Engaging people who inject drugs and their peers in HIV testing and harm reduction in Ukraine: do they make a difference?

  • Nataliia Kravchenko ICF Alliance for Public Health (Formerly ICF International HIV/AIDS Alliance in Ukraine), Kiev, Ukraine
  • Olga Denisiuk ICF Alliance for Public Health (Formerly ICF International HIV/AIDS Alliance in Ukraine), Kiev, Ukraine
  • Julia Kuznetsova ICF Alliance for Public Health (Formerly ICF International HIV/AIDS Alliance in Ukraine), Kiev, Ukraine
  • Joshua Chadwick Jayaraj Tuberculosis Research and Prevention Center, Yerevan, Armenia
  • Rony Zachariah WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
  • Pavlo Smyrnov ICF Alliance for Public Health (Formerly ICF International HIV/AIDS Alliance in Ukraine), Kiev, Ukraine
Keywords: Key populations, HIV-testing, SORT IT, optimized case finding, operational research, HIV self-testing

Abstract

Introduction: People Who Inject Drugs (PWID) should be offered HIV-testing and harm reduction services. We assessed the effectiveness of including PWID and their peers in HIV-testing by comparing for a period before (2013-2014) and after their introduction (2015-2017), the a) numbers HIV tested b) number enrolled in harm reduction and c) frequency of HIV-testing.

Methodology: An analysis of programme data involved PWID aged ≥ 14 years (1st January 2013-31st December 2017) in Ukraine. Between 2013-2014, HIV-testing (VCT) was done by trained health workers. From 2015, this was Directly Assisted HIV Self-testing (DAST) done by social workers and peers. Optimized HIV case finding (OCF) was introduced (in 2016) as an overlapping strategy with DAST.

Results: A total of 844,837 HIV tests were done with 23,427 (2.8%) HIV-positive results. With VCT, there were 164,417 HIV tests compared to 639,685 after engagement of PWID and their peers (>3-fold increase). The highest HIV positive yield (20%) was when OCF was included. With increasing HIV-testing caseload, a progressive decrease in enrollment in harm reduction was seen (85% in 2014 to 47% in 2017, X2 for trend P < 0.001). OCF resulted in enrollment into harm reduction of 2722 HIV-positives, which was 35% higher than through DAST alone (7,5%). HIV re-testing almost doubled with DAST.

Conclusion: Active engagement of PWID and their peers in HIV-testing increased uptake of HIV-testing. Including OCF has a synergistic effect in HIV-positive yield. Strategies are urgently needed to ensure that individuals who are HIV tested are enrolled in harm reduction.

Published
2019-07-31
How to Cite
1.
Kravchenko N, Denisiuk O, Kuznetsova J, Jayaraj J, Zachariah R, Smyrnov P (2019) Engaging people who inject drugs and their peers in HIV testing and harm reduction in Ukraine: do they make a difference?. J Infect Dev Ctries 13:118S-125S. doi: 10.3855/jidc.11293
Section
The Ukrainian SORT IT Course