In 2023–2024, our partners in Kyrgyzstan and Belarus conducted an assessment of access to viral load and drug resistance testing. Our team has prepared a summary report based on data collected over the past year, providing an analysis of the current situation in both countries.
The report includes information on the availability of viral load and drug resistance tests, an analysis of the main barriers limiting access to testing and to obtaining results, and an evaluation of patients’ awareness of their test results. It also covers their understanding of the purpose and necessity of testing, as well as methods of monitoring the effectiveness of ART in Belarus and Kyrgyzstan.
The analysis of drug resistance test availability shows that in Belarus, only one drug resistance test is registered, and it is produced domestically. Meanwhile, no such test is registered in Kyrgyzstan. Belarus conducts about 1,000 tests annually, which meets the country’s needs according to clinical protocols. In Kyrgyzstan, an average of 200–300 tests are provided per year through a research and humanitarian project with an international partner (Russia).
Current clinical protocols in Belarus align with recommendations from the European AIDS Clinical Society (EACS), specifying who is recommended for drug resistance testing. In Kyrgyzstan, there is no clearly defined procedure for ordering and conducting drug resistance testing, although certain documents contain some testing recommendations.
Patient surveys in Belarus and Kyrgyzstan indicate that both countries maintain a high coverage rate for viral load testing: about 95% of all PLHIV in both countries (94% in Belarus and 96% in Kyrgyzstan) underwent testing at least once in the previous 12 months. Respondents in both countries demonstrated a relatively high level of knowledge about viral load tests – more than two-thirds understand that the purpose of viral load testing is to check whether ART is working. In both countries, the majority of respondents know (or have received) their most recent viral load test results (89% in Belarus and 81% in Kyrgyzstan). However, in one region of Kyrgyzstan, Jalal-Abad, PLHIV demonstrate a significantly lower level of knowledge about testing and interpreting results. In this region, respondents are statistically much less likely to receive or know their viral load test results, and doctors’ comment on these results less frequently than in the other two surveyed regions.
Overall, both countries are currently transitioning to dolutegravir-based regimens, which may reflect decreased interest from decision-makers in drug resistance testing, as well as fewer indications for such testing.
Key recommendations formulated based on the assessment emphasize the need for comprehensive national evaluations of patient awareness about their test results, as well as training healthcare personnel to effectively communicate laboratory diagnostic data to patients in both countries. Additionally, local NGOs are encouraged to conduct awareness-raising activities for patient communities aimed at increasing knowledge about the importance of ART effectiveness, the causes of drug resistance, its diagnosis, and the importance of timely detection of resistance to specific medications.
This report was prepared with the methodological and technical support of the International Treatment Preparedness Coalition (ITPC GLOBAL) and with financial support from the Robert Carr Fund.
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