Harm Reduction Efforts Among People Who Inject Drugs Help to Halt Spread of HIV in Ukraine

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Karanja Kinyanjui

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Article Number: 1

HIV incidence in the general population has dropped for the first time in more than a decade

ABSTRACT Harm reduction efforts among people who inject drugs have contributed to a decrease in HIV incidence in Ukraine, according to a statement by the International HIV/AIDS Alliance in Ukraine.

Harm reduction programmes in the Ukraine have resulted in a decrease in HIV transmission among people who inject drugs (PID) which, in turn, has helped to stabilise the HIV epidemic in that country.

This information was contained in a statement released on 6 March 2013 by the International HIV/AIDS Alliance in Ukraine. The statement provided the results of an analysis of the impact of harm reduction programmes in Ukraine.

Transmission of HIV among PID dropped from 7,127 in 2006 to 5,935 in 2012, the statement said. In addition, 20,743 individuals tested positive for HIV nationally in 2012, down 2% from 21,177 the previous year.

Ukraine has the largest HIV-prevention programme in the Eastern Europe and Central Asia (EECA) region. Implemented by Alliance Ukraine, the programme covers 302 cities, small towns and villages. Alliance Ukraine has been implementing HIV prevention programmes among vulnerable groups in the country with support from the Global Fund.

In a 2011 report, UNAIDS said that the Russian Federation and Ukraine account for almost 90% of the EECA’s HIV epidemic. Injecting drug use is the leading cause of HIV infection in this region.

The analysis by the Alliance Ukraine revealed that:

• The drop in HIV transmission among PID occurred despite annual increases in the numbers of PID who go for testing.
• The number of reported HIV cases dropped 9% from 2011 to 2012.
• The drop in the number of people testing positive for HIV was the first decrease since 1999.
• In 2012, 171,958 people who use drugs had access to services such as syringe exchange, condom distribution, rapid testing and counselling for HIV and sexually transmitted infections.

Andriy Klepikov, Executive Director, International HIV/AIDS Alliance in Ukraine, thanked the Global Fund and implementing partners for mutual efforts that resulted in the positive results.

“We are looking forward to your support and wider dissemination of the lessons learned from the Ukrainian experience,” he said.

The statement drew a comparison between the Ukrainian and Russian HIV programmes. It said that while both countries have large awareness programmes and low access to antiretroviral therapy, Ukraine has extensive prevention programmes with PID and provides substitution maintenance therapy to wean individuals off illegal drugs. These differences account for the fact that HIV incidence in Russia continues to rise while incidence in Ukraine is falling, the statement said.

The statement also noted that the Ukrainian government has never allocated any funds to HIV prevention programmes.

The release of the statement elicited congratulatory messages from various people and organisations.

“These results will reinforce the collaboration between UNAIDS and Civil Society in advocating on harm reduction strategies in all the countries of the region,” said Dr Jean-Elie Malkin, from UNAIDS’ Regional Support Team for Eastern Europe and Central Asia.

Karlo Boras, a member of the Developing Country NGO delegation on the Global Fund Board, observed that harm reduction remains one of the most disputed topics in Eastern countries and said that he looked forward to sharing the knowledge and learning more about the remarkable achievement.

“Let me congratulate all of you whose hard work and devotion made it possible that, for the first time since 1999, the overall number of newly registered HIV cases in Ukraine decreased,” he said.

Anna Shakarishvili, Senior Technical Adviser, UNAIDS Liaison Office in Washington, DC, described Alliance Ukraine as “true champions” not only within the region but far beyond for providing most essential and effective services to those in need and advocating for their rights.

“We look forward to hearing more good news from you all, and hope that all this evidence finds its reflection in the new national strategy and especially both national and local financial and other political decisions,” she said.

In a letter to the Eurasian Harm Reduction Network on 25 February, Global Fund Executive Director Mark Dybul said that the Fund recognises the importance of continuing to support programmes in Eastern Europe and Central Asia.

“Although our focus will be on countries with the highest disease burden and the least ability to pay, if we are to defeat AIDS, TB and malaria within a generation, we need to make sure our efforts are global and nobody is left behind,” Dr Dybul said.

The statement by Alliance Ukraine is available on the organisation’s website here. The UNAIDS report referred to in this article is the World AIDS Day Report 2011 which can be downloaded directly here.