отношения пациента к лечению и в значительной степени повлиять на эффективность будущих лечебных мероприятий. Исследование, результаты которого представлены в статье, было проведено в 2017 г. путем анонимного анкетирования. В исследовании приняло участие 334 студента 4-го курса лечебного и педиатрического факультетов Новосибирского государственного медицинского университета. Для опроса была использована адаптированная анкета, созданная на основе типового опросника ЮНЭЙДС (UNAIDS-Joint United Programme on HIV/AIDS). Обнаружено, что студенты-медики не осуждают ВИЧ-инфицированных людей. Они не считают, что люди с положительным ВИЧ-статусом обязательно ведут себя безнравственно и поэтому заслуживают это заболевание. Они готовы помогать этим пациентам, хотя сами при этом испытывают страх заражения во время лечебных манипуляций. Установлено незнание ряда правовых вопросов, касающихся ВИЧ-инфицированных пациентов.

Scleroatrophic lichen (SL) is a chronic inflammatory skin disease of unknown etiology characterized by scar formation. The most frequent localization of SL is the anogenital area. In females, the most common anogenital symptoms are pain, itching, dysuria and dyspareunia. Male patients often present with complaints of a white rash on the penile skin, itching, painful erections and urination, and bleeding or ulceration during intercourse. Although clinical descriptions of SL date back to the mid-20th century, the pathophysiological mechanism remains unclear to this day. The main hypotheses of the pathophysiology of SL are infectious, autoimmune, and chronic irritation theories (occlusive exposure to various irritants, such as urine, leads to chronic skin injury that causes the disease). It is assumed that SL quite often goes undiagnosed for a long time. However, sometimes dermatoses such as eczema in the anogenital area are misdiagnosed by specialists as SL. In this article, the authors discuss in detail the existing hypotheses of SL development, its clinical manifestations, and current methods of diagnostics and therapy.

Women are the main population responsible for new HIV infections and the persistence of the HIV pandemic. The article provides a review of the current literature on the factors and mechanisms by which the vaginal microbiome can contribute to HIV infection. A key determinant of susceptibility to HIV infection is the composition of the vaginal microbiome, which can influence the local immune cell population and inflammation status. A low diversity microbial composition dominated by Lactobacillus crispatus does not increase the risk of HIV infection, and a high microbial diversity environment associated with bacterial vaginosis increases the risk of HIV infection. The female reproductive tract has a unique susceptibility to viral infection because tissue-specific immunity must elicit rapid antimicrobial responses to pathogens while maintaining sperm tolerance. It is important to note that the risk of HIV infection during sexual intercourse is multifactorial and is determined not only by the state of the microbiota of a woman’s genital tract, but also by the state of the partner’s microbiota, the viral load of HIV in the blood of the sexual partner, the presence/absence of anti-retroviral therapy in the partner, hormonal background and the phase of the menstrual cycle, which also affect the state of the microbiota.

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Western Siberia is one of the main regions with a large number of HIV-infected individuals. District therapists are the main link that makes the first contact with HIV infected people. However, it is not yet clear how general practitioners agree with the communication with HIV infected people. In turn, effective communication between the doctor and the patient can be crucial in the formation of a positive attitude of the patient to treatment and significantly affect the effectiveness of future treatment activities. The study was conducted in 2017 by anonymous questionnaires. The study involved 334 medical students of the 4th year of the therapeutic and pediatric faculties of the NSMU. For the survey, an adapted questionnaire was developed, based on the UNAIDS model questionnaire. It was found that medical students do not condemn HIV infected people. They do not believe that people with a positive HIV status necessarily behave immorally and therefore deserve this disease. They are ready to help these patients, although they themselves feel the fear of infection during medical manipulations. A lack of knowledge of a number of legal issues concerning HIV infected patients has been established.