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Tetiana Saliuk 1 , Olga Varetska 1 ,Yulia Skoropatska, Ganna Berleva 2 ,Larisa Bochkova 3

First indications of impact of prevention programs among injecting drug users on the HIV epidemic in Ukraine. Results based on data triangulation from different sources. Tetiana Saliuk 1 , Olga Varetska 1 ,Yulia Skoropatska, Ganna Berleva 2 ,Larisa Bochkova 3

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Tetiana Saliuk 1 , Olga Varetska 1 ,Yulia Skoropatska, Ganna Berleva 2 ,Larisa Bochkova 3

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  1. First indications of impact of prevention programs among injecting drug users on the HIV epidemic in Ukraine. Results based on data triangulation from different sources Tetiana Saliuk1, Olga Varetska1,Yulia Skoropatska, Ganna Berleva2,Larisa Bochkova3 1 International HIV/AIDS Alliance, Ukraine; Kyiv, Ukraine 2 HIV/AIDS Alliance Consultant, Ukraine 3 Ukrainian Center for HIV/AIDS Prevention; Kyiv, Ukraine

  2. HIV Prevalence Map of Ukraine

  3. Surveillance system in Ukraine • First Generation Surveillance (HIV/AIDS case reporting) • Second Generation Surveillance: • Routine and sentinel HIV and STI surveillance • Bio-behavior surveillance (IDU, MSM, FSF, Bridge Populations) • TB cases monitoring 3. Third Generation Surveillance: • AIDS death cases monitoring • ART adherence monitoring • ARV Resistance monitoring

  4. Number of new cases by rout of transmission in Ukraine (data from routing case monitoring)

  5. HIV prevalence among IDUs (2006): data from routine serum monitoring (RS) and sentinel surveillance (SS)

  6. Number of new cases of HIV among IDUsand percentage of young users among them

  7. How we measure incidence in Ukraine Among general population it is possible to estimate incidence within routing monitoring based on data from ANC Among risk groups, the only way is to look at a group with recent risky behavior. Based on bio-behavior data it was clear seen that HIV infection risk is increasing with length of using drugs. The risk coefficient for drug users with a length of risky behavior from 1 to 3 years is 1.9.

  8. Median HIV prevalence among recent IDUs (less then 2 years of injection drugs), 8 cities

  9. Median HIV prevalence among young IDUs (8 cities)

  10. Behavior changes among recent IDUs (BSS data, 12 cities)

  11. Programmatic monitoring (SYREX database): Coverage of harm reduction program

  12. Conclusions and discussions • Existing monitoring system allows to control situation and take appropriate decisions • Various monitoring tools create a possibility for data triangulation • Different sources indicate the stabilization of HIV epidemic among IDU’s and show the decreasing of HIV incidence in this group after 4 years of National Harm Reduction Program • Further intervention among IDUS have to be done to protect HIV transmission into general population • What other incidence estimation tools can be used?

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