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Heavy taxation of interest income becomes a structural driver of property prices in a low-interest-rate environment. Inflation-adjusted price appreciation in 1996-2017 is approximately 200 basis points higher in 14 countries allowing no exemptions on interest income than in 37 countries that tax interest income at favorable rates or provide exemptions. Results for average returns over long-term periods are confirmed in models with annual frequencies, city-level data, and in a sample of 39 OECD countries for which price/rent ratios are available. It appears that investors view direct real estate, a heavily tax-favored asset, as an inflation hedge and/or alternative to fixed income asset. Higher interest income taxation may be fueling demand for direct real estate investments by retail investors. Separately, my empirical findings suggest that easy monetary policy effects can be magnified through the housing channel in countries that do not allow exemptions on interest income. Consequently, we should expect larger investment misallocations due to asset prices departure from fundamentals in some geographies. JEL Classification Codes: E3, E4, F3, G1, G5, H2.

Growing tax competition among national governments in the presence of capital mobility distorts equilibrium in the international corporate tax market. This paper is related to the literature that examines impact of international tax policies on corporate accounting statements. Employing international firm-level data, this study revisits the race-to-the-bottom hypothesis and documents that tax exemptions lowering effective tax rates relative to statutory rates increase pre-tax returns. This finding directly contradicts the implicit tax hypothesis documented by Wilkie (1992), who provided empirical evidence on inverse relationship between pre-tax return and tax subsidy. We also find evidences that relative importance of permanent versus timing component depends on the geography and that decline in corporate tax rates reduces impact of tax subsidies on profitability. Our findings suggest that tax subsidies play a different role than in 1968-1985, which was examined by Wilkie (1992). These results are consistent with the race-to-the-bottom hypothesis and income shifting explanation

Large acquisitions in the United States by Canadian firms lower growth prospects and profitability of Canadian companies. Results are driven by post-acquisition performance of the largest Canadian industries, including oil & gas, mining and precious metals, which together account for almost 40 percent of Canadian firms with asset size above 100 million reported in Compustat research files. Cross-border acquisitions of firms in high tech industries do not improve performance of Canadian firms.

Direct real estate returns are correlated with shifts in weather patterns, which are proxied by changes in four moments of distribution for differences in average and maximum daily temperatures, deviations from optimal temperatures and climate risk index reported by Germanwatch. Changes in the volatility of daily temperatures are inversely correlated with direct real estate returns. The volatility effect appeared to be marginal in 1996-2007, but it became more pronounced in 2010-2017. Other moments of the distribution, including changes in means, skewness and kurtosis, fail to obtain predictive power. Results are robust to tests in a smaller sample of capital cities and the exclusion of observations with the most significant volatility increases.

Background Perinatal depression among HIV-positive women has negative implications for HIV-related and other maternal and infant outcomes. The aim of this study was to investigate the burden and correlates of perinatal depression among HIV-positive women in Ukraine, a lower middle income country with one of the largest HIV-positive populations in Europe. Methods Cross-sectional surveys nested within the Ukraine European Collaborative Study were conducted of HIV-positive women at delivery and between 1 and 12 months postpartum. Depressive symptoms in the previous month were assessed using a self-report screening tool. Other data collected included demographics, antiretroviral therapy (ART)-related self-efficacy, and perceptions of risks/benefits of interventions to prevent mother-to-child transmission (PMTCT). Characteristics of women with and without a positive depression screening test result were compared using Fisher’s exact test and χ2 test for categorical variables. Results A quarter (27 % (49/180) antenatally and 25 % (57/228) postnatally) of participants screened positive for depressive symptoms. Antenatal risk factors were living alone (58 % (7/12) vs 25 % (42/167) p = 0.02), being somewhat/terribly bothered by ART side effects (40 % (17/43) vs 23 % (30/129) not /only slightly bothered, p = 0.05) and having lower ART-related self-efficacy (43 % (12/28) vs 23 % (25/110) with higher self-efficacy, p = 0.05). Postnatally, single mothers were more likely to screen positive (44 % (20/45) vs 21 % (18/84) of cohabiting and 19 % (19/99) of married women, p

