THAC0401 - Oral Abstract Session
How do PWID prevention activities impact the HIV epidemic? Case of Ukraine
Presented by Olga Varetska (Ukraine).
O. Varetska, A. Klepikov, T. Salyuk
ICF 'International HIV/AIDS Alliance in Ukraine', Kyiv, Ukraine
Background: International HIV/AIDS Alliance in Ukraine implements the largest HIV-prevention programme for people who inject drugs (PWID) in Eastern Europe and Central Asia (EECA), with support of Global Fund. Nine years after programme''s start, it is time to answer whether and how it influences Ukraine''s HIV epidemic.
Description: Alliance''s HIV-prevention programme for PWID is implemented in 302 cities throughout Ukraine. In 2013, Alliance supported provision of services, including syringes, information materials, condoms, HIV and STI rapid testing and counselling, to 196,460 PWID (63.4% of estimated PWID population).
Lessons learned: Since 2007, epidemiologists have observed a reduction in HIV case data among PWID: the number of registered HIV cases dropped from 7,127 in 2006 to 5,847 in 2013. Official registration data are also confirmed by sentinel surveillance results: HIV prevalence among recent injectors (proxy HIV incidence indicator) fell from 29.9% in 2004 to 1.7% in 2013.
However, HIV case registration among the general population continues to grow (21,631 cases in 2013 compared to 20,743 in 2012 and 21,177 in 2011), as does the heterosexual share of HIV transmission. A recent triangulation study suggests an association between heterosexual HIV transmission and risky sexual practices among PWID in Ukraine. According to 2013 surveillance, while 96.9% of PWID indicated having used sterile injecting equipment during last injection, only 54.1% reported using condom during last intercourse.
Conclusions/Next steps: Results suggest effectiveness of HIV prevention among PWID in PWID-driven epidemics in reducing injection risk of transmission, and call for governmental commitment to increase / sustain level of funding for HIV prevention among PWID in EECA. This is especially critical given anticipated reductions in donor funding.
Further, latest epidemic trends require prevention programmes to target sexual partners of PWID, and focus on sexual mode of HIV transmission when working with PWID to achieve significant results in suppressing HIV rates among general population.
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