{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:03:37Z","timestamp":1768003417327,"version":"3.49.0"},"reference-count":59,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:00:00Z","timestamp":1632960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005326","name":"Yale University","doi-asserted-by":"publisher","award":["pilot grant entitled \u201cBarriers to HIV Care for Adults 50yo+, a Neglected but at-risk Population in Ukraine\u201d"],"award-info":[{"award-number":["pilot grant entitled \u201cBarriers to HIV Care for Adults 50yo+, a Neglected but at-risk Population in Ukraine\u201d"]}],"id":[{"id":"10.13039\/100005326","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005326","name":"Yale University","doi-asserted-by":"publisher","award":["MacMillan Center for International and Area Studies under the pilot grant entitled \u201cStigma among older women with HIV in Ukraine\u201d"],"award-info":[{"award-number":["MacMillan Center for International and Area Studies under the pilot grant entitled \u201cStigma among older women with HIV in Ukraine\u201d"]}],"id":[{"id":"10.13039\/100005326","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005326","name":"Yale University","doi-asserted-by":"publisher","award":["Yale LGBT Studies Program under Fund for Lesbian and Gay Studies (FLAGS) Research Award"],"award-info":[{"award-number":["Yale LGBT Studies Program under Fund for Lesbian and Gay Studies (FLAGS) Research Award"]}],"id":[{"id":"10.13039\/100005326","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Doris Duke Foundation","award":["2015216"],"award-info":[{"award-number":["2015216"]}]},{"name":"Doris Duke Foundation","award":["K01DA047194"],"award-info":[{"award-number":["K01DA047194"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>The Eastern Europe and Central Asian (EECA) region has the highest increase in HIV incidence and mortality globally, with suboptimal HIV treatment and prevention. All EECA countries (except Russia) are low and middle-income (LMIC). While LMIC are home to 80% of all older people living with HIV (OPWH), defined as \u226550 years, extant literature observed that newly diagnosed OPWH represent the lowest proportion in EECA relative to all other global regions. We examined HIV diagnoses in OPWH in Ukraine, a country emblematic of the EECA region.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We analysed incident HIV diagnoses from 2015\u20132018 and mortality trends from 2016\u20132018 for three age groups: 1) 15\u201324 years; 2) 25\u201349 years; and 3) \u226550 years. AIDS was defined as CD4&lt;200cells\/mL. Mortality was defined as deaths per 1000 patients newly diagnosed with HIV within the same calendar year. Mortality rates were calculated for 2016, 2017, and 2018, compared to age-matched general population rates, and all-cause standardized mortality ratios (SMRs) were calculated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>From 2015\u20132018, the proportion of OPWH annually diagnosed with HIV increased from 11.2% to 14.9% (p&lt;0.01). At the time of diagnosis, OPWH were also significantly (p&lt;0.01) more likely to have AIDS (43.8%) than those aged 25\u201349 years (29.5%) and 15\u201324 years (13.3%). Newly diagnosed OPWH had the same-year mortality ranging from 3 to 8 times higher than age-matched groups in the Ukrainian general population.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>These findings suggest a reassessment of HIV testing, prevention and treatment strategies in Ukraine is needed to bring OPWH into focus. OPWH are more likely to present with late-stage HIV and have higher mortality rates. Re-designing testing practices is especially crucial since OPWH are absent from targeted testing programs and are increasingly diagnosed as they present with AIDS-defining symptoms. New strategies for linkage and treatment programs should reflect the distinct needs of this target population.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0256627","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T19:12:35Z","timestamp":1633029155000},"page":"e0256627","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["An expanding HIV epidemic among older adults in Ukraine: Implications for patient-centered care"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9971-6767","authenticated-orcid":true,"given":"Julia","family":"Rozanova","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oleksandr","family":"Zeziulin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine M.","family":"Rich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick L.","family":"Altice","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetiana","family":"Kiriazova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7407-4892","authenticated-orcid":true,"given":"Irina","family":"Zaviryukha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetiana","family":"Sosidko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Komal","family":"Gulati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constance","family":"Carroll","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheela V.","family":"Shenoi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,9,30]]},"reference":[{"issue":"3","key":"pone.0256627.ref001","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.2105\/AJPH.2012.301161","article-title":"Growing older with HIV\/AIDS: new public health challenges","volume":"103","author":"S Cahill","year":"2013","journal-title":"Am J Public Health"},{"key":"pone.0256627.ref002","volume-title":"WHO global strategy on people-centred and integrated health services","author":"World Health Organization","year":"2016"},{"issue":"12","key":"pone.0256627.ref003","doi-asserted-by":"crossref","first-page":"e0166942","DOI":"10.1371\/journal.pone.0166942","article-title":"Uptake of Community-Based Peer Administered HIV Point-of-Care Testing: Findings from the PROUD Study","volume":"11","author":"L Lazarus","year":"2016","journal-title":"PLoS One"},{"issue":"12","key":"pone.0256627.ref004","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1097\/QAD.0000000000001870","article-title":"Achieving the fourth 90: healthy aging for people living with HIV","volume":"32","author":"TG Harris","year":"2018","journal-title":"Aids"},{"issue":"2","key":"pone.0256627.ref005","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s11904-010-0041-9","article-title":"HIV and aging: time for a new paradigm","volume":"7","author":"AC Justice","year":"2010","journal-title":"Curr HIV\/AIDS Rep"},{"issue":"Suppl 1","key":"pone.0256627.ref006","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/QAI.0b013e31825a3668","article-title":"HIV and aging: state of knowledge and areas of critical need for research. 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