HIV Reduction among Women Who Inject Drugs Can Be Achieved Through Women-Specific Programs and Global Targets: A Model from Ukraine

The International HIV/AIDS Alliance in Ukraine (Alliance) is one of the largest harm reduction programs in the world, and it has been working toward increased coverage of women who inject drugs. In 2009, Alliance supported harm reduction interventions for 150,815 PWID annually (about half the total estimated 2009 PWID population in Ukraine).^3,4 In 2009, Alliance set targets for reaching 60% of PWID and specifically of women who inject drugs. Alliance has used various measures to increase service availability and access for women, who inject drugs throughout Ukraine, including the following: 

• Extension of the minimal harm reduction package of services (which initially included needle and condom distribution, education and counseling, and rapid testing for HIV) to include screening and treatment for sexually transmitted infections through rapid tests for syphilis, gonorrhea, and chlamydia, pregnancy test distribution, and distribution of disinfectants to those involved into sex work. For hardest-to-reach populations, mobile clinics have been procured and equipped with gynecological chairs to allow examination and rapid testing 
• Peer-driven intervention (PDI), a chain-referral model, which includes education and recruitment through outreach. PDI gives PWID per-task nominal rewards to perform the core activities that outreach employees perform—at less expense and greater effectiveness. Alliance Ukraine specifically targeted women who inject drugs as priority group for the PDI intervention to increase coverage of women who inject drugs⁵ 
• Providing economic opportunities for women. Women who used drugs were provided with training and employment opportunities, such as beauty courses, opening of hairdressing practices, etc.
• Introduction of gender-sensitive approaches, such as women-focused outreach and counseling (which considered sex and gender aspects of addiction), structured training activities (educational sessions specifically for women who inject drugs), short-term childcare provided by social workers, case-management (designated time slots for women who inject drugs, group meetings for volunteers from among women who inject drugs and women drug users, counseling by specialists including gynecologists and lawyers), and gender-sensitive organizational policies.⁶

Full article at:   http://goo.gl/lJh3L7

By:   Deshko, Tetiana PhD

International Technical Support Hub, International HIV/AIDS Alliance in Ukraine, Kyiv, Ukraine.

Correspondence to: Tetiana Deshko, PhD, 5 Dymytrova st., building 10A 9th floor, 03680, Kyiv, Ukraine. Tel.: +380 50 387 16 14 (e-mail: deshko@aidsalliance.org.ua).

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Sex, Drugs and Prisons: HIV Prevention Strategies for Over 190 000 Clients in Ukraine

One hundred and forty non-governmental organisations implementing human immunodeficiency virus (HIV) prevention programmes among clients, including people who inject drugs, prisoners, female sex workers, men who have sex with men and street children in Ukraine, 2010–2011.

Among enrolled clients, to assess factors associated with HIV testing, HIV retesting within a year of initial testing and HIV seroconversion.

Of 192 487 clients, 42 109 (22%) underwent an initial HIV test (22% were positive). Among HIV-negative clients at baseline, 10 858 (27%) were retested within a year: 317 (3%) of these were HIV-positive. HIV testing and retesting rates were lower among prisoners (0.3%) and others (street children and partners of those in risk groups, 6%), and those who did not receive counselling or services such as condom and needle distribution. Individuals who were not counselled were more likely to seroconvert.

In this large cohort of high-risk groups from Eastern Europe, HIV testing was low and HIV sero-conversion was high. This is of public health concern, bringing into question the overall quality of counselling and how well it is tailored to the specific needs of various risk groups. Qualitative studies to understand the reasons for non-testing are urgently required for designing client-specific interventions.

TABLE 3

Factors associated with HIV seroconversion within a year of initial HIV testing among clients enrolled in HIV prevention programmes in Ukraine, 2010–2011

Read  full article at:  http://ht.ly/SHUWd 

By: O. Denisiuk,1 P. Smyrnov,1 A. M. V. Kumar,2 S. Achanta,3 K. Boyko,1 M. Khogali,4 B. Naik,3 and R. Zachariah4

1 International HIV/AIDS Alliance in Ukraine, Kyiv, Ukraine

2 International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India

3 World Health Organization India Country Office, New Delhi, India

4 Médecins Sans Frontières (MSF), Operational Centre Brussels, Medical Department, Operational Research Unit (LUXOR), MSF-Luxembourg, Luxembourg

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