Evolution of the HIV epidemic process in the Republic of Belarus: patterns and specific features (1987—2024)

Abstract

Objective. To conduct a comprehensive analysis of the epidemiological situation of HIV infection in the Republic of Belarus and to identify the main patterns and specific features of the epidemic process during 1987—2024.
Materials and methods. A retrospective epidemiological analysis of official surveillance data was performed. 
Results. Four stages of the epidemic process were identified over the 38-year period. In 1987—1995, only sporadic imported cases were reported, mainly associated with sexual transmission. The second stage (1996—2004) was marked by a 144-fold increase in HIV incidence compared to 1995 and the predominance of non-medical parenteral transmission through injecting drug use. During this period, the first preventive programs were introduced. In 2005—2018, sexual transmission became dominant, although the epidemic demonstrated alternating phases of slowdown and subsequent acceleration of incidence growth. A set of evidence-based preventive measures was actively implemented. Since 2019, the fourth stage has been ongoing, characterized by a steady annual decline in newly diagnosed HIV cases. This trend is associated with the introduction of universal access to antiretroviral therapy in 2018, which became the most effective tool of prevention. Between 2019 and 2024, the average annual decline in incidence reached 9.8% (p < 0.05).
Conclusion. The consistent implementation of preventive interventions, and above all the universal treatment approach, has had a decisive impact on the HIV epidemic in Belarus, ensuring a sustained reduction in incidence in recent years.