DEMOGRAPHIC AND EPIDEMIOLOGICAL CHARACTERISTICS OF THE HIV-INFECTED PREGNANT WOMEN IN SAINT-PETERSBURG

Analysis of the epidemiological and demographic characteristics of HIV-infected pregnant women is important for organizing effective care for this group of patients and further reducing the frequency of mother-to-child transmission. Between 2014 and 2017 in Saint-Petersburg, there were 2524 deliveries in HIV-infected women who were observed during pregnancy, mainly in the Saint-Petersburg AIDS Center (AIDS Center). The average frequency of perinatal HIV transmission over the study period in the city was 1,3%, which is lower than the average for Russia. Out of 2524 women recently confined, 1858 HIV-infected women, who were observed during pregnancy at the AIDS Center in 2014–2017, were enrolled. Risk groups for perinatal HIV transmission in Saint-Petersburg are HIV-infected pregnant women: external or internal migrants, women with late registration at the dispensary registration for pregnancy in the antenatal clinic and the AIDS Center and, accordingly, late initiation of perinatal HIV transmission, active consumers of surfactants, pregnant women with low adherence to observation in medical institutions and to getting antiretroviral agents. The increase in coverage of the city’s population with HIV testing reveals new infections, including among women of reproductive age, as well as their partners. The timely use of ARV at the planning stage of pregnancy reduces perinatal HIV transmission and the risks of opportunistic diseases. The availability of medical care and free distribution of ARV drugs to all pregnant women who applied to the AIDS Center helps to reduce perinatal HIV transmission, including among internal and external migrants who do not have a permanent registration in Saint-Petersburg. Counseling women at the planning stage and during pregnancy by various specialists of the AIDS Center (gynecologists, infectious disease specialists, psychologists, narcologists) allows one to form a commitment to monitoring, to receiving ARV, giving up bad habits, to reduce the incidence of HIV-dissidence.

1. Belyakov N.A., Rassokhin V.V., Samarina A.V. HIV infection: family planning, medical, social and clinical issues of prevention and treatment in women and children. Medical Тhematic Archive No. 9. Saint-Petersburg: Baltic medical educational center, 2015, 65 p. (In Russ.).

2. The results of an epidemiological study among women living with HIV. Abbvie, 2015. URL: https://www.abbvie.ru/press/AbbVie-Russia-announces-results-of-epidemiological-study-for-women-living-with-HIV.html (June 18, 2019) (In Russ.).

3. Country progress report — Russian Federation. Global monitoring of the AIDS epidemic 2018, p. 14 (In Russ.).

4. Gusev D.A., Samarina A.V., Yastrebova E.B., Muzaleva O.L. Modern aspects of prevention of perinatal HIV transmission in Saint-Petersburg. Journal of Infectology, 2019, Vol. 11, No. 1, pp. 58–64 (In Russ.).

5. Niauri D.A., Musatova E.V., Kolobov A.V., Martirosyan M.M., Karev V.E., Tsinzerling V.A. Role of social and reproductive factors in perinatal HIV transmission. Obstetrics and Women’s Diseases, 2013, Vol. 62, No. 3, pp. 50–57 (In Russ.).

6. Belyakov N.A., Rakhmanina N.Yu., Rakhmanova A.G. Woman, child and HIV. Saint-Petersburg: Baltic medical educational center, 2012, pp. 101 (In Russ.).

7. Yastrebova E.B., Vinogradova T.N., Rakhmanova A.G. Approaches to solving the problem of mother-to-child transmission of HIV and maintaining family health taking into account medical and social characteristics. Epidemiology and Infectious Diseases, 2012, No. 2, pp. 21 (In Russ.).

8. Niauri D.A., Yakovlev A.A., Penchuk T.E. Features of obstetric clinic and practice of delivery of HIV-infected women in Saint-Petersburg. Obstetrics and Women’s Diseases, 2014, Vol. 63, No. 5, pp. 64–72 (In Russ.).

9. Information Bulletin of the Saint-Petersburg AIDS Center for 2018 «HIV infection in Saint-Petersburg». URL: https:// www.hiv-spb.ru (June 18, 2019) (In Russ.).

10. Russia’s population in 2016. 24 annual demographic report. Resp. ed. S.V.Zakharov. Moscow: Publishing house of Higher school of Economics, 2018, 448 p. (In Russ.).

11. Samarina A.V., Akatova N.Yu., Whiteman M.K., Kissin D.M. Factors determining the choice of method of contraception in HIV-infected women. HIV Infection and Immunosuppressive Disorders, 2012, Vol. 4, No. 1, pp. 57–68 (In Russ.).

