HIV Prevention, Diagnosis, Treatment and Care for At-Risk Populations
Ukraine has one of the highest rates of HIV / AIDS prevalence in Eastern Europe. The first HIV infection cases among Ukrainians were registered in 1987. Over the next seven years the disease spread slowly - from six to forty new cases per year. In 1995, the situation changed dramatically when the infection started spreading among injecting drug users. This social group still remains the most vulnerable, being a major medium of the HIV spread. Cumulative number of IDUs among all officially registered HIV cases is 68%. At the same time, rates of HIV transmission via sexual activity are on the rise (in most cases - heterosexually). Male and female HIV infection rates are 58% and 42%, respectively.
Thus, despite an HIV spillover into the general population, most-at-risk populations remain the driving force in the epidemic: injecting drug users (IDUs), male and female commercial sex workers (CSWs), and men who have sex with men (MSM) and have high HIV prevalence rates.
Late HIV diagnoses result in high morbidity and mortality. HIV testing and early diagnosis are the first important steps towards ending the epidemic. A successful strategy for engaging and motivating at-risk populations to get tested for HIV, early diagnosis and treatment will significantly reduce the spread of HIV and allow to prevent the aggravation and new waves of the epidemic.
The Project aims to reduce the number of new HIV infections in Kyiv City and region by providing comprehensive HIV services, including prevention, care and treatment.
Tasks and objectives include:
- to implement measures aimed at reducing the risks of transmission of HIV, Hepatitis B and C, STIs (sexually transmitted infections);
- to expand access to HIV, Hepatitis and STIs diagnostics for most-at-risk populations;
- to ensure HIV diagnosis with further enrollment into HIV care and treatment;
- to ensure early TB detection among most-at-risk populations to start early treatment.
Target populations: injecting drug users (IDUs), male and female commercial sex workers, including transgenders (CSWs).
The objectives will be achieved by implementing the following program components:
- Outreach among key populations, providing comprehensive information on HIV, hepatitis, tuberculosis;
- Prevention programs in healthcare settings;
- Prevention programs in correctional facilities;
- Counseling centers for -at-risk populations and their families and friends;
- CITI – Community initiated treatment intervention;
- Building a comprehensive partnership to optimize customer satisfaction.
On the one hand, this program is based on the philosophy of choice and the need to do everything possible to protect and save drug users and sex workers. On the other hand, the program provides low threshold services, mostly for individuals, that can impact risk behavior of the Organization’s clients.
Preventive activities focus on testing high-risk populations for HIV and facilitating access to HIV treatment and care. The coverage and quality of antiretroviral therapy programs (ART) have a decisive influence on AIDS mortality and HIV transmission. Therefore, our programs provide HIV testing services and medical and social support to HIV-positive individuals (if a rapid test result is positive).
Given the TB epidemic in Ukraine, Convictus Ukraine operates counseling and street outreach stations to ensure timely detection of the disease. At all service stations more than a third of all clients take a TB screening questionnaire. If there are more than three positive answers, a social worker offers a respondent to get his/her smear tested for infection. A client provides a sputum sample under supervision of a nurse. If a smear test result is positive, a client is referred to a TB doctor to take more tests and receive treatment according to state standards. Social and outreach workers provide counseling on TB signs and symptoms, transmission, treatment and care and emphasize the need for early diagnosis and treatment of this disease.
Program implemented with financial support from ICF Alliance for Public Health within the single consolidated program on HIV and TB for 2015-2017 in Ukraine with the support of the Global Fund to Fight AIDS, Tuberculosis and Malaria.