HIV infections among displaced persons

Tetyana employs a method known as phylogeography, a branch of phylodynamic analysis that allows epidemiologists to trace the spread of viruses across sub-populations and broad geographic regions. She first encountered this approach during her doctoral studies, where her training in biogenetics and biogeography led her to apply these tools to pressing real-world challenges. It quickly became clear to her that such analyses were urgently needed to understand HIV transmission among displaced populations in Ukraine. A junior research fellowship at the University of Oxford provided the opportunity to refine her methodological framework. “I realized I had both the skills and the motivation to address these issues in Ukraine,” she explains. “No one else was conducting this kind of molecular analysis among displaced people.”

Nearly a decade later, it is evident that Tetyana’s research holds significant implications for public health. “We now see that most transmissions occur within the first year after displacement,” she explains. “Even if individuals remain in their new location for decades, the risk of infection is highest in that initial period.” These findings have direct relevance for both treatment and the design of more effective prevention strategies. Molecular tools make it possible to pinpoint the timeframes in which transmission is most likely, allowing interventions to be better targeted. As a result, researchers can more accurately evaluate the impact of preventive measures and identify when and where resources are needed most.

Getting Those Affected into Treatment
People diagnosed with HIV are treated with antiretroviral drugs, which reduce the viral load to undetectable levels – effectively eliminating the risk of transmission. “Getting people into treatment,” Tetyana explains, “means suppressing the virus to the point where their health outlook improves significantly and further transmission is prevented – something that benefits public health as a whole.” The key, however, is to identify those infected and ensure they receive consistent care – an especially difficult task among displaced populations.

Tetyana’s research paints a sobering picture: HIV-positive displaced persons are significantly less likely to remain in treatment. “Many were diagnosed before they were displaced,” she explains. “But only a small fraction achieve viral suppression afterward. And without that, they remain infectious.” Her findings highlight the urgent need for rapid integration into healthcare systems – something that often fails due to bureaucratic barriers. The data shows that the risk of transmission is highest in the early phase of displacement, precisely when access to healthcare is most limited. “When people are displaced,” Tetyana says, “they’re focused on immediate survival – finding shelter, food, and safety. Health isn’t always a top priority. Displaced persons often think in short-term horizons. You don’t die of HIV tomorrow, but ten years from now.” To address this, she argues, it’s essential to reduce bureaucratic obstacles and make access to care as straightforward as possible. “We have to ask ourselves: do we want to continue as before, or do we want to take proactive steps to reach displaced populations? If we’re serious about public health, we need to set the right priorities.”

The situation is especially urgent for displaced persons who use drugs. One of the more unexpected findings was the high rate of homelessness among this group. Many lose homes inherited from family due to displacement and are forced to rely on shelters or the goodwill of relatives. Drug addicts are difficult roommates. The others lose patience, and so a large proportion of drug-addicted displaced persons end up homeless on the streets. As a result, a significant number of drug-dependent displaced persons eventually end up on the streets. “We found a high prevalence of HIV in this group,” Tetyana explains. “Only a small portion were homeless immediately after displacement – the majority became homeless by the time we conducted our survey.” The study’s insights extended beyond epidemiology into behavioral and social dynamics. In response, Tetyana and her team are working closely with NGOs in Ukraine, some of which have since begun operating their own shelters. This collaboration ensures that the research not only informs public health but also contributes directly and indirectly to practical interventions on the ground.

Bringing Science into Politics and Practice
Building on her previous work, Tetyana is now leading a federally funded study on HIV transmission among displaced and local gay men in Ukraine. This new project combines molecular epidemiology with in-depth analysis of social networks. “We’re trying to understand how social support – or the absence of it – affects access to healthcare,” she explains. Her team is interviewing over 1200 participants in Kyiv and Lviv, gathering both biological samples and detailed network data: who they talk to, how frequently, and how these relationships have shifted since the onset of the war. By tracking both the structure and dynamics of these networks, the study aims to reveal how changes in social connectedness influence the risk of HIV transmission.

The study is also methodologically groundbreaking: it is the first longitudinal study of its kind in Ukraine to track participants over time using objective clinical indicators such as viral load, rather than relying solely on self-reported data. Much of the data collection is conducted remotely – through self-testing kits and Zoom interviews – an adaptation to the dual challenges of war and the pandemic.

Conducting research under current conditions in Ukraine demands exceptional resilience. Tetyana is full of praise for her colleagues on the ground. “Despite bombings, insecurity, and outdated equipment, they continue to carry out high-quality research and provide care,” she says. She is particularly inspired by NGOs that send mobile clinics to the front lines to deliver healthcare to women. “There’s a remarkable drive to do serious science and help people with minimal resources. It never stops impressing me,” she adds. “Some of the equipment they’re using is older than I am.”

Tetyana’s work exemplifies how cutting-edge science can inform public health practice, even under the most difficult circumstances. By combining molecular tools with social research and close collaboration with local partners, she is helping to ensure that vulnerable populations are not overlooked. Her research not only sheds light on how HIV spreads among displaced communities but also points the way toward more effective, equitable healthcare interventions.