12. Whiteman M., Kissin D., Samarina A. et al. Determination of contraceptive choice among women with HIV. AIDS, 2009, Vol. 23, No. 1, pp. 47–54.

13. Clinical guidelines for the prevention of mother-to-child transmission of HIV. Ed. acad. N.N.Volodin. Moscow, 2015, 37 p. (In Russ.).

14. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. DHHS, 2016, А1–2.

15. Information Bulletin of the Saint-Petersburg AIDS Center for 2015 and 2017 «HIV infection in Saint-Petersburg». URL: https://www.hiv-spb.ru (June 18, 2019) (In Russ.).

16. Use of antiretroviral drugs as a package of measures to prevent mother-tochild transmission of HIV. Clinical guidelines (treatment Protocol). Moscow, 2015, 59 p. (In Russ.).

17. Department of Health and Human Services/Recommendations for Use of Antiretroviral Drugs in PregnantHIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States, 2016. URL:http://aidsinfo.nih/gov/guidelines (June 18, 2019).

18. Yushchuk N.D., Maslyakov V.V., Arystanbekova M.S. Problems of prevention of perinatal transmission of HIV. Infectious Diseases: News, Opinions, Training, 2019. Vol. 8, No. 1, pp. 47–51 (In Russ.).

19. Human immunodeficiency virus — medicine: a guide for physicians. Ed. A.N.Belyakov, A.G.Rakhmanova. Saint-Petersburg: Baltic medical educational center, 2011, 656 p. (In Russ.).

20. Rakhmanova A.G., Vinogradova E.N., Voronin E.E., Yakovlev A.A. HIV infection. Clinic and treatment. Adherence to treatment. Chemoprophylaxis of mother-to-child transmission of HIV. Diagnosis and treatment of HIV infection in children. Medical, social and psychological counselling: guidance for medical and psychological services. 2nd ed., rev. and add. Saint-Petersburg: WWM, 2006, 158 p. (In Russ.).

21. Clinical guidelines. HIV infection: Prevention of perinatal transmission of human immunodeficiency virus. Ed. E.E.Voronin, L.Yu.Afonina, I.B.Latysheva, V.Ya.Rosenberg, Yu.A.Fomin. Moscow: MOH of Russia, 2017, 51 p. (In Russ.).

22. Statistical Bulletin of the Federal state statistics service of Saint-Petersburg and Leningrad region. Saint-Petersburg, 2017 (In Russ.).

23. Order of the Government of Saint-Petersburg dated 06.09.2018 № 49-rp «Program of measures for the implementation in Saint-Petersburg of the State strategy to combat the spread of HIV in the Russian Federation for the period up to 2018 and beyond. Saint-Petersburg, 2018 (In Russ.).

24. Bulekov I.S., Krupitsky E.M. Randomized placebo-controlled study of the effectiveness of butorphanol in the relief of opium withdrawal syndrome in HIV-infected pregnant women. Review of Psychiatry and Medical Psychology named after V.M.Bekhterev, 2008, No. 1, pp. 36–39 (In Russ.).

25. Safonova P.V., Rassokhin V.V., Diclemente R.D., Brown D.L., Sales D., Rose I.S., Rybnikov V.Yu., Vinogradova T.N., Belyakov N.A. Past experience with psychoactive substances and present risk behaviour in HIV-infected women. HIV Infection and Immunosuppressive Disorders, 2014, Vol. 6, No. 4, pp. 24–34 (In Russ.).

26. Belyakov N.A., Vinogradova T.N., Rosenthal V.V., Sizova N.V., Rassokhin V.V., Lisitsina Z.N., Panteleeva O.V., Dvorak S.I. Evolution of the HIV epidemic in Saint-Petersburg — reduction of morbidity, aging and aggravation of the disease. HIV Infection and Immunosuppressive Disorders, 2015, Vol. 7, No. 2, pp. 7–17 (In Russ.).

27. Novikova O.N., Shvets E.M. Risk factors and features of the course of pregnancy, childbirth and the state of the newborn in HIV-infected women. Mother and Child in Kuzbass, 2017, No. 3 (70), pp. 16–20 (In Russ.).

28. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Recommendations for a public health approach. 2nd ed. Geneva: WHO, 2016, 480 p.

29. Clinical guidelines. HIV infection in adults. Ed. E.E.Voronin, L.Yu.Afonina, V.Ya.Rosenberg, I.B.Latysheva, G.D.Kaminsky, Yu.I.Bulankova, T.N.Melnikova, M.V.Radzikhovskaya, Yu.A.Fomin. Moscow, 2017, 21 p. (In Russ.).