A study explores the link between conflict-induced displacement of people and the spread of HIV within Ukraine. Ongoing political unrest in eastern Ukraine has led to the relocation of more than 1.7 million people in a country plagued by one of the largest HIV epidemics in Europe. To determine whether the large-scale movement of people displaced by war reflects HIV spread within the country, Tetyana Vasylyeva et al. analyzed HIV-1 subtype A polymerase DNA sequences collected from 427 patients at 24 regional clinics between 2012 and 2015--a period spanning the onset of the current military conflict in 2014. Epidemiological and phylogeographic analysis revealed that the eastern regions of Donetsk and Lugansk--home to nearly a quarter of the country's registered HIV-infected people--were the main exporters of viral lineages within the country. From the East, the virus appears to have spread to the central and southern regions, as well as to the cities of Kyiv and Odessa. Following 2013, the start of the armed conflict represents a watershed for virus dissemination, with the movement of war-displaced people mirroring the redistribution of extant viral infections within the country. Virus importation events were partly correlated with sexual practices among people who inject drugs--a group considered a major driver of the epidemic; consistent use of condoms during sex was tied to lower importation. Conversely, the number of virus exportation events to a given location rose with the number of internally displaced people who moved to that location. According to the authors, the study underscores the need for HIV surveillance and prevention measures in regions of Ukraine beyond those directly affected by armed conflict.
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Article #17-01447: "Molecular epidemiology reveals the role of war in the spread of HIV in Ukraine," by Tetyana Vasylyeva et al.
MEDIA CONTACT: Tetyana Vasylyeva, University of Oxford, UNITED KINGDOM; e-mail: tetyana.vasylyeva@zoo.ox.ac.uk
Journal
Proceedings of the National Academy of Sciences