HIV AND HCV AMONG PEOPLE WHO INJECT DRUGS IN UKRAINE: A STABILIZATION OR A CALM BEFORE THE STORM?


Author: Kornilova M, Sazonova Y

Theme: Epidemiology & Public Health Research Year: 2019

Background: Ukraine is experiencing one of the biggest HIV and HCV epidemics in the World. From their
onset they were primarily IDU driven. Tremendous efforts that community-based organizations
investing in prevention slowed down the HIV spread among KP including PWID. HIV prevalence has
stabilized at the level of 22%. On the contrarily, the latest HCV trend demonstrating almost 10%
increase. To answer the question of whether the country should expect the resumption of HIV epidemic
among PWID we have conducted this analysis.
Methods: We performed data analysis of the 3 subsequent rounds of IBBS(integrated bio-behavioral
surveys) among PWID conducted in 2013, 2015 and 2017. PWID were recruited through RDS(responded
driven sampling) and the samples totaled 9,502; 9,405 and 10,076 respectively. We compared HIV
prevalence and incidence, risk behavior and the HCV prevalence. Data analysis was performed in RDSAnalyst taking into account size of the network with prior adjustments for outliers and calculation of
95%CI.
Results: The HIV prevalence among PWID hasn’t changed much in the last 3 years and accounted
19.7%(18.9-20.5%) in 2013, 21. 9% (21.2-22.9%) in 2015 and 22.6%(21.6-23.3%) in 2017. The clean
needle use at last injection was reported as high as 97% and episodes of sharing injecting equipment in
the last 30 days as low as 6% for all 3 years, sharing of “cookers” dropped down from 48% in 2013 to
31% in 2017. Regardless of the less reported injecting risks the HIV incidence is ascending from 0.74%
(0.33-1.44%) in 2013, 1.36% (0.85-1.87%) in 2015 to 2.44%(1.86-3.22%) in 2017. And the HCV
prevalence has also significantly increased from 54.3%(53.3-55.3%) in 2015 to 63.8%(62.8-64.7%) in
2017.
Conclusion: Despite the overall appearance of the stabilization of the HIV prevalence among PWID in
Ukraine there are several concerning epidemiological markers such as increasing HIV incidence and
growing HCV prevalence which suggest that injection risks are still present and transmission is ongoing.
Slowing down the prevention efforts can be hazardous and may renew the fast HIV epidemic growth in
this group.
Disclosure of Interest Statement: The authors do not have any conflicts of interest in relationships with
this publication and presentation.

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