Public Health

doi: 10.25005/2074-0581-2023-25-1-22-35

D.S. Sayburkhonov1, S.S. Karimov2, D.А. Kadyrova3, N.А. Abdukhamedov4, M.M. Ruziev5

1Center for AIDS Prevention and Control of Dushanbe, Dushanbe, Republic of Tajikistan
2Department of Epidemiology, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
3Department of Family Medicine № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
4Republican Center for AIDS Prevention and Control, Dushanbe, Republic of Tajikistan
5Tajik Research Institute of Preventive Medicine, Dushanbe, Republic of Tajikistan

Objective: To assess the current results of the integration of HIV services into primary health care (PHC) facilities in Tajikistan in the example of Dushanbe

Methods: A comparative analysis of the official statistical data on human immunodeficiency virus infection (HIV) of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan (MHSP RT) was carried out in dynamics. The data of electronic records of people living with HIV (PLHIV) in the system of electronic tracking of HIV cases, including patients receiving integrated HIV services in PHC facilities, were analyzed. The materials of local and foreign scientific medical journals were studied. The method of descriptive statistics was used in the work.

Results: In 2021, 922 new cases of HIV were detected in Tajikistan, including 1) people with sexual transmission – 83.7%; 2) labor migrants (LM) and those tested for clinical indications – 49.2%; 3) people over 50 years of age – 12.3%. The share of LM during HIV testing was 3% of the total population tested for HIV in 2021. The number of PLHIV in the country as of December 31, 2021, was 10,077; 8740 of them (86.7%) received antiretroviral therapy (ART), of which 14.2% were above 50 years of age. As of December 31, 2021, 1,155 (11.5% of all PLHIV in the country) received HIV service at the PHC facilities, 21.2% of them were children (<18 years old), and 78.8% – were adults (18+). Among adult patients, 34.7% were from key population groups (KPs); 1146 (99.2%) PLHIV received ART, of which 97.6% showed viral load (VL) suppression. Coverage of PLHIV with ART in the regions of the country varied from 81.8% to 90.1%.

Conclusion: According to the research data, the HIV epidemic continues in the country with increasing infection circulation in the general population and “aging” of HIV. So far, the integration of HIV services into PHC facilities of the country was carried out only in the City Health Centers (CHCs) of Dushanbe, where every third adult PLHIV was from KPs. Almost all PLHIV received ART at the CHCs, and VL suppression was observed in most of them. In the CHCs, it is necessary to expand HIV testing at the initiative of health workers. It is recommended to start implementing the integration of HIV services in the CHCs of other large cities of the country.

Keywords: HIV infection, people living with HIV, antiretroviral therapy, viral load suppression, integration of HIV services, primary health care.

Download file:

