HIV Risks, Testing, and Treatment in the Former Soviet Union: Challenges and Future Directions in Research and Methodology

Main Article Content

Victoria M. Saadat


Background. The dissolution of the USSR resulted in independence for constituent republics but left them battling an unstable economic environment and healthcare. Increases in injection drug use, prostitution, and migration were all widespread responses to this transition and have contributed to the emergence of an HIV epidemic in the countries of former Soviet Union. Researchers have begun to identify the risks of HIV infection as well as the barriers to HIV testing and treatment in the former Soviet Union. Significant methodological challenges have arisen and need to be addressed. The objective of this review is to determine common threads in HIV research in the former Soviet Union and provide useful recommendations for future research studies.

Methods. In this systematic review of the literature, Pubmed was searched for English-language studies using the key search terms “HIV”, “AIDS”, “human immunodeficiency virus”, “acquired immune deficiency syndrome”, “Central Asia”, “Kazakhstan”, “Kyrgyzstan”, “Uzbekistan”, “Tajikistan”, “Turkmenistan”, “Russia”, “Ukraine”, “Armenia”, “Azerbaijan”, and “Georgia”. Studies were evaluated against eligibility criteria for inclusion.

Results. Thirty-nine studies were identified across the two main topic areas of HIV risk and barriers to testing and treatment, themes subsequently referred to as “risk” and “barriers”. Study design was predominantly cross-sectional. The most frequently used sampling methods were peer-to-peer and non-probabilistic sampling. The most frequently reported risks were condom misuse, risky intercourse, and unsafe practices among injection drug users.  Common barriers to testing included that testing was inconvenient, and that results would not remain confidential.  Frequent barriers to treatment were based on a distrust in the treatment system. 

Conclusion. The findings of this review reveal methodological limitations that span the existing studies. Small sample size, cross-sectional design, and non-probabilistic sampling methods were frequently reported limitations. Future work is needed to examine barriers to testing and treatment as well as longitudinal studies on HIV risk over time in most-at-risk populations. 

Article Details

How to Cite
Saadat, V. M. (2016). HIV Risks, Testing, and Treatment in the Former Soviet Union: Challenges and Future Directions in Research and Methodology. Central Asian Journal of Global Health, 4(2).
Author Biography

Victoria M. Saadat, Department of Health Research and Policy, Stanford University of Medicine, Stanford, CA

Victoria Saadat earned her BS in Electrical Engineering at the University of Southern California (USC) and she is currently pursing her Masters in Epidemiology and Clinical Research at the Stanford University School of Medicine. Outside of research, Victoria is involved in consulting work with a healthcare start-up in Kazakhstan and is preparing to apply to medical school. Her main research interest is about the challenges of developing modernized healthcare systems in the former Soviet Republics.


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