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ID: 1079

Type of submission: Oral

Conference track: Practice

Topics: Harm Reduction Services and Service Provision; Innovative Harm Reduction Programmes

Presenting author: Tetiana Deshko

Presenting author biography:

Over 15 years in AIDS response and harm reudciton. Expertise in developing and implementing KP HIV programs in Ukraine, Belarus and Uzbekistan; launching HCV program in Ukriane; launching and improving harm reudciton in Africa and Asia. Hold PhD, member of international harm reudction groups, seeded Harm Reduciton Academy course.

Bringing Harm Reduction Servises to Scale: Experience from Ukraine

Tetiana Deshko, Olga Cheshun, Pavlo Smyrnov, Victor Isakov

In the world, coverage with effective interventions like needle exchange, HIV testing and ARV treatment for drug users is very low, approximately 10% of the need. Many of the harm reduction programs have been seeded and some components are present in 76 countries, yet bringing them to scale remains a challenge.
Within the current program Alliance for Public Health and its partner NGOs across Ukraine are reaching annually to 200,000 (or 64% of the estimate) persons injecting drugs (PWID). The intervention distributes 20M syringes, 15M condoms, performs 300,000 HIV tests per year, constituting the main entry to HIV treatment programs. These interventions led to the decline in new HIV infections in Ukraine: among drug users - starting 2008 and general population - starting 2012. Ukraine program is considered a model for the region and is internationally acknowledged among best response practices in concentrated HIV epidemics.
Analysis of 15 years of program implementation points out to interventions contributing to the most substantial increase in service coverage. Between 2008 and 2009 the most significant programmatic growth occurred with 50% increase from 102,562 PWID in 2008 to 150,815 in 2009. The factors contributing to this growth are the two interventions introduced in 2009 – pharmacy based harm reduction and mobile clinics based programs, covering respectively 15,529 PWID and 29,947 visits to clinics contributing to some 80% of the 2009 coverage increase.
Since then APH has continued to support these interventions which are forming the share if its reach today. In particular, pharmacies have reached in 2015 some 22,078 PWID (or 10% of annual reach) and mobile clinics – 24,155.
Detailed review of the implementation modalities of these two interventions serves as a practical tool of how to bring harm reduction services to scale to achieve HIV epidemic result.