Aims To compare clinical status, mother-to-child transmission (MTCT) rates, use of prevention of (PMTCT) interventions and pregnancy outcomes between HIV-infected injecting drug users (IDUs) and non-IDUs. Design and setting Prospective cohort study conducted in seven human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) Centres in Ukraine, 2000‐10. Participants Pregnant HIV-infected women, identified before/ during pregnancy or intrapartum, and their live-born infants (n = 6200); 1028 women followed post-partum. Measurements Maternal and delivery characteristics, PMTCT prophylaxis, MTCT rates, preterm delivery (PTD) and low birth weight (LBW). Findings Of 6200 women, 1111 (18%) reported current/previous IDU. The proportion of IDUs diagnosed with HIV before conception increased from 31% in 2000/01 to 60% in 2008/09 (P < 0.01). Among women with undiagnosed HIV at conception, 20% of IDUs were diagnosed intrapartum versus 4% of non-IDUs (P < 0.01). At enrolment, 14% of IDUs had severe/advanced HIV symptoms versus 6% of non-IDUs (P < 0.001). IDUs had higher rates of PTD and LBW infants than non-IDUs, respectively, 16% versus 7% and 22% versus 10% (P < 0.001).IDUsweremorelikelytoreceivenoneonatalorintrapartumPMTCTprophylaxiscomparedwithnon-IDUs (OR 2.81, p < 0.001). MTCT rates were 10.8% in IDUs versus 5.9% in non-IDUs; IDUs had increased MTCT risk (adjusted odds ratio 1.32, P = 0.049). Fewer IDUs with treatment indications received HAART compared with nonIDUs (58% versus 68%, P = 0.03). Conclusions Pregnant human immunodeficiency virus-infected injecting drug users in Ukraine have worse clinical status, poorer access to prevention of mother-to-child transmission prophylaxis and highly active antiretroviral therapy, more adverse pregnancy outcomes and higher risk of mother-to-child transmission than non-injecting drug user women.

This article studies information content of order imbalance using a sample of tender offers in 1993 to 2006. Order imbalance measures are statistically significant, but their economic effect appears small. Order imbalances could be used by market regulators to document information leakage, but not by uninformed investors to design profitable investment strategies.

background: Ukraine has the highest antenatal HIV prevalence in Europe. The national prevention of mother-to-child transmission (MTCT) programme has reduced the MTCT rate, but less attention has been given to the prevention of unintended pregnancy among HIV-positive women. Our objectives were to describe the reproductive health, condom use and family planning (FP) practices of HIV-positive childbearing Ukrainian women and to identify factors associated with different methods of post-natal contraception. methods: HIV-infected childbearing women, diagnosed before or during pregnancy, were enrolled prospectively in a post-natal cohort study in four regional HIV/AIDS centres in Ukraine from December 2007. Logistic regression models were used to identify factors associated with post-natal FP practices. results: Data were available for 371 women enrolled by March 2009; 82% (n ¼ 303) were married or cohabiting, 27% (97 of 363) reported a current HIV-negative sexual partner and 69% were diagnosed with HIV during their most recent pregnancy. Overall, 21% (75 of 349) of women were not using contraception post-natally (of whom 80% reported no current sexual activity), 50% (174 of 349) used condoms, 20% (74 of 349) relied solely/partially on coitus interruptus and 4% used hormonal methods or intrauterine device. Among married/cohabiting women, consistent use of condoms in the previous pregnancy [AOR 1.96 (95%CI 1.06 –3.62)], having an HIV-positive partner [AOR 0.42 (0.20–0.87)], current sexual activity [AOR 4.53 (1.19–17.3)] and study site were significantly associated with post-natal condom use; 16% of those with HIV-negative partners did not use condoms. Risk factors for non-use of FP were lack of affordability [AOR 6.34 (1.73–23.2)] and inconsistent use of condoms in the previous pregnancy [AOR 7.25 (1.41–37.2)]. conclusions: More than 40% of HIV-positive women in this population are at risk of unintended pregnancy and the one in six women in HIV-discordant couples not using barrier methods risk transmitting HIV to their partners. Our study results are limited by the observational nature of the data and the potential for both measured and unmeasured confounding.

