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Update on epidemic in Ukraine: civil society perspective Andriy Klepikov International HIV/AIDS alliance in Ukraine [email protected]. Key Results. Reduction of HIV new cases (per 100 000 tests made) Stabilization of the epidemic among general population - PowerPoint PPT Presentation
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www.aids2014.org
Update on epidemic in Ukraine:civil society perspective
Andriy KlepikovInternational HIV/AIDS alliance in [email protected]
www.aids2014.org
Key Results
• Reduction of HIV new cases (per 100 000 tests made)
• Stabilization of the epidemic among general population
• Reduction of AIDS Mortality
Key factors • Large-scale prevention program among PWID• Scaling up of ART
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Effectiveness of HIV prevention programs among PWID has an impact on the overall
epidemic
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Effectiveness of HIV prevention programs
2005 2006 2007 2008 2009 2010 2011 2012 -
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
200,000
0
200
400
600
800
1000
1200
Cases among young PWID and coverage by prevention
# PWID covered by prevention# Registered cases among PWID <25 y.o.
All data sources confirm inverse correlation between increasing coverage of prevention programs and number of new cases among PWID. The annual coverage exceeds 200000 PWID
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Scaling up of OST
Jan/04Jun/04
Nov/04
Apr/05
Sep/05
Feb/06
Jul/06
Dec/06
May/07
Oct/07
Mar/08
Aug/08Jan/09
Jun/09
Nov/09
Apr/10
Sep/10
Feb/11
Jul/11
Dec/11
May/12
Oct/12
Mar/13
Aug/13Jan/14
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
Total number of OST clients by medication
Buprenorphine, Ukraine Methadone, Ukraine
Crimea annexation
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Implications of NFM for Ukraine
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KPs WILL SUFFER THE MOST
Services Services
2014 (R10) 2015 (NFM)HIV risk reduction communication (Social worker counseling)
HIV risk reduction communication (Social worker counseling)
Screening for HIV and counseling (VCT) provided by medical staff
Screening for HIV and counseling (VCT) with assistance of social/outreach worker
Distribution of Distribution of syringes and needles, syringes and needles, spirit wipes, spirit wipes,condoms condoms IOM IOMLubricants Screening for HCV Screening for HCV
TB questionnaire (screening) with nurse involvement Screening for TB ( questionnaire) Testing and counseling for STI Screening for HBV Vaccination against hepatitis B Overdose prevention Narcologist support Psychological support Social support Holding self-help groups, informational classes Legal advice Needles/syringes exchange and utilization Project administration Project administration
Cost per client - $30,66Cost per client - $18,73 ($16,47 + $2,26 above allocation)
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UNEXPETED DOMESTIC FUNDING DECREASE
As the comparison made in USD it takes into account devaluation of national currency, happened between planning and actual budget allocation
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Ideology vs. Science
Example from Ukraine:Russian authorities cut over 800 OST patients from vital medical services. As of today it has led to closure of OST in Crimea. Such cut is classified as tortures. It has resulted in dozen deaths!
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Next steps
Negotiations with the Global Fund, with in-country and external stakeholders in order not to allow decreasing coverage or limiting the service package for PWID
Maintaining emergency projects such as the one for patients of OST moved from Crimea or war zones in Eastern Ukraine which currently provides services to 120 patients.
Stronger positioning of Ukraine in the region, building on the evidence based interventions and innovations have been constituting taking the epidemic under control
Piloting innovations such outreach testing; engaging more in Hepatitis C and TB, including treatment
