Pregnant women living with HIV may not receive the recommended treatment
Researchers obtained HIV epidemic profiles and regional data -- including OAT treatment -- for 23 regions in the Ukraine. Their mathematical model evaluated the efficiency of current OAT treatment programs and assessed the effect of expanding those programs to treat 20% of the drug-injecting population.
Taking into account regional differences, the study showed that scaling up OAT in regions with large populations of people who inject drugs -- like Dnipropetrovsk, Odessa, and Kyiv -- would lead to the greatest reductions in infections and death, but that smaller regions not covered by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) remain highly vulnerable to HIV outbreaks and need to be considered when allocating resources.
PEPFAR is the U.S. government's response to the global HIV/AIDS epidemic.
Scaling up OAT programs requires initiative on several fronts, said Zelenev.
In addition to expanding capacity at existing treatment sites, he said that expansion of addiction treatment into primary care clinics, as well as through take-home pharmacy prescriptions, can offer pathways for increased access to effective treatment.
"The expansion of OAT has not been adequate," he said.
Amid the ongoing military conflict with Russia, Ukraine faces a difficult financial situation that exacerbates the public health crisis.
Frederick Altice, professor of medicine, epidemiology and public health at Yale, and a co-author, said the study reveals the importance of scaling up evidence-based treatments to prevent new HIV infections and death.
"Ukraine is a major country in the Eastern European and Central Asian region, the only region globally where new HIV infections and HIV-related deaths remain increasing," he said. "Findings from this study have important implications for other countries throughout the region where the HIV epidemic is similar. In nearby Russia, new HIV infections and deaths are increasing faster than in any other country in the region due to their complete bans on OATs -- one of the greatest HIV prevention tools we have available to us." Source:
Yale University Journal reference:
Tan, J., et al. (2019) Effect of expanding opioid agonist therapies on the HIV epidemic and mortality in Ukraine: a modelling study. Lancet HIV . doi.org/10.1016/S2352-3018(19)30373-X .
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