OBJECTIVES: The scale-up of delivery of antiretroviral therapy (ART) in low-income and middle-income countries has been coupled with the collection of data aimed at monitoring the welfare of the HIV-positive and treated populations in those countries. We aimed to compare the data items collected and reported and the degree of harmonization achieved following the publication of WHO tools for collection and reporting of these data in 2006 and of two United Nations General Assembly Special Session (UNGASS) indicators relating to the health of patients on ART in 2008. DESIGN: Retrospective examination of monitoring tools used in four countries in 2008 and 2010. METHODS: We examined and compared the type of information collected and reported from treatment and care programmes in Malawi Uganda Tanzania and Ukraine. We also assessed the effect of the publication of the WHO-recommended data capture and reporting tools and the UNGASS-recommended indicators on harmonizing data in these four countries 2 years following the publication of each of these tools and indicators. RESULTS: : Although the majority of WHO-recommended data items were included in patient record cards clinic ART registers and in reports submitted to the ministries of health in the countries by 2010 there remains little concordance between the four countries examined on the specific items included in patient records and monitoring reports. Furthermore numerous additional items which differ by country and which are not included in WHO recommendations are still recorded and reported. CONCLUSION: The differences and diversity of data reported across countries continues to challenge our ability to make international comparisons and to assess programme performance.

