Successful implementation of HIV programs in Ukraine
Zahedul IslamZahedul IslamInternational HIV/AIDS Alliance in UkraineInternational HIV/AIDS Alliance in Ukraine
Briefing meeting for French Red Cross, Kiev. March 2010
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Population size Estimation
2
• Recommended IDUs estimated range
• Recommended FSWs estimated range
• Recommended MSM aged 15-49 estimated range
230 000- 360 000
63 000- 93 000
95 000- 213 000
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Alliance programs in Ukraine
• • $79 million Round 6 HIV program for vulnerable population 2007 – 2012
• Recently approved R9 TB proposal Alliance as SR
• USAID SUNRISE and other bilateral donor programs
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Area of activities
• Working on prevention programs focused on MARP’s specially targeting IDU’s, FSW, MSM and prisoners• SMT program for IDU’s• Integrated care for HIV+ IDU’s• Medical and psychosocial support to IDU’s• Street children program• STI testing and treatment• Trainings for NGO’s• Capacity building• Technical support• Drop in center
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Injecting drug users – key driving force of the epidemic in the region
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Prevention programs for female sex workers
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ART programs
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Pavel Kutsev
Past life….
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Pavel Kutsev
Life has changed ever since
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Substitution Maintenance Therapy
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Milestone of these programs
• Rapid scale up of Methadone based SMT program in Ukraine (5252 as of March 2010, 843 with Bup and 4409 with Methadone)
• Scaling up prevention: more than 266 000 injecting Scaling up prevention: more than 266 000 injecting drug usersdrug users, over 45 000 women involved in commercial , over 45 000 women involved in commercial sex, 28 881 men having sex with men, and more than sex, 28 881 men having sex with men, and more than 80 000 prisoners have accessed prevention services 80 000 prisoners have accessed prevention services
SMT scale up in 2009-2010
AU plans for SMT scale up in 2009-2013
266 666
45 729
28 881
80 404
0% 20% 40% 60% 80% 100% 120% 140% 160%
IDU
CSW
MSM
Prisoners
% target implementation
Vulnerable groups covered with HIV/AIDS
prevention programsMARP coverage
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• IDUs report less risky behaviour: IDUs who report use of sterile injecting equipment during last injection: 2006: 80% 2007: 83% 2008: 86%
• Fewer registered HIV cases amongst IDUs: after a decade of constant rise the number of new registered HIV cases has peaked (while numbers being tested continued to rise). 2006: 7,127 2007: 7,084 2008: 7,009
• Decreasing HIV prevalence among newly initiated IDUs (who have been injecting drugs for less than 2 years): 2004: 30% 2006: 18% 2008: 11%
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Achievements
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Service gaps
Simplified HIV testing and confirmation
Hepatitis treatment poorly available
Integrated service for PLHA (MARP’s)
Needs vs coverage
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Challenges
• Stigma and discrimination
• Criminalization of the drug usage
• Wider introduction of HIV rapid testing
• Decentralization of health care service provision
• Integration of social services in to clinical care
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Thank you