Contribution of Mobile Populations to the HIV Epidemic Process: Analysis of Adherence and Effectiveness of Antiretroviral Therapy

Despite achieving high indicators of the HIV care continuum, which according to the Kazakh Scientific Center of Dermatology and Infectious Diseases reached 82-88-90 in 2023 and 83-90-92 in 2024, reflecting substantial coverage of antiretroviral therapy (hereinafter ART), these indicators are aggregated in nature and do not account for the heterogeneity of specific population groups. Mobile populations (particularly foreign nationals) are of particular importance in sustaining the epidemic process, as they are characterized by instability in dispensary follow-up, reduced adherence to ART, and limited access to healthcare services. At the same time, existing approaches to evaluating treatment effectiveness are predominantly based on the fact of ART prescription and do not always reflect actual clinical and laboratory outcomes. This creates a discrepancy between formal treatment coverage and its real effectiveness. The insufficient study of the contribution of mobile populations, defined in this study as foreign nationals, to the persistence of HIV transmission, particularly considering adherence levels and virological treatment outcomes, determines the relevance of this research.