To investigate the scale-up of antenatal combination antiretroviral therapy (cART) in Ukraine since this became part of the national policy for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV).Data on 3535 HIV-positive pregnant women who were enrolled into the Ukraine European Collaborative Study in 2008-2010 were analysed. Factors associated with receipt of zidovudine monotherapy (AZTm) - rather than cART - and rates of mother-to-child transmission (MTCT) of HIV were investigated.cART coverage increased significantly, from 22% of deliveries in 2008 to 61% of those in 2010. After adjusting for possible confounders, initiation of antenatal AZTm - rather than cART - was associated with cohabiting (versus being married; adjusted prevalence ratio, aPR: 1.09; 95% confidence interval, CI: 1.02-1.16), at least two previous live births (versus none; aPR: 1.22; 95% CI: 1.11-1.35) and a diagnosis of HIV infection during the first or second trimester (versus before pregnancy; aPR: 1.11; 95% CI: 1.03-1.20). The overall MTCT rate was 4.1% (95% CI: 3.4-4.9); 42% (49/116) of the transmissions were from the 8% (n = 238) of women without antenatal ART. Compared with AZTm, cART was associated with a 70% greater reduction in the risk of MTCT (adjusted odds ratio: 0.30; 95% CI: 0.16-0.56).Between 2008 and 2010, access to antenatal cART improved substantially in Ukraine, but implementation of the World Health Organization's Option-B policy was slow. For MTCT to be eliminated in Ukraine, improvements in the retention of women in HIV care and further roll-out of Option B are urgently needed.Étudier le renforcement du traitement prénatal par association d'antirétroviraux (TPAA) en Ukraine puisqu'il fait partie intégrante de la politique nationale pour la prévention de la transmission mère-enfant (PTME) du virus de l'immunodéficience humaine (VIH).Une analyse a été menée sur les données de 3535 femmes enceintes séropositives qui ont été inscrites dans l'étude collaborative européenne pour l'Ukraine en 2008-2010. Une étude a aussi été réalisée sur les facteurs associés à un traitement à la zidovudine en monothérapie (TZM), plutôt qu'à un TPAA, et sur le taux de transmission de la mère à l'enfant (TME) du VIH.La part du TPAA a considérablement augmenté, passant de 22% des traitements en 2008 à 61% en 2010. Après ajustement pour les facteurs confondants possibles, le TZM prénatal, plutôt que le TPAA, a été associé au cas de cohabitation (par rapport au mariage; ratio de prévalence ajusté, RPa: 1,09; intervalle de confiance (IC) à 95%: 1,02 à 1,16), à au moins deux naissances antérieures (par rapport à aucune; RPa: 1,22; IC à 95%: 1,11 à 1,35) et à un diagnostic d'infection au VIH au cours du premier ou du deuxième trimestre (par rapport à avant la grossesse; RPa: 1,11; IC à 95%: 1,03 à 1,20). Le taux de TME global était de 4,1% (IC à 95%: 3,4 à 4,9), 42% (49/116) des transmissions provenaient des 8% (n = 238) de femmes n'ayant pas reçu de TPAA. Par rapport au TZM, le TPAA a été associé à une réduction supérieure à 70% du risque de transmission mère-enfant (rapport des cotes ajusté, RCa: 0,3; IC à 95%: 0,16 à 0,56).Entre 2008 et 2010, l'accès au TPAA s'est nettement amélioré en Ukraine, mais la mise en œuvre de l'option B de la politique de l'Organisation mondiale de la Santé a été lente. Pour que la TME soit éliminée en Ukraine, l'amélioration de la rétention des femmes dans les services de soins du VIH et la poursuite du déploiement de l'option B sont des points urgents à régler.Investigar la generalización del tratamiento antirretroviral combinado prenatal en Ucrania desde que entró a formar parte de la política nacional de prevención de la transmisión de madre a hijo del virus de la inmunodeficiencia humana (VIH).Se analizaron los datos de 3535 mujeres embarazadas seropositivas incluidas en el Estudio Colaborativo Europeo Ucraniano entre 2008 y 2010. Se investigaron los factores asociados a la recepción de una monoterapia con zidovudina —y no el tratamiento antirretroviral combinado prenatal— y las tasas de transmisión de madre a hijo del VIH.La cobertura del tratamiento antirretroviral combinado prenatal aumentó significativamente, del 22% de partos en 2008 al 61% de los de 2010. Tras ajustarla por los posibles factores de confusión, el inicio de la monoterapia con zidovudina —y no el tratamiento antirretroviral combinado prenatal— estuvo asociado con la cohabitación (frente a los matrimonios; razón de prevalencia ajustada: 1,09; intervalo de confianza 95%: 1,02–1,16), al menos dos nacimientos vivos anteriores (frente a ninguno; razón de prevalencia ajustada: 1,22; intervalo de confianza 95%: 1,11–1,35) y un diagnóstico de infección por VIH durante el primer o segundo trimestre (frente a antes del embarazo, razón de prevalencia ajustada: 1,11; intervalo de confianza 95%: 1,03–1,20). La tasa total de transmisión de madre a hijo fue del 4,1% (intervalo de confianza 95% 3,4–4,9); el 42% (49/116) de las transmisiones fueron del 8% (n = 238) de las mujeres que no recibieron antirretrovirales prenatales. En comparación con la monoterapia con zidovudina, el tratamiento antirretroviral combinado prenatal estuvo asociado con una reducción un 70% mayor del riesgo de transmisión (razón de posibilidades ajustada: 0,30; intervalo de confianza 95%: 0,16–0,56).Entre 2008 y 2010, el acceso al tratamiento antirretroviral combinado prenatal mejoró sustancialmente en Ucrania, pero la implementación del enfoque en la opción B de la Organización Mundial de la Salud se reveló lenta. Para eliminar la transmisión de madre a hijo en Ucrania, se necesitan con urgencia mejoras en la retención de las mujeres en la atención al VIH y un mayor despliegue de la opción B.