  1. Rafiev KhK, Tursunov RA, Nurov RM. Epidemicheskie osobennosti razvitiya VICh-infektsii v Tadzhikistane [Epidemic features of HIV infection development in Tajikistan]. Vestnik Avitsenny [Avicenna Bulletin]. 2012;4:117-21.
  2. Nurov RM, Rafiev KhK, Rakhmanova AG, Aslanov BI. Razvitie epidemicheskogo protsessa VICh-infektsii v Respublike Tadzhikistan [Development of HIV infection epidemic process in the Republic of Tajikistan]. VICh-infektsiya i immunosupressii. 2014;2:118-23
  3. Karimov SS, Abdukhamedov NA, Ruziev MM, Sayburkhonov DS, Nurlyaminova ZA, Madzhitova TP, i dr. Lechenie VICh v Tadzhikistane i zadachi v svyazi s Global'noy strategiey 90-90-90 [HIV treatment in Tajikistan and objectives in relation to the Global Strategy 90-90-90]. Zhurnal infektologii. 2015;7(3):43.
  4. Tsoy VN, Rakhmanov ER, Sharipov TM, Bukhoriev KM. Effektivnost' i priverzhennost' k terapii VICh-infektsii v Respublike Tadzhikistan [Effectiveness and adherence to HIV therapy in the Republic of Tajikistan]. Vestnik Avitsenny [Avicenna Bulletin]. 2017;19(1):98-102. https://doi.org/10.25005/2074-0581- 2017-19-1-98-102
  5. Sweeney S, Obure CD, Maier CB, Greener R, Dehne K, Vassall A. Costs and efficiency of integrating HIV/AIDS services with other health services: A systematic review of evidence and experience. Sex Transm Infect. 2012;88(2):85-99
  6. Nachega JB, Parienti JJ, Uthman OA, Gross R, Dowdy DW, Sax PE, et al. Lower pill burden and once-daily antiretroviral treatment regimens for HIV infection: A meta-analysis of randomized controlled trials. Clin Infect Dis. 2014;58(9):1297- 307.
  7. Sizova NV, Volova LYu, Malyuzhenko IV, Isaeva GN, Kovelenov AYu, Minaeva SV, i dr. Pervye rezul'taty primeneniya kombinirovannogo preparata rilpivirin/tenofovir/emtritsitabin u rossiyskikh patsientov s VICh-infektsiey v real'noy klinicheskoy praktike [First results of using the combined drug rilpivirine/tenofovir/ emtricitabine in Russian HIV-infected patients in real clinical practice]. Epidemiologiya i infektsionnye bolezni. Aktual'nye voprosy. 2015;6:1-7.
  8. Smith MK, Powers KA, Muessig KE, Miller WC, Cohen MS. HIV treatment as prevention: The utility and limitations of ecological observation. PLoS Med. 2012;9(7):e1001260. https://doi.org/10.1371/journal.pmed.1001260
  9. Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV positive partner is using suppressive antiretroviral therapy. JAMA. 2016;316(2):171-81.
  10. Belyaeva VV, Kozyrina NV, Kuimova UA, Efremova OS. Dokontaktnaya profilaktika VICh-infektsii v diskordantnykh parakh: poiski resursov i otsenka riskov [HIV-infection pre-exposure prophylaxis in discordant couples: quest of resources and risks estimate]. Zhurnal infektologii. 2020;12(3):6-11.
  11. Fonner VA, Dalglish SL, Kennedy CE, Baggaley R, O’Reilly KR, Koechlin FM, et al. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS. 2016;30:1973.
  12. Baeten JM, Palanee-Phillips T, Brown ER, Schwartz K, Soto-Torres LE, Govender V, et al. Use of a vaginal ring containing dapivirine for HIV-1 prevention in women. N Engl J Med. 2016;375:2121-32.
  13. Landovitz RJ, Li S, Grinsztejn B, Dawood H, Liu AY, Magnus M, et al. Safety, tolerability, and pharmacokinetics of long-acting injectable cabotHIVuninfected individuals: HPTN 077, a phase 2a randomized controlled trial. PLoS Med. 2018;15:e1002690.
  14. Kadyrova DA, Abdukhamedov NA. Priverzhennost' antiretrovirusnoy terapii, kak odin iz vazhnykh faktorov na puti k global'noy tseli 90-90-90 [Adherence to antiretroviral therapy as one of the important factors on the way to the global goal 90-90-90]. Zhurnal infektologii. 2020;12(3):150.
  15. Kadyrova DA, Karimov SS, Abdukhamedov NA. Rol' i zadachi sluzhby pervichnoy mediko-sanitarnoy pomoshchi v svyazi s genderno-vozrastnymi osobennostyami rasprostraneniya VICh-infektsii v Tadzhikistane [The role and objectives of primary health care services due to gender- and age-related features of HIV infection in Tajikistan]. Vestnik Avitsenny [Avicenna Bulletin]. 2019;21(2):258- 262. https://doi.org/10.25005/2074-0581-2019-21-2-258-262
  16. Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;382:1525-33.
  17. Kuimova UA, Belyaeva VV, Kravchenko AV, Kanestri VG, Pokrovskaya AV, Goliusova MD, i dr. Kachestvo zhizni i udovletvoryonnost' poluchaemoy terapiey lyudey, zhivushchih s VICh: rezul'taty oprosa patsientov, prinimayushchikh antiretrovirusnuyu terapiyu [The life quality and satisfaction with treatment in people living with HIV: Results of a survey of patients taking antiretroviral therapy]. Zhurnal infektologii. 2021;13(3):52-8.
  18. Smirnov AN, Granovskaya-Tsvetkova AM, Tsalenchuk YaP. Ambulatornaya diagnostika vazhneyshikh vnutrennikh zabolevaniy [Outpatient’s diagnostics of the most important internal diseases]. Leningrad, RF: Meditsina; 1988. 320 p.

Author information:

Sayburkhonov Dilshod Saygufronovich,
Director of the Center for AIDS Prevention and Control of Dushanbe
ORCID ID: 0000-0002-8740-7158
E-mail: saif64@mail.ru

Karimov Sayfuddin Saytodzhevich,
Doctor of Medical Sciences, Assistant of the Department of Epidemiology, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-8740-7158
E-mail: saif64@mail.ru

Kadyrova Dilrabo Abdukayumovna,
Doctor of Medical Sciences, Full Professor, Professor of the Department of Family Medicine № 1, Avicenna Tajik State Medical University
ORCID ID: 0000-0003-3704-0981
SPIN-код: 9504-1376
Author ID: 334197
E-mail: kadirova_d@mail.ru

Abdukhamedov Numon Abdulloevich,
Doctor in the Republican Center for AIDS Prevention and Control
ORCID ID: 0000-0002-2080-495X
SPIN-код: 5739-3713
Author ID: 1171248
E-mail: numon.art@mail.ru

Ruziev Murodali Mekhmondustovich,
Doctor of Medical Sciences, Director of the Tajik Research Institute of Preventive Medicine
ORCID ID: 0000-0001-6267-9483
E-mail: m.ruziev@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Sayburkhonov Dilshod Saygufronovich
Director of the Center for AIDS Prevention and Control of Dushanbe

734064, Republic of Tajikistan, Dushanbe, A. Navoi str., 4a

Tel.: +992 (900) 001651

E-mail: sdilshod80@mail.ru

Materials on the topic: