1. HIV/AIDS epidemic in Belarus Julia Dabravolskaj, MD Belarusian State Medical University

2. “Bare” Statistics 11.5 thousands of registered HIV+ people ≈45% live in Gomel region >70% of new cases – reproductive age group Unprotected sex – main route of transmission (80% of new cases)

3. Clinical issues Atypical presentation of OIs –> HIV-infection is difficult to diagnose IRIS Difficulties in HIV/HCV treatment Methodone and HAART inconsistence Fast development of new treatment strategies – not all specialists consider updates Low consistency between specialists Unsolved issues on care of elderly HIV+ Low rates of disclosure

4. HAART issues What is done 4274 patients initiated HAART 80.2% adherent in 1-year term 23.6% new cases – AIDS (late presentation) What should be done 8790 patients should initiate HAART Global Fund Grant is expiring. Life-time treatment of 1 HIV+ person costs ≈$35,000.

5. Policy issues: No laws that would allow stigmatization, but at the same time – no laws that might punish for discrimination No laws that might clarify issues serodiscordant couples face According to laws – sexual active HIV+ person ‘commits a crime’ without considering additional facts (condom use, rape etc.) Government should provide an HIV+ person with necessary treatment, however, it’s often impossible due to economic factors

6. Effective management of HIV/AIDS epidemic include: High quality diagnostic tests Free access to HAART Psychological support If one of the key elements is affected …

7. Thank you for attention!