HIV and Pregnancy in the Russian Federation

Unlike in most other world regions, the HIV epidemic in the Russian Federation (Russia) is on the rise. Previously linked primarily to intravenous injecting drug use, HIV transmission in Russia has now entered the general population, and over half of patients diagnosed recently in Russia were infected through heterosexual contact. With women accounting for an increasing proportion of new HIV diagnoses, optimal management of HIV in pregnancy is a public health priority. The vertical transmission rate is estimated to have declined to around 1-2% in recent years due to successful prevention of mother-to-child transmission programmes, but rates among vulnerable groups such as women who inject drugs and those accessing antenatal care late are likely higher.

This PhD will examine the epidemiology of HIV among pregnant women in Russia using data from clinical sites participating in REACH (Russian European Alliance for research among women, Children and adolescents impacted by HIV, TB and HCV), a study funded by the European Union Horizon 2020 research and innovation programme. Using data on over 5,000 pregnancies occurring in two regions in Russia with high HIV prevalence (St Petersburg and Irkutsk) between 2013 and 2018, the PhD will address key questions related to perinatal HIV transmission, HIV disease progression and treatment among pregnant women, and pregnancy outcomes among women with co-infections with Hepatitis C and/or tuberculosis. Findings will contribute to the development of strategies to manage HIV and other infections in pregnant women in Russia and elsewhere in Eastern Europe and help guide future research priorities.