Background:
Ukraine has a numerous population of PWID, 314,000, with 20% HIV positivity and 60% that of HCV. War has brought population migration, destroying of health infrastructure and deprioritisation of health seeking behavior. Nevertheless, civil society stood up to fill the gaps and redevelop harm reduction services to fit new realities.
Methods:
The following harm reduction service modifications have been made in Ukraine starting 2022 to respond to new challenges:
Development of online commodities request and mailing;
Development of telemedicine consultation of doctors, psychologists
Development of AI powered virtual outreach worker to consult 24/7;
Provision of take-home OAT doses and trying of long-acting HIV prevention and OAT;
Reaching remote areas close to frontlines with mobile vans-based services;
Focusing on mental health, including on ADHD among stimulant users pilot study.
Results:
This allowed to increase mailing of commodities to nearly 20,000 PWID annually, increase OAT coverage by 26% between 2022 and 2024, reach 10,000 people with digital outreach worker consultations within 12 months, provide 81,298 HIV tests based on mobile vans including close to the frontline. Thanks to these innovations, as well as coordinated government, civil society and international donor responses, HIV epidemic is under control in Ukraine amidst war.
Conclusion:
These lessons – in favor of online and digital services, mobile vans for depopulated and remote areas, convenient mediation and commodities dispensing and use of long-acting agents, attention to mental health – should be used in other harm reduction programs as they optimize resources and increase reach which is relevant to many contexts. |