تحري زيادة العلاج التوليفي بمضادات الفيروسات القهقرية (cART) قبل الولادة في أوكرانيا حيث أصبح جزءاً من السياسة الوطنية لتوقي انتقال فيروس العوز المناعي البشري من الأم إلى الطفل (PMTCT).تم تحليل البيانات التي تخص 3535 سيدة حاملاً إيجابية لفيروس العوز المناعي البشري تم تسجيلهن في الدراسة التعاونية الأوروبية الأوكرانية في الفترة من 2008 إلى 2010. وتم تحري العوامل المرتبطة بتسلم العلاج أحادي الدواء من نوع زيدوفودين (AZTm) – بدلاً من العلاج التوليفي بمضادات الفيروسات القهقرية – ومعدلات انتقال فيروس العوز المناعي البشري من الأم إلى الطفل.ازدادت تغطية العلاج التوليفي بمضادات الفيروسات القهقرية بشكل كبير، من 22 % من الولادات في عام 2008 إلى 61 % من الولادات في عام 2010. وبعد تصحيحه من أجل العوامل المسببة للالتباس المحتمل، كان بدء العلاج أحادي الدواء بالزيدوفودين قبل الولادة – بدلاً من العلاج التوليفي بمضادات الفيروسات القهقرية – مرتبطاً بالمعاشرة (في مقابل الزواج؛ نسبة الانتشار المصححة: 1.09؛ فاصل الثقة 95 %: من 1.02 إلى 1.16) ومولودين حيين على الأقل في السابق (في مقابل عدم إنجاب مولود؛ نسبة الانتشار المصححة: 1.22؛ فاصل الثقة 95 %: من 1.11 إلى 1.35) وتشخيص الإصابة بعدوى فيروس العوز المناعي البشري أثناء الثلاثة شهور الأولى أو الثانية (في مقابل قبل الحمل؛ نسبة الانتشار المصححة: 1.11؛ فاصل الثقة 95 %: من 1.03 إلى 1.20). وكان المعدل الإجمالي لانتقال الفيروس من الأم إلى الطفل 4.1 % (95 % فاصل الثقة: من 3.4 إلى 4.9)؛ وكانت نسبة 42 % (49/116) من حالات الانتقال ناجمة عن 8 % (العدد = 238) من السيدات اللاتي لم تحصلن على العلاج بمضادات الفيروسات القهقرية قبل الولادة. وكان العلاج التوليفي بمضادات الفيروسات القهقرية، مقارنة بالعلاج أحادي الدواء بالزيدوفودين، مرتبطاً بزيادة الانخفاض بنسبة 70 % في مخاطر انتقال الفيروس من الأم إلى الطفل (نسبة الاحتمال المصححة: 0.30؛ فاصل الثقة 95 %: من 0.16 إلى 0.56).في الفترة من 2008 إلى 2010، تحسن الوصول إلى العلاج التوليفي بمضادات الفيروسات القهقرية قبل الولادة بشكل كبير في أوكرانيا، غير أن تنفيذ سياسة الخيار "ب" لمنظمة الصحة العالمية كان بطيئاً. وثمة حاجة ماسة لإجراء تحسينات على استبقاء السيدات في رعاية فيروس العوز المناعي البشري وزيادة نشر الخيار "ب" من أجل التخلص من انتقال الفيروس من الأم إلى الطفل في أوكرانيا.调查在产前联合抗逆转录病毒疗法（cART）成为乌克兰预防艾滋病（HIV）母婴传播国家政策组成部分之后在该国的推广情况。对参与2008-2010 年乌克兰欧洲合作研究的3535 名HIV阳性孕妇的数据进行分析。调查了接受非cART的齐多夫定单药治疗（AZTm）与HIV母婴传播（MTCT）率的关联因素。cART覆盖率显著增加，从2008 年22%分娩增加到2010 年61%。在针对可能的混杂因素进行调整后，开始产前AZTm（而非cART）与同居生活（较之已婚；调整患病率比，aPR：1.09；95%置信区间，CI：1.02–1.16）、之前至少两次活产（对比无活产；aPR：1.22；95% CI：1.11–1.35）以及孕前期或孕中期HIV感染诊断（对比孕前；aPR：1.11；95% CI：1.03–1.20）相关。整体MTCT率为4.1%（95% CI：3.4–4.9）；42%（49/116）的传播来自8%（n = 238）不进行产前ART治疗的女性。较之AZTm，与cART关联而降低的MTCT风险要多70%（调整优势比：0.30；95% CI：0.16–0.56）。在2008 和2010 年间，乌克兰产前cART的可及性得到显著改善，但是实施世界卫生组织方案B政策实施缓慢。要在乌克兰中消除MTCT，迫切需要改善女性HIV医疗保持率和进一步推出方案B。Проведение исследования в области увеличения масштабов применения дородовой комбинированной антиретровирусной терапии (кАРТ) на Украине с того момента, как она стала частью национальной политики в области профилактики передачи от матери к ребенку (ППМР) вируса иммунодефицита человека (ВИЧ).Были проанализированы данные по 3535 ВИЧ-инфицированным беременным женщинам, которые приняли участие в Украинско-Европейском совместном исследовании в 2008-2010 годах. Были исследованы факторы, связанные с использованием монотерапии зидовудином (АЗТм), вместо кАРТ, и количеством случаев передачи ВИЧ от матери к ребенку (ПМР).Охват терапией кАРТ существенно вырос с 22% рождений в 2008 году до 61% в 2010 году. После поправки на возможные искажающие факторы, использование дородовой АЗТм, вместо кАРТ, было связано с сожительством (по сравнению с браком; скорректированный коэффициент распространенности (СКР): 1,09; 95% доверительный интервал (ДИ): 1,02-1,16), по крайней мере с двумя предыдущими живорождениями (по сравнению с их отсутствием; СКР: 1,22, 95% ДИ: 1,11-1,35) и постановкой диагноза ВИЧ-инфекции в течение первого или второго триместра (по сравнению с его постановкой до беременности, СКР: 1,11, 95% ДИ: 1,03-1,20). Общая частота ПМР составила 4,1% (95% ДИ: 3,4-4,9), 42% (49/116) случаев передачи были у 8% (N = 238) женщин без дородовой АРТ. По сравнению с АЗТм, кАРТ привела к 70%-му снижению риска ПМР (скорректированное соотношение шансов: 0,30, 95% ДИ: 0,16-0,56).Между 2008 и 2010 годами доступ к дородовой кАРТ на Украине существенно улучшился, но реализация проводимой Всемирной организацией здравоохранения политики "Вариант Б" была слишком медленной. Для полного устранения ПМР на Украине требуется расширение участия женщин в программах лечения ВИЧ-инфекции и дальнейшее проведение в жизнь политики "Вариант Б".

