Complex approach to tackling HIV/AIDS epidemic among IDUs

Tuesday 15 August. Time: 12:30-14:00. Location: Poster Exhibition Area, Level 800, South Building of Metro Toronto Convention Centre.

Abstract category:C34 Harm-reduction strategies and prevention programmes for drug users

Author : Shulga L.

Issues: The International HIV/AIDS Alliance in Ukraine is currently implementing the Ukrainian national programme on HIV/AIDS response supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The first phase of the programme implementation demonstrated that separation of prevention, care and support and their poor coordination on the local level led to artificial reduction of services to representatives of key target groups (IDUs and PLHA) who substantially overlap (70% of those with HIV in Ukraine were infected by means of injecting drugs). As a result, community based services and information approach was developed that combined such components as prevention among vulnerable groups, treatment, care and support, informational services and advocacy on the local level.

Description: This approach can be described on the example of Kyiv region where following services are available:

  • outreach syringe exchange points (31)
  • newspaper for IDUs 'Butterfly'
  • self help groups for IDUs, CSWs and their closest environment
  • counselling by social workers, medical staff, lawyers
  • referral to HIV, Hepatitis C, STIs testing
  • access to VCT and post-test counseling
  • rehabilitation services, substitution therapy, ARV treatment, counseling on adherence of those on ST and ARV treatment, advocacy.

By the end of 2005, there were 6,170 IDUs covered by the programme, including 43 on substitution therapy and 319 on ARV treatment.

Lessons learned: Despite the achievements, obstacles to scaling up were revealed, including:

  1. drug use scene had changed dramatically that made potential clients a more closed group
  2. drug users in rural areas and small towns are poorly covered by harm reduction and prevention programmes.
Recommendations: We anticipate that overcoming of these obstacles should be based on:
  • so called 'address outreach'
  • inviting doctors to stationary syringe-exchange points
  • broadening projects to rural areas
  • cooperation with local government.