Presentation french red cross, Alliance Ukraine, march17 2010

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