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Ukraine

Ukraine is experiencing one of the fastest growing HIV epidemics in the world. It is estimated that 1.4% people aged between 15 and 49 are living with HIV. According to UNAIDS/WHO, the actual number of people infected is considerably higher than official statistics suggest. While the Ukrainian Centre for AIDS Prevention has registered 104,645 cases of HIV-infection among adults and children (as of January 1, 2007), international experts estimated the actual number of people living with HIV to be around 377,000 in 2005, and the epidemic is still growing. In 2006, 16,078 new cases of HIV-infection were officially registered up from 13,770 in 2005.

Recent studies indicate that injecting drug users, female sex workers, men who have sex with men, prisoners and street children aged 10-18 years are the populations most at risk from HIV-infection. These populations represent over 80% of all reported cases of HIV-infection. Prisoners also represent a highly vulnerable population, with HIV prevalence in the prison population at 2.7% - considerably higher than in the general population.

In 2006, about 45% of new HIV cases were among injecting drug users. Heterosexual transmission accounted for 35%, and children born to HIV-positive mothers accounted for 16.4%.

Southern and eastern regions of Ukraine are the most affected - including the oblasts (administrative divisions) of Dnipropetrovs’k, Donets’k, Odesa, Mykolaiv and the Crimean Republic. While a third of the population lives in these regions, they represent two-thirds of all officially registered HIV cases. Western regions of Ukraine remain the least affected.

What we do

The Alliance country office in Ukraine was established in December 2000 with funding from the United States Agency for International Development (USAID), to support the project ‘NGO Support and Resource Development for HIV/AIDS Prevention in Ukraine'. The project aim was to increase the capacity of local non-governmental organisations involved in prevention of HIV and AIDS and sexually transmitted infections, and in care and support.

At present, the Alliance programme in Ukraine is undertaking two of the largest HIV initiatives in Ukraine:

Overcoming HIV/AIDS epidemics in Ukraine, financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria.The Alliance was nominated the programme’s Principal Recipient in March 2004.

Scaling up the National Response to HIV/AIDS through Information and Services (SUNRISE), a USAID-supported project implemented by the Alliance since September 2004.

With funding from the Global Fund and USAID the Alliance supports more than 150 NGOs working in the area of HIV prevention and care. This is achieved through onward granting, coupled with support and training in practical and transferable skills in organisational development and HIV programming. The Alliance supports a wide range of prevention and care activities, in particular HIV prevention programming with vulnerable communities including sex workers and injecting drug users, the development of the self-help movement, establishment of community centres, implementation of care and support programmes in penitentiary institutions, non-medical care including home-based care, the organisation of therapeutic communities and the maintenance of the National HIV/AIDS hotline.

In addition to onward granting and technical support the Alliance promotes good policy and practice through the development and dissemination of a wide range of resources and guidance materials throughout Ukraine as well as Central Asia, Russia and Central and Eastern Europe. This includes practical resources aimed at building skills in the following areas: participatory methodologies for community assessment; peer outreach with injecting drug users; working with sex workers; partnership building; strategic planning; monitoring and evaluation, policy and advocacy and a series of booklets for positive people. Alliance materials and tools are distributed to local and international NGOs, AIDS Centres, state local health care authorities, media groups, schools, donors, social sciences institutes and government departments. All materials are available here.

The Alliance also works in partnership with the state National AIDS Centre, providing training for health care providers as well as procuring and supplying antiretroviral treatment and substitution therapy.

In addition to the life-saving treatment programme, Alliance priorities are substitution therapy and prevention work among injecting drug users, who remain the group most vulnerable to and affected by HIV in Ukraine.

What we have achieved

Thanks to the implementation of two of the largest HIV initiatives in Ukraine, the Alliance’s 2006 achievements include:

• an increased number of adults and children receiving life-saving treatment – over 3,700 people receiving antiretroviral treatment and 4,487 women gaining access to prevention of mother-to-child transmission. Despite initial challenges the programme has also supported the provision of substitution therapy to over 520 opiate-dependent people;
• in addition, the programme has supported the supply of medications essential for managing opportunistic infections and for post-exposure prophylaxis;

  This is a testament to the active participation of hundreds of supporting and implementing organisations, and new partnerships between the government, NGOs and local networks.

There has been a considerable scaling up of HIV prevention services for groups vulnerable to HIV:

• financial and technical support to 150 non-governmental organisations in the regions helped establish a new public drive to fight the HIV epidemic in Ukraine.
• in 2006, more than 110,000 injecting drug users, over 15,000 women involved in commercial sex, approximately 7,000 men who have sex with men, and more than 29,000 prisoners had access to prevention services.

Future plans

In the near future the Alliance plans to focus its efforts on ensuring sustainable government funding and continuous monitoring of cost-effectiveness. This relates to the area of government procurement and of defining government policy on the introduction of substitution maintenance therapy programmes appropriate to the scale-up required to halt the spread of HIV through injecting drug use, still one of the key drivers of the HIV epidemic in Ukraine.

Within the Global Fund Programme, a large scale up of work in substitution therapy and treatment is planned to further expand the number of people receiving antiretroviral treatment to 6,000 and substitution therapy to 6,000 by October 2008. The scale up of substitution therapy in particular will require greater efforts to develop the capacity of treatment services as well as NGO support services and information in this area. In addition the Alliance will continue to support HIV prevention and care work with vulnerable communities and aims to reach 26,300 positive people through non-clinical care and support work, and 150,000 injecting drug users with HIV prevention services and information.

Read more about the Alliance’s Global Fund work in Ukraine

Read more about the Alliance’s SUNRISE project

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