This study develops an empirical proxy for the quality of segment reporting from data in corporate annual reports, and provides evidence that financial markets price the quality of segment reporting as systematic (non-diversifiable) risk. Lower segment information quality is associated with higher cost of equity capital in the cross-section of asset returns. Further, quality of reporting has larger impact on the cost of equity capital for firms with lower analyst following. Analyst coverage proxy lowers magnitude of the segment information variable, but the latter retains significance in all asset-pricing tests.

Background Ukraine has the highest HIV prevalence (1.6%) and is facing the fastest growing epidemic in Europe. Our objective was to describe the clinical, immunological and virological characteristics, treatment and response in vertically HIV-infected children living in Ukraine and followed from birth. Methods The European Collaborative Study (ECS) is an ongoing cohort study, in which HIV-1 infected pregnant women are enrolled and followed in pregnancy, and their children prospectively followed from birth. ECS enrolment in Ukraine started in 2000 initially with three sites, increasing to seven sites by 2009. Results A total of 245 infected children were included in the cohort by April 2009, with a median age of 23 months at most recent follow-up; 33% (n = 77) had injecting drug using mothers and 85% (n = 209) were infected despite some use of antiretroviral prophylaxis for prevention of mother-to-child transmission. Fifty-five (22%) children had developed AIDS, at a median age of 10 months (IQR = 6-19). The most prevalent AIDS indicator disease was Pneumocystis jiroveci pneumonia (PCP). Twenty-seven (11%) children had died (median age, 6.2 months). Overall, 108 (44%) children had started highly active antiretroviral treatment (HAART), at a median 18 months of age; median HAART duration was 6.6 months to date. No child discontinued HAART and 92% (100/108) remained on their first-line HAART regimen to date. Among children with moderate/severe immunosuppression, 36% had not yet started HAART. Among children on HAART, 71% (69/97) had no evidence of immunosuppression at their most recent visit; the median reduction in HIV RNA was 4.69 log10 copies/mL over a median of 10 months treatment. From survival analysis, an estimated 94%, 84% and 81% of children will be alive and AIDS-free at 6, 12 and 18 months of age, respectively. However, survival increased significantly over time: estimated survival rates to 12 months of age were 87% for children born in 2000/03 versus 96% for those born in 2004/08. Conclusion One in five children had AIDS and one in ten had died. The half of children who received HAART has responded well and survival has significantly improved over time. Earlier diagnosis and prompt initiation of HAART remain key challenges.

Social marginalisation and other challenges facing HIV-positive pregnant women in Ukraine may put them at increased risk of relinquishing their infants to the state. We described rates of infant abandonment (exclusive non-parental care to most recent follow-up, censored at two years of age) and investigated associated factors using logistic regression models, in 4759 mother-infant pairs enrolled across six Ukrainian sites in the European Collaborative Study from 2000 to May 2009. Median maternal age was 26.0 years, 81.8% were married or cohabiting and 60.6% were nulliparous at enrolment. An injecting drug use (IDU) history was reported by 18.4%, 80.2% took antiretroviral therapy (ART) antenatally and most deliveries were vaginal. A small but significant proportion of infants had been cared for exclusively in institutions by their second birthday (2.1% overall), decreasing from 3.8% (15/393) in 2000-2002 to 1.6% (49/3136) in 2006-2009 (p0.01), concurrent with prevention of mother-to-child transmission scale-up. A further 1% of infants spent some time in non-parental care. Antenatal ART was associated with an 88% reduced abandonment risk (adjusted odds ratio (AOR) 0.12), versus receipt of single dose nevirapine only, and this was reflected in HIV infection prevalence in the two groups (17.1% of abandoned infants versus 6.6% in parental care). Mothers without a cohabiting partner or husband were more likely to abandon (AOR 4.08), as were active IDUs (AOR 3.27) and those with ≥1 previous children (AOR 1.89 for second-born and AOR 2.56 for subsequent births). Women delivering by elective caesarean section were less likely to abandon (AOR 0.37 versus vaginal), as were those leaving full-time education later (AOR 0.61 for 17-18 years versus ≤16 years and AOR 0.23 for ≥19 years versus ≤16 years). Interventions to extend family planning and IDU harm reduction services along with non-stigmatising antenatal care to marginalised women are needed, and may reduce abandonment.

