Early stages of HIV treatment cascade in people living with HIV in Saint-Petersburg, Russia

ABSTRACT

The proportion of people living with HIV (PLWH) in need of antiretroviral therapy (ART) is growing rapidly in Russia. Successful treatment outcomes reduces disease progression and contributes to HIV epidemic control.

We conducted a pilot study following 100 PLWH newly found eligible for ART in St. Petersburg, Russia. We determined the proportion of PLWH who initiated ART, remained in treatment, and achieved an undetectable VL during 6-month follow up. Semi-structured interviews were conducted prior the initiation of ART and progress along the cascade was assessed through medical chart review. Individual characteristics associated with successful ART outcomes were assessed as part of efforts to generate hypotheses.

Almost all (96%) participants initiated ART, full retention was demonstrated by 80%, among whom 71% achieved undetectable VL. Optimal retention was associated with older age and higher education (p < 0.05). There was no significant difference in ART outcomes between those who used illicit drugs and those had not.

Interventions to improve treatment effectiveness should emphasize that initiation, optimal retention and achieving an undetectable VL are independent of drug abuse status. However, our pilot study highlights the need for the further research in the examining links between individual and structural factors and ART effectiveness.

KEYWORDS:

• HIV
• ART
• adherence
• retention
• Russia

Acknowledgements

We are grateful to all subjects for their participation, and to our colleagues at Yale University, First Pavlov State Medical University of St. Petersburg, St. Petersburg Research Psychoneurological Institute named after Bekhterev, St. Petersburg State University, St. Petersburg Institute for Informatics and Automation of the Russian Academy of Sciences, St. Petersburg Centre for Control and Prevention of AIDS and Other Infections, Regional Public Organization of social projects in the field of welfare “STELLIT” for their support. All authors had full access to all the data in the study and jointly had final responsibility for the decision to submit for publication.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

M. V. Vetrova http://orcid.org/0000-0002-9698-0327

Additional information

Funding

This work was supported by AIDS International Training and Research Program [grant number D43TW001028].