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INHSU 2015 4Th International Symposium on Hepatitis Care In HIV AND HCV AMONG PEOPLE WHO INJECT DRUGS IN UKRAINE: A STABILIZATION OR A CALM BEFORE THE STORM? Session K: Hepatitis C and Risk Prevention INHSU 2019, Montreal, Canada Kornilova M, Sazonova Y Alliance for Public Health, Kyiv, Ukraine Disclosures • The authors do not have any conflicts of interest in relationships with the research conducted, subsequent data analysis and presentation of the result of the research Background Ukraine has one of the biggest IDU-driven HIV and HCV epidemics in the World with the estimated number of PLWH 245,000, and ~ 5 mln. people infected with HCV The estimated number of PWID ~346,900 The largest GF funded HIV-prevention program for PWID in EECA region started in 2004 and includes OST, syringe exchange, information, condoms, HTC 226,469 PWID are covered with the prevention services HIV prevalence among PWID is ~22% and demonstrating a stable trend over the last 5 years The country is in transition from GF to domestic funding with government taking over the prevention services The IBBS conducted in 2017 has detected a 10% increase of the HCV prevalence comparing to the previous surveys Is this increasing HCV trend signalling that we should expect the resumption of the HIV epidemic among PWID? Methods Secondary analysis of the 3 subsequent rounds of IBBS among PWID conducted in 2013, 2015 and 2017 Method of recruitment – RDS Sample size: 9,502; 9,405 and 10,076 participants respectively Variables analyzed: HIV prevalence and incidence, injecting behavior and the HCV prevalence Statistical analysis: RDS-A with the network size analysis, prior adjustments for outliers and calculation of 95% CI Results Epidemiological Trends Injecting Practices 100.0% 70.0% 90.0% 97.0% 97.0% 97.0% 60.0% 80.0% 63.8% 70.0% 56.6% 55.0% 50.0% 54.3% 60.0% 51.0% 50.0% 39,1% 40.0% 40.0% 28.0% 48.0% 30,9% 30.0% 21.9% 30.0% 22.6% 19.7% 20.0% 5,5% 20.0% 10.0% 5,8% 6.0% 0.0% 10.0% 0.7% 1.36% 2.44% 2013 2015 2017 0.0% Sterile needle/syringe used at last injection 2013 2015 2017 Sharing syringe during last 30 days Sharing "cookers" while preparing drugs HIV prevalence anti HCV prevalence HIV incidence Pre-filled syringe use Conclusions Concerning epidemiological markers such as increasing HIV incidence and growing HCV prevalence are suggesting that injection risks are still present and transmission is ongoing Slowing down the prevention efforts, decreasing the coverage and shrinking the preventoin package can be hazardous and may renew the HIV epidemic growth as well as fuel the HCV spread in this group This is particularly important to keep in mind in the view of the ongoing transition from the external to the domestic funding and government is taking the lead in prevention programs Acknowledgements • Center for Public Health of the Ministry of Health of Ukraine • US Centers for Disease Control and Prevention • Alliance Ukraine Consultancy • International and national experts: Tetiana Salyuk (APH), Charles Vitek (CDC) , Roxolana Kulchinska (CDC, Ukraine), Marianna Azarskova (CDC, Ukraine), Bharat Parekh (CDC),Andrea Kim (CDC),Yulia Barska (Kyev Mohyla Academy), Yulia Sereda (Independent Expert), Tetiana Liulchuk (Gramashevsky Institute, Kyiv). • Regional branches of AIDS centers, PWID-serving NGOs, regional coordinators and teams at Vinnytsia, Dnipro, Kryvyi Rig (Dnipropetrovska oblast), Donetsk, Zhytomyr, Zaporizhzhia, Melytopol (Zaporizka oblast), Ivano-Frankivsk, Kyiv, Bila Tserkva (Kyiv region), Vasylkiv (Kyiv region), Fastiv (Kyiv region), Kropyvnytskiy, Severodonetsk (Lugansk region), Lutsk, Lviv, Mykolaiv, Odesa, Poltava, Rivne, Sevastopol, Simferopol (AR of Crimea), Sumy, Ternopil, Uzhgorod, Kharkiv, Kherson, Khmelnytskyi, Cherkasy, Chernivtsi, Chernigiv. • And all study participants THANK YOU! [email protected].
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