Background Ukraine was the epicentre of the HIV epidemic in Eastern Europe, which has the most rapidly accelerating HIV epidemic world-wide today; national HIV prevalence is currently estimated at 1.6%. Our objective was to evaluate the uptake and effectiveness of interventions for prevention of mother-to-child transmission (PMTCT) over an eight year period within operational settings in Ukraine, within the context of an ongoing birth cohort study. Methods The European Collaborative Study (ECS) is an ongoing birth cohort study in which HIV-infected pregnant women identified before or during pregnancy or at delivery were enrolled and their infants prospectively followed. Three centres in Ukraine started enrolling in 2000, with a further three joining in September 2006. Results Of the 3356 women enrolled, 21% (689) reported current or past injecting drug use (IDU). Most women were diagnosed antenatally and of those, the proportion diagnosed in the first/second trimester increased from 47% in 2000/01 (83/178) to 73% (776/1060) in 2006/07 (p < 0.001); intrapartum diagnosis was associated with IDU (Adjusted odds ratio 4.38; 95%CI 3.19–6.02). The percentage of women not receiving any antiretroviral prophylaxis declined from 18% (36/205) in 2001 to 7% in 2007 (61/843) (p < 0.001). Use of sdNVP alone substantially declined after 2003, with a concomitant increase in zidovudine prophylaxis. Median antenatal zidovudine prophylaxis duration increased from 24 to 72 days between 2000 and 2007. Elective caesarean section (CS) rates were relatively stable over time and 34% overall. Mother-to-child transmission (MTCT) rates decreased from 15.2% in 2001 (95%CI 10.2–21.4) to 7.0% in 2006 (95%CI 2.6–14.6). In adjusted analysis, MTCT risk was reduced by 43% with elective CS versus vaginal delivery and by 75% with zidovudine versus no prophylaxis. Conclusion There have been substantial improvements in use of PMTCT interventions in Ukraine, including earlier diagnosis of HIV-infected pregnant women and increasing coverage with antiretroviral prophylaxis and the initial MTCT rate has more than halved. Future research should focus on hard-to-reach populations such as IDU and on missed opportunities for further reducing the MTCT rate.

Objectives The aim of the study was to investigate the prevalence of and risk factors for hepatitis C or B virus (HCV or HBV) coinfection among HIV-infected pregnant women, and to investigate their immunological and virological characteristics and antiretroviral therapy use. Methods Information on HBV surface antigen (HBsAg) positivity and HCV antibody (anti-HCV) was collected retrospectively from the antenatal records of HIV-infected women enrolled in the European Collaborative Study and linked to prospectively collected data. Results Of 1050 women, 4.9% [95% confidence interval (CI) 3.6–6.3] were HBsAg positive and 12.3% (95% CI 10.4–14.4) had anti-HCV antibody. Women with an injecting drug use(r) (IDU) history had the highest HCV-seropositivity prevalence (28%; 95% CI 22.8–35.7). Risk factors for HCV seropositivity included IDU history [adjusted odds ratio (AOR) 2.92; 95% CI 1.86–4.58], age (for ≥35 years vs.

We investigated prevalence of sexually transmitted infections (STI) in a cohort of HIV-1-infected pregnant women and described factors associated with STI diagnosis, as a nested study within the European Collaborative Study (ECS). The ECS is a cohort study in which HIV-infected pregnant women are enrolled and their children followed from birth, according to standard clinical and laboratory protocols. Information on STIs diagnosed during pregnancy was collected retrospectively from the antenatal records of women enrolling between January 1999 and October 2005; other variables were obtained from the ECS prospective database. A total of 1,050 women were included: 530 in Western Europe and 520 in Ukraine. Syphilis was the most common bacterial STI (2% prevalence, 95% CI 1.2–3.0). Prevalence of HPV-related genital lesions was 8.6% (95%CI 6.9–10.4) and prevalence of Trichomonas vaginalis was 12.1% (95%CI 10.2–14.2). Women in Ukraine (AOR 10.7, 95%CI 3.7–30.5), single women (AOR 3.9, 95%CI 1.2–12.7), sexual partners of injecting drug users (AOR 3.8, 95%CI 1.4–10.4) and women with